20.500.12556/DiRROS-28822 Two-year outcomes of tissue-level and bone-level two-piece zirconia implants a case series Background/objectives: Zirconia dental implants are increasingly recognised as an alternative to titanium implants due to their biocompatibility and aesthetics. Initially developed as one-piece systems, zirconia implants have evolved into two-piece designs with different platform levels; however, comparative data on their primary and secondary stability– particularly as assessed by resonance frequency analysis (RFA)—and marginal bone dynamics remain limited. This case series aimed to evaluate the implant stability and marginal bone changes of two-piece zirconia implants with bone-level (BL) and tissue-level (TL) platforms in patients missing maxillary premolars. Methods: Thirteen zirconia implants (n = 13; 7 BL, 6 TL; Z5-TL/Z5-BL, Z-Systems, Switzerland) were placed in 11 patients with healed ridges. The implant stability quotient (ISQ) was measured immediately after insertion and before prosthetic loading. Lithium disilicate crowns were cemented after four months, and follow-ups were conducted for an average of 35 months (SD = 12). Results: Initial ISQ values ranged from 73 to 79, increasing to 76–84 at 3–4 months, indicating high implant stability for both BL and TL implants. The extent of marginal bone loss (MBL) after two years was greater around BL implants (mean 0.46 mm) compared to TL implants (mean 0.2 mm), although probing depths and bleeding on probing remained minimal in both groups, with only one TL implant showing gingival recession. Conclusions: Over a short observation period, two-piece zirconia implants with tissue-level platforms appeared to demonstrate superior marginal tissue stability. Further, larger-scale controlled studies are required to confirm these preliminary observations. zirconia implants ceramic two-piece bone-level tissue-level implant stability ISQ cirkonijevi vsadki keramika dvodelni na ravni kosti na ravni tkiva stabilnost vsadka true false true Angleški jezik Slovenski jezik Neznano 2026-04-08 13:06:33 2026-04-08 13:06:34 2026-04-09 03:51:22 0000-00-00 00:00:00 2026 0 0 Nasl. z nasl. zaslona; Opis vira z dne 15. 1. 2026; str. 1-13 no. 1 Vol. 6 2026 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.31 2673-6373 10.3390/oral6010001 264750083 RAZ_Zarkovic_Gjurin_Sonja_2026.pdf RAZ_Zarkovic_Gjurin_Sonja_2026.pdf 1 D42988EF7AF523CA902FED5D2E543E5C 9626f3c6da303a80233612a8ec7fddad3af8e23a327e8a177de883b2d669fb1e 1faf10a4-333b-11f1-b941-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=42944 https://www.mdpi.com/2673-6373/6/1/1 1 02a01644-333b-11f1-b941-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=42943 Univerzitetni klinični center Ljubljana 0 0 0