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Peer-reviewedCC BYClinical and experimental dental research

Design Matters? Evaluating Implant Macro-Geometry in Immediate Implants: A Randomized Clinical Trial With Six-Month Interim Analysis.

5 affiliations
  1. 1CL Dentistry, Segni, Italy.
  2. 2Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA.
  3. 3Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland.
  4. 4Department of Oral Pathology, Oral Medicine, and Oral & Maxillofacial Surgery, University of Tripoli School of Dentistry, Tripoli, Libya.
  5. 5Private practice, Salerno, Italy.

Abstract

Objectives

To compare the early stability trajectories of two tissue-level implant macro-designs after immediate placement, using monthly resonance frequency analysis (ISQ) over 6 months.Materials and methods

Single-center randomized clinical trial in adults requiring immediate implant placement in posterior sites. ISQ was recorded at implant placement and monthly for 6 months. A linear mixed-effects model (subject-level random intercept; fixed effects for group, visit, their interaction, and baseline ISQ) was fitted, with the group × visit interaction as the primary inferential term. The 6-month endpoint was assessed by baseline-adjusted ANCOVA, with equivalence tested against a ±3 ISQ margin (2 one-sided tests).Results

Thirty implants were placed in 30 patients (aggressive self-tapping, n = 15; conservative uniform-thread, n = 15). ISQ increased significantly over time in both groups (p < 0.001). The group × visit interaction was significant (χ² = 43.25, df = 5, p < 0.001); baseline-adjusted differences favored the aggressive design at t1 (+3.84 ISQ, 95% CI 1.64 to 6.03; p = 0.004) and t2 (+3.70, 95% CI 1.51 to 5.90; p = 0.005), and were no longer detectable from t3. At 6 months, the baseline-adjusted difference was -0.73 ISQ (95% CI -2.91 to 1.46; p = 0.500), and equivalence within ±3 ISQ was supported (TOST p = 0.021). All aggressive-design implants reached ISQ ≥ 70 by 3 months versus 33% in the conservative group (p = 0.001).Conclusions

Within the limitations of this trial, the more aggressive macro-design showed significantly higher stability during the first 2 months of healing, with significantly different trajectories over time, whereas at 6 months, no between-group difference was demonstrated and equivalence within the pre-specified ±3 ISQ margin was supported. Macro-design therefore influenced the timing of stability acquisition rather than stability at 6 months, supporting its relevance for early loading protocols.Trial registration

ClinicalTrials.gov identifier: NCT06711744; Date of registration: 21 November 2024; EC Protocol ID: 6271 (Ethics Committee Lazio 3).

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BibTeX
@article{carosi2026design,
  title = {{Design Matters? Evaluating Implant Macro-Geometry in Immediate Implants: A Randomized Clinical Trial With Six-Month Interim Analysis.}},
  author = {Paolo Carosi and Andrea Laureti and Abdusalam Alrmali and Alessandro Pinto and Hom-Lay Wang and Claudia Lorenzi},
  journal = {Clinical and experimental dental research},
  year = {2026},
  month = oct,
  doi = {10.1002/cre2.70490},
  url = {https://europepmc.org/article/MED/42927630},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Design Matters? Evaluating Implant Macro-Geometry in Immediate Implants: A Randomized Clinical Trial With Six-Month Interim Analysis.
AU  - Paolo Carosi
AU  - Andrea Laureti
AU  - Abdusalam Alrmali
AU  - Alessandro Pinto
AU  - Hom-Lay Wang
AU  - Claudia Lorenzi
PY  - 2026
DA  - 2026/10/01
JO  - Clinical and experimental dental research
DO  - 10.1002/cre2.70490
UR  - https://europepmc.org/article/MED/42927630
AB  - Objectives  To compare the early stability trajectories of two tissue-level implant macro-designs after immediate placement, using monthly resonance frequency analysis (ISQ) over 6 months.Materials and methods  Single-center randomized clinical trial in adults requiring immediate implant placement in posterior sites. ISQ was recorded at implant placement and monthly for 6 months. A linear mixed-effects model (subject-level random intercept; fixed effects for group, visit, their interaction, and baseline ISQ) was fitted, with the group × visit interaction as the primary inferential term. The 6-month endpoint was assessed by baseline-adjusted ANCOVA, with equivalence tested against a ±3 ISQ margin (2 one-sided tests).Results  Thirty implants were placed in 30 patients (aggressive self-tapping, n = 15; conservative uniform-thread, n = 15). ISQ increased significantly over time in both groups (p < 0.001). The group × visit interaction was significant (χ² = 43.25, df = 5, p < 0.001); baseline-adjusted differences favored the aggressive design at t1 (+3.84 ISQ, 95% CI 1.64 to 6.03; p = 0.004) and t2 (+3.70, 95% CI 1.51 to 5.90; p = 0.005), and were no longer detectable from t3. At 6 months, the baseline-adjusted difference was -0.73 ISQ (95% CI -2.91 to 1.46; p = 0.500), and equivalence within ±3 ISQ was supported (TOST p = 0.021). All aggressive-design implants reached ISQ ≥ 70 by 3 months versus 33% in the conservative group (p = 0.001).Conclusions  Within the limitations of this trial, the more aggressive macro-design showed significantly higher stability during the first 2 months of healing, with significantly different trajectories over time, whereas at 6 months, no between-group difference was demonstrated and equivalence within the pre-specified ±3 ISQ margin was supported. Macro-design therefore influenced the timing of stability acquisition rather than stability at 6 months, supporting its relevance for early loading protocols.Trial registration  ClinicalTrials.gov identifier: NCT06711744; Date of registration: 21 November 2024; EC Protocol ID: 6271 (Ethics Committee Lazio 3).
SN  - 2057-4347
ER  -