Study of the Month – October 2026: Oval or Triangular? Immediate Placement of an Oval Zirconia Implant in the Aesthetic Zone
29.10.2026 · 8 min
In the October 2026 Study of the Month, Prof. Dr. Etyene Schnurr presents a clinical case by Dr. Gregor Hočevar involving the immediate placement of an SDS Tissue-Level Oval zirconia implant in the aesthetic zone. The case documents the treatment workflow and clinical development over a 3-year follow-up period.
But the central question of this case is not simply whether the implant remained stable. Why was an oval implant selected instead of a triangular implant?
In this patient, the peri-implant soft tissues were clinically assessed as healthy at 6 months, and the tissue contours appeared maintained. At the 3-year follow-up, the treating clinician documented stable clinical conditions and clinically stable peri-implant soft tissue contours.
The case raises one specific clinical question: Why was an oval implant selected instead of a triangular im
The Clinical Case
The clinical case was performed by Dr. Gregor Hočevar and involved a 60-year-old patient who received immediate implant placement in the region of tooth 11 in 2023.
An SDS Tissue-Level Oval implant (SDS 1.2 Oval, 4.6 × 14 mm) was placed and, at the clinician's discretion, combined with PRF and collagen following the GH technique. A non-functional provisional restoration was delivered immediately after surgery.
The objective was to combine immediate implant placement with a restorative concept adapted to the individual anatomy of the anterior site.
For more background on soft tissue management, socket preservation, and papilla preservation in the aesthetic zone, see Socket Preservation & Papilla Preservation in Implant Dentistry.
Why Oval instead of Triangular?
SDS offers implants with both oval and triangular geometries. Which geometry is used in a given situation is a decision of the treating clinician, within the indications stated in the instructions for use.
In this particular case, four factors were relevant to the decision:
1. Available Space
The available three-dimensional space at the implant site influences which implant geometry can be positioned appropriately.
The oval and triangular designs differ in their cross-sectional shape and buccolingual dimension. In this case, the clinician judged that the space available at site 11 accommodated the oval geometry.
2. Palatal Preparation
Immediate implant placement at tooth 11 requires precise control of the implant position within the extraction site.
In this case, the surgical preparation on the palatal aspect was another consideration when selecting the oval geometry.
3. Tooth Dimensions
The dimensions of the tooth being replaced and the available extraction socket influence implant selection.
In this case, the implant shape was chosen with regard to the individual anatomy of the site rather than by applying one standard geometry to every anterior situation.
4. Prosthetic Considerations
Implant selection also needs to reflect the planned prosthetic restoration.
In this case, the clinician considered the oval geometry to be compatible with the planned restoration. The implant choice was therefore part of a prosthetically driven treatment plan rather than an isolated surgical decision.
So, What Is the Answer?
In this case:
All of the above.
Available space, palatal preparation, tooth dimensions, and prosthetic considerations all contributed to the selection of an oval implant.
This does not mean that an oval implant is generally preferable to a triangular implant.
The clinical takeaway is more specific:
Implant geometry should be selected according to the anatomical, surgical, and restorative requirements of the individual case.
A triangular implant may therefore represent the more appropriate option in a different anterior situation.
Clinical Outcome After 6 Months
At the 6-month evaluation, the peri-implant tissues appeared healthy and stable.
Volumetric assessment showed maintenance of the tissue contours, after which the definitive restoration was cemented.
These observations describe the outcome of this individual clinical case and should not be interpreted as evidence of superiority of the oval implant design.
3-Year Follow-Up
The 3-year follow-up is the most recent documented time point of this case.
Three years after immediate implant placement, the clinical evaluation showed:
- stable clinical conditions
- clinically stable peri-implant soft tissue contours
The case therefore documents the clinical development from immediate placement and provisionalization through definitive restoration to a 3-year follow-up.
Clinical Relevance
This case illustrates why the choice between an oval and triangular implant cannot be reduced to the question of which design is “better.”
In the presented case, the oval implant was selected because several anatomical, surgical, and restorative factors supported its use.
The 3-year follow-up documented stable clinical conditions and clinically stable peri-implant soft tissue contours in this patient. As a single case, it does not allow general conclusions about immediate placement of ceramic implants in the aesthetic zone.
Conclusion
This clinical case documents the immediate placement of an oval tissue-level zirconia implant at tooth 11 with a non-functional provisional restoration and follow-up over three years.
The decision to use an oval rather than triangular implant was based on available space, palatal preparation, tooth dimensions, and prosthetic considerations.
Rather than demonstrating that one geometry is universally superior, the case highlights the importance of choosing implant geometry according to the requirements of the individual clinical situation.
*Note for U.S. clinicians: Certain implant designs discussed in this educational series may not currently be available in the United States. Product availability and indications vary by market and regulatory approval status.
Please refer to our current U.S. Product Portfolio for information on the SDS products currently available in the United States.
FAQs – Oval vs. Triangular Implant in the Aesthetic Zone
1. Why choose an oval implant instead of a triangular implant in the aesthetic zone?
2. Which factors were considered when selecting an oval implant in this anterior case?
3. What is the difference between an oval and a triangular dental implant?
4. Can an oval zirconia implant be placed immediately after tooth extraction?
Note: The information provided is intended for educational purposes only and does not replace clinical judgment. Treatment decisions should be based on individual patient assessment and applicable clinical guidelines.
Disclaimer: This article describes a single clinical case. The observations are specific to this patient and cannot be generalised; individual results may vary. Treatment decisions are the sole responsibility of the treating clinician. Always follow the instructions for use of all products used. Product availability, indications and approvals may differ by country.
Author of the Clinical Case Report
Scientific Review & Medical Validation
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