Clinical evaluation and bone loss prediction of titanium-zirconium implants: A retrospective study of 1-5-year follow-up

Department

Internal Medicine

Document Type

Article

Publication Title

Journal of Dentistry

Abstract

OBJECTIVES: To evaluate the clinical and radiographic outcomes of titanium-zirconium implants, identify risk factors and develop predictive models for bone loss progression.

METHODS: Patients with titanium-zirconium implants were screened for inclusion and underwent follow-ups. Cumulative survival rates at the implant and patient levels were calculated using life tables. Clinical and radiographic data were retrospectively analyzed for implant/restoration success rates and peri-implant marginal bone loss. Factors influencing marginal bone loss were examined using generalized estimating equations (GEE). Support vector machine (SVM), artificial neural network (ANN), logistic regression (LR), and random forest (RF) were used to develop the prediction models of bone loss.

RESULTS: 573 titanium-zirconium implants from 399 patients were included, with an average observation time of 27.6 ± 11.5 months (12-63 months). The cumulative 5-year survival rate was 99.1% at the implant level, and 98.8% at the patient level. The mean probing depth was 3.1 ± 1.2 mm, with 23.6% incidence of bleeding on probing. The mean marginal bone loss was 0.37-0.52 mm. GEE analysis showed that marginal bone loss was significantly influenced by follow-up time, advanced age, narrow-diameter implant, location, and fixed partial denture. LR and ANN models demonstrated optimal predictive performance, both with 93.5% accuracy. Baseline marginal bone level emerged as the most significant predictor, with an importance score of 41.3.

CONCLUSIONS: The 1-5-year outcomes revealed that titanium-zirconium implants achieved high survival and success rates, with limited marginal bone loss. The prediction model demonstrated 93.5% accuracy, identifying baseline marginal bone level as the primary determinant of bone loss progression.

CLINICAL SIGNIFICANCE: Titanium-zirconium implants achieve satisfactory clinical outcomes and identifies the baseline marginal bone level as the primary determinant of bone loss progression. (clinical trial registration number: ChiCTR2300069888).

First Page

106516

DOI

10.1016/j.jdent.2026.106516

Volume

166

Publication Date

3-1-2026

Medical Subject Headings

Humans; Zirconium; Titanium; Retrospective Studies; Dental Implants; Middle Aged; Female; Male; Alveolar Bone Loss; Follow-Up Studies; Aged; Adult; Risk Factors; Dental Restoration Failure; Treatment Outcome; Dental Prosthesis Design; Dental Implantation, Endosseous; Neural Networks, Computer

PubMed ID

41577164

Link to Full Text

Share

COinS