Success of Dental Implants Placed Without Primary Stability: A Retrospective Study of Neodent GM Helix, BioTem AR, and MegaGen AnyOne Systems in a Private Practice
Keywords:
Dental Implants; Primary Stability; Secondary Stability; Osseointegration; Immediate Placement; Bone GraftingAbstract
Background: This retrospective study evaluated the success rates of dental implants placed without primary stability in a private practice setting, utilizing three contemporary implant systems and stability-oriented protocols. Materials and Methods: Records from 63 patients receiving 97 implants (Neodent GM Helix, n=35; Biotem AR, n=39; MegaGen AnyOne, n=23; 76 in maxilla, 21 in mandible) placed between January 2021 and September 2024 in Qazvin, Iran, were reviewed. Absence of primary stability was defined as insertion torque <10 N·cm and/or intraoperative spinning. Immediate placements (n=23) received grafting; all implants were submerged, uncovered at approximately 3 months, and loaded at approximately 4 months. Success was assessed using modified Albrektsson/Buser criteria. Statistical analysis included Wilson 95% confidence intervals and Fisher’s exact or χ² tests. Results: Overall success rate was 95.9% (93/97; 95% CI 89.9–98.4%). success rate by system was 97.1 % (34/35) for Neodent, 94.9% (37/39) for Biotem, 95.7% (22/23) for MegaGen with no significant difference among the systems (P=0.91). Immediate placements achieved a 100% success rate, compared to 94.6% for delayed placements , with no significant difference (P=0.58). Success rates were 96.1% in the maxilla and 95.2% in the mandible , with no significant difference (P=1.00). Four early failures occurred (≤4 weeks), all in delayed placements; no late failures were observed. Systemic conditions (diabetes, hypertension, hypothyroidism) did not increase failure rates (P=0.61). All implant failures occurred in posterior regions and delayed timing of placement, while anterior and immediately placed implants achieved 100% success.
Conclusion: In carefully selected cases employing atraumatic techniques, socket grafting and sealing for immediate sites, and conservative loading protocols, implants placed without primary stability demonstrated clinically acceptable success rates comparable to private practice benchmarks. Nonetheless, the absence of mechanical primary stability remains a risk factor, particularly in the posterior maxilla or type IV bone.
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