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CompletedNCT03908177Updated Apr 23, 2026

Comparison of Clinical Performance and Safety of Zirconia vs. Titanium Implants: a Multi-national RCT.

An interventional study of Ceramic Dental Implant and Titanium Dental Implant in Dental Implants, Single-Tooth, sponsored by Institut Straumann AG. Completed at 3 sites in 3 countries. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-04-23.

Sponsored by Institut Straumann AG · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
121
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

A post-market, multi-centre, prospective, open, randomized-controlled, non-inferiority clinical study to compare short-term performance and safety of the Straumann PURE 2-piece Ceramic Implant with Straumann Bone Level Implant using a fully digital workflow.

Read the detailed description

To compare short-term performance and safety of the Straumann PURE 2-piece Ceramic Implant with Straumann Bone Level Implant using a fully digital workflow. Post-market, multi-centre, prospective, open, randomized-controlled, non-inferiority clinical study investigating patients in need of dental implant therapy for single-tooth gap rehabilitation. The follow up time is1 year after final crown restoration.

02

Conditions studied

  • Dental Implants, Single-Tooth
03

In context

Lead sponsor

Institut Straumann AG is the lead sponsor of 28 studies on the registry; 1 is open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • Patients must have voluntarily signed the Informed Consent Form before any study related procedures are performed, are willing and able to attend scheduled follow-up visits and agree that the pseudonymized data will be collected, analysed, and published.
  • Patients must be males or females who are a minimum of 18 years of age.
  • Patients, who are in need of a single tooth replacement with a dental implant in the premolar-to-premolar area in the mandible or maxilla (excluding lower incisors).
  • Presence of natural teeth on both sides of the study implant position and opposing dentition (single tooth gap).
  • Patients with healed extraction sockets, which means that at implant surgery:

    • Soft tissue coverage of the socket is complete; and
    • Alveolar bone is reconsolidated (around 16 weeks after tooth extraction).

Exclusion criteria

Exclusion Criteria:

  • Patients with inadequate bone volume where major bone augmentation would be required at implant location.
  • Inadequate anatomic situation that would prevent prosthetic-driven planning based on CBCT.
  • Presence of implants neighbouring the study implant.
  • Patients with inadequate oral hygiene (FMPS ≥ 20%).
  • Patients with local root remnants.
  • Patients with inadequate wound healing capacity.
  • Patients with incomplete maxillary and mandibular growth.
  • Patients with medical contraindications to implant surgery (uncontrolled bleeding disorders, psychoses, prolonged therapy-resistant functional disorders, xerostomia, weakened immune system, illnesses requiring periodic use of steroids or uncontrollable endocrine disorders.
  • Patients with drug or alcohol abuse.
  • Patients with allergies or hypersensitivity to zirconium oxide (ZrO2), yttrium oxide (Y2O3), hafnium dioxide (HfO2), aluminium oxide (Al2O3), and titanium (Grade 4).
  • Patients with medical contraindications to implant surgery (uncontrolled bleeding disorders, psychoses, prolonged therapy-resistant functional disorders, xerostomia, weakened immune system, illnesses requiring periodic use of steroids or uncontrollable endocrine disorders).
  • Patients with conditions or circumstances, in the opinion of the Investigator, which would prevent completion of study participation or interfere with analysis of study results, such as history of non-compliance or unreliability.
  • Pregnancy or intention to become pregnant at any point during the study duration.

Furthermore, patients with uncontrolled periodontitis and less than 3 mm of keratinized mucosa at the day of surgery will be excluded from the study. Controlled periodontitis is defined as treated periodontitis with two or less pockets that are \< 4 mm in depth or the existence of ≤ 20% bleeding on probing.

If the planned implant position is the second premolar, the adjacent molar must be present. Shortened arches with missing molars are not eligible in such a case.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
121 participants (actual)

Study arms

  • Experimental
    Study Group (SG)

    Receive new zirconia implant: Straumann® PURE 2-piece Ceramic Implant (tissue level), ZLA

    Device: Ceramic Dental Implant

  • Active comparator
    Control Group (CG)

    Receive standard titanium implant: Straumann® Bone Level Implant, Titanium, SLA

    Device: Titanium Dental Implant

Interventions

  • DeviceCeramic Dental Implant

    The ceramic implant will be placed in healed extraction sockets in the premolar-to-premolar area in the mandible and maxilla for single tooth replacement followed by prosthetic loading after 4 months healing time. Type 4 surgery will be performed as defined by the ITI Consensus Statements for Implant Placement in Extraction Sockets: healed sites, typically around 16 weeks after tooth was extracted or after tooth was lost to allow complete healing of the ridge as well as soft- and hard tissue maturation. Both SG and CG receive routine treatment, only the choice of the implant material is defined by the study protocol.

  • DeviceTitanium Dental Implant

    The titanium implant will be placed in healed extraction sockets in the premolar-to-premolar area in the mandible and maxilla for single tooth replacement followed by prosthetic loading after 4 months healing time. Type 4 surgery will be performed as defined by the ITI Consensus Statements for Implant Placement in Extraction Sockets: healed sites, typically around 16 weeks after tooth was extracted or after tooth was lost to allow complete healing of the ridge as well as soft- and hard tissue maturation. Both SG and CG receive routine treatment, only the choice of the implant material is defined by the study protocol.

06

What researchers measure

Primary outcomes

  1. Bone Level Change

    Change in crestal bone level measured by analysis of standardized peri-apical xrays 12 months after loading \[mm\].

    Time frame: 12 months after implant loading (final crown restoration)

Secondary outcomes

  1. Implant survival

    Implant survival rates 3, 6 months and 1 year after loading: yes/no

    Time frame: 12 months after loading.

  2. 14 item Oral Health Impact Profile (OHIP-14)

    The local language version of the OPHIP-14 is a self-reported questionnaire that measures dysfunction, discomfort and disability attributed to oral conditions. The questionnaire focuses on seven dimensions of impact: Functional limitation; Pain; Psychological discomfort; Physical disability; Psychological disability; Social disability; Handicap. The patients will be asked to respond according to frequency of impact on a 5-point Likert scale coded never (score 0), hardly ever (score 1), occasionally (score 2), fairly often (score 3) and very often (score 4).

    Time frame: 12 months after loading.

Other outcomes

  1. Adverse Events

    Adverse Events will be recorded at every visit.

    Time frame: 18 months after inclusion.

  2. Device Deficiencies

    Any device complications and deficiencies will be recorded as Device Deficiencies.

    Time frame: 18 months after inclusion.

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Study locations

3 sites
  • Dusseldorf University Hospital, Poliklinik für Zahnärztliche Prothetik
    Düsseldorf, 40225, Germany
  • The University of Hong Kong, Prince Philip Dental Hospital
    Hong Kong, Hong Kong
  • Implantology Institute
    Lisbon, 1070-064, Portugal
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References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 23, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT03908177
Lead sponsor
Institut Straumann AG
Collaborators
Avania
Responsible party
Sponsor
First posted
Apr 9, 2019
Start date
Sep 7, 2019
Primary completion
Apr 1, 2025
Completion
Apr 1, 2025
Last update
Apr 23, 2026

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Apr 2026. You cannot join it, but the record below documents what was studied.

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