Comparative Assessment of the Primary Stability of Straumann BLX Implant Design Using an In Vitro Sinus Lift–Simultaneous Implant Insertion Model
Straumann BLX is a novel implant system that has been proclaimed to provide an ideal primary stability in all types of bone. In the current study, the primary stability of the Straumann BLX implant systems with Straumann tapered effect (TE) implants have been comparatively assessed in bovine ribs by using a simultaneous sinus elevation and implant insertion model. In the study group, BLX (4.0 × 12 mm), TE (4.1 × 12 mm), BLX (4.5 × 12 mm), and TE (4.8 × 12 mm) were placed in each bony window, which resembles the sinus maxillaris. As a control, BLX and TE implants with the same sizes were inserted into the proximal diaphysis of the bovine ribs. A total of 40 implant insertions were performed. Stability was measured with resonance frequency analysis. In the study group, 4.8-mm TE implants showed significantly higher values compared with 4.5-mm BLX implants (P = .116). However, 4.0-mm BLX implants in the control group showed higher stability compared with 4.0-mm-diameter TE (P = .014). The primary stability of the BLX implants in the control group was significantly higher compared with the experimental group in both widths (P= .018 for BLX 4.0 mm and P = .002 for BLX 4.5 mm, respectively). The use of the TE design with a wide diameter in simultaneous implant placement with sinus lift could present higher implant stability quotient values and might be a more appropriate option for implant recipient sites with poor bone volume and quality. However, the advantage of BLX design in standard implant insertion protocols could be of value.
(a) Prior to preparation of the samples, bone biopsies were taken. (b) Preparation of the study model with a residual bone height of 5.00 mm. (c) Drilling sequence. (d) Implant placement with a peak insertion torque of ≥80 N/cm.
Placement of the implants (BLX [4.0 × 12 mm], tapered effect [TE; 4.1 × 12 mm], BLX [4.5 × 12 mm], and TE [4.8 × 12 mm]) into the proximal diaphysis of the bovine ribs.
(a) Implants (BLX [4.0 × 12 mm], tapered effect [TE; 4.1 × 12 mm], BLX [4.5 × 12 mm], and TE [4.8 × 12 mm]) in situ. (b) Measurement of the primary stability with the Osstell device.
Samples stained with toluidine blue solution were examined regarding the relative amounts of bone area vs total tissue in 1- × 1-mm squares (% bone area/total tissue).
Figure 5. Tapered effect (TE) implants in the study group showed relatively higher implant stability quotient (ISQ) values compared with BLX in both 4.0-mm BLX vs 4.1-mm TE and 4.5-mm BLX vs 4.8-mm TE subgroups. The difference between BLX 4.5 mm and TE 4.8 mm was statistically significant (P = .040).
Figure 6. BLX implants of 4.0 mm in the control group showed significantly higher ISQ values compared with TE implants with 4.0 mm diameter (P = .014). The superiority of BLX implants with a diameter of 4.5 mm over TE implants with a diameter of 4.8 mm was statistically insignificant (P = .116).
Differences in implant stability quotient (ISQ) values of each implant design between the control and experimental groups. The primary stability of the BLX implants in the control group was significantly higher compared with that of the experimental group in both widths (P = .018 for 4.0-mm BLX and P = .002 for 4.5-mm BLX, respectively). However, despite showing lower ISQ values in the study model, the differences among tapered effect (TE) implants were statistically insignificant for both diameter (P = .840 for 4.1-mm TE and P = .588 for 4.8-mm TE).
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