Two Ceramic Implant Systems Under Standardized Conditions: Insights from a New In Vitro Biomechanical Study
29.10.2026 · 10 min
Primary implant stability is not determined by a single factor. Implant geometry, dimensions, and the corresponding drilling protocol interact as a complete system. This makes it particularly relevant to investigate how different commercial ceramic implant systems perform biomechanically under standardized conditions.
A 2026 in vitro study by Mourão et al., published in Bioengineering, examined this relationship by comparing the SDS 2.2 ceramic implant system from Swiss Dental Solutions with the Nobel 2.2 ceramic implant system from Nobel Biocare in standardized type II artificial bone.
Importantly, the study compared the complete implant systems, including differences in implant dimensions, macrogeometry, and drilling protocols. The results therefore cannot be attributed to individual design features, nor can findings from this artificial bone model be directly translated into conclusions about osseointegration or long-term clinical outcomes.
Two Ceramic Implant Systems Under Standardized Conditions
A total of 52 ceramic implants, 26 from each system, were placed in standardized polyurethane blocks designed to represent type II bone.
The following implants were evaluated:
- SDS 2.2: Y-TZP, 3.8 × 11 mm
- Nobel 2.2: ATZ, 4.2 × 12 mm
Both implants were placed using their respective system-specific drilling sequences.
The study focused on four biomechanical and experimental parameters: insertion torque, reverse/removal torque, resonance frequency analysis (RFA) in two directions, and drill-surface temperature during osteotomy preparation.
An important consideration when interpreting the findings is that this was not an isolated material comparison. The tested implants differed in dimensions, macrogeometry, and drilling protocols. The investigation should therefore be understood as a comparison of two complete commercial ceramic implant systems under defined experimental conditions.
Insertion Torque: Differences in Mechanical Anchorage
Insertion torque reflects the rotational resistance encountered during implant placement and provides information about the mechanical engagement between the implant and the prepared implant site.
The measured values were:
- SDS 2.2: 43.04 ± 5.38 Ncm
- Nobel 2.2: 31.27 ± 6.07 Ncm
The mean difference between the two groups was 11.77 Ncm.
The different dimensions of the tested implants are also noteworthy. The SDS implant measured 3.8 mm in diameter and 11 mm in length, while the Nobel implant measured 4.2 × 12 mm.
However, the observed differences cannot be attributed to a single design characteristic. Insertion torque is influenced by several interacting factors, including implant dimensions, macrogeometry, osteotomy preparation, and the properties of the surrounding substrate.
The findings therefore primarily describe the biomechanical behavior of the respective implant and drilling protocol combination.
Removal Torque as a Measure of Mechanical Retention
After assessing initial stability, the researchers measured the maximum torque required to initiate removal of the implants from the artificial bone.
The following values were recorded:
- SDS 2.2: 46.54 ± 5.47 Ncm
- Nobel 2.2: 28.31 ± 10.07 Ncm
The mean difference was 18.23 Ncm.
These values describe the mechanical retention of the tested implant and drilling-protocol combinations in the artificial type II bone model; given the exploratory statistics, they do not establish a generalizable system effect.
An important distinction is necessary when interpreting this parameter. Because removal torque was measured immediately after placement and without a healing period, it represents mechanical retention within the artificial substrate only.
It does not represent osseointegration or secondary biological stability.
Resonance Frequency Analysis: ISQ Values in Two Directions
In addition to torque measurements, the researchers evaluated initial implant stability using resonance frequency analysis. RFA assesses the stiffness of the implant-substrate complex and is expressed as the Implant Stability Quotient, or ISQ.
Measurements were performed in two perpendicular directions.
Buccolingual:
- SDS 2.2: 66.58 ± 2.06 ISQ
- Nobel 2.2: 60.15 ± 3.73 ISQ
Mesiodistal:
- SDS 2.2: 66.46 ± 2.27 ISQ
- Nobel 2.2: 59.77 ± 3.84 ISQ
The ISQ values describe the stiffness of the implant–substrate complex in this artificial bone model; they are not a measure of osseointegration.
Considering insertion torque and RFA together is particularly relevant because the two methods assess different biomechanical properties. Insertion torque reflects rotational resistance during implant placement, while RFA evaluates the stiffness of the implant-substrate complex.
The two parameters should therefore not be considered interchangeable. Instead, they provide complementary information about immediate mechanical stability.
Temperature Development During Osteotomy Preparation
In addition to mechanical stability, the study investigated temperature changes during the system-specific osteotomy sequences.
The SDS protocol consisted of four drilling steps, while the Nobel protocol consisted of five.
The highest mean final drill-surface temperatures were measured at:
- SDS Drill 2: 51.92 °C
- Nobel Drill 4: 64.29 °C
For the remaining SDS drilling steps, mean final temperatures ranged from 29.12 to 32.57 °C. For the Nobel system, the remaining mean final temperatures ranged from 27.16 to 42.84 °C.
Why the Temperature Data Require Careful Interpretation
The temperatures reported in the study were measured at the exposed surface of the drills using a thermal imaging camera.
The researchers did not directly measure the temperature within the polyurethane block or surrounding bone.
This distinction is particularly important because approximately 47 °C maintained for a certain exposure period is frequently discussed in the literature in the context of potential thermal bone injury. However, the drill-surface temperatures measured in this study cannot be equated with intraosseous temperature.
The duration of temperature exposure was also not determined.
Consequently, the measured values do not demonstrate thermal bone injury. Rather, they provide experimental information about the thermal behavior of individual drilling steps under the specific conditions of the study.
Why Implant Design and Drilling Protocol Must Be Considered Together
The study illustrates why the biomechanical characteristics of an implant should not be reduced to a single parameter.
Implant diameter, implant length, thread geometry, and osteotomy preparation interact to influence how an implant engages with the surrounding substrate during placement.
This is particularly important when interpreting insertion torque. The higher value measured for SDS 2.2, for example, cannot be attributed solely to the implant material, surface characteristics, or any single aspect of its geometry.
Instead, the scientifically relevant aspect is the interaction between implant design and the system-specific drilling protocol.
This shifts the focus from individual product characteristics toward evaluating the implant and its surgical preparation protocol as an integrated system.
What Can the Study Tell Us About Clinical Practice?
Under standardized experimental conditions, the two tested commercial ceramic implant systems showed different biomechanical values. Because of the exploratory statistics and limited block-level replication, these differences cannot be generalized to the systems as a whole.
When assessing immediate mechanical stability, the implant material should therefore not be considered in isolation. Implant dimensions, macrogeometry, and surgical preparation of the implant site all interact.
The study primarily provides preclinical insight into how different system concepts may behave in terms of immediate mechanical anchorage.
However, the experimental design does not allow direct conclusions regarding osseointegration, implant survival, or long-term clinical outcomes.
Limitations of the Study
The results should be interpreted within the context of the experimental study design.
Artificial Bone Rather Than Biological Tissue
Polyurethane blocks allow biomechanical parameters to be investigated under standardized conditions while reducing biological variability. However, they do not reproduce key characteristics of human bone.
Blood supply, cellular healing, remodeling, inflammatory responses, and osseointegration are not represented in this model.
Different Implant Dimensions and Drilling Protocols
SDS 2.2 and Nobel 2.2 differed in their dimensions as well as other implant- and system-specific characteristics. Different drilling sequences were also used.
The observed results therefore cannot be attributed to a single factor such as material composition, implant surface, or macrogeometry.
Limited Independent Block Replication
Another important limitation relates to the experimental setup. Twenty-five SDS implants were placed in one block and 25 Nobel implants in another block. One additional implant from each system was placed in a shared third block.
Although the implants served as the individual units of measurement, independent replication at the block level was limited.
For this reason, the authors explicitly describe the statistical comparisons as exploratory. The results do not establish a generalizable system effect and should be interpreted accordingly.
Conclusion
The study by Mourão et al. provides a direct in vitro comparison of two commercial ceramic implant systems and adds to the still limited body of comparative evidence in this specific area.
Above all, the findings are consistent with the view that the biomechanical behavior of an implant should be interpreted together with its geometry and corresponding drilling protocol.
Evaluating the implant and surgical preparation as an integrated system is therefore one of the most relevant aspects of this investigation. At the same time, the findings remain preclinical. Further research with independent block replication and direct, time-resolved temperature measurements within the substrate is needed to further investigate and contextualize the observed differences.
FAQ – Comparison of SDS 2.2 and Nobel 2.2 ceramic implants
What did the in vitro comparison of SDS 2.2 and Nobel 2.2 ceramic implants show?
What insertion torque was measured for SDS 2.2 and Nobel 2.2?
What ISQ values were measured for SDS 2.2 and Nobel 2.2?
Does higher insertion torque or ISQ indicate clinical superiority?
Did the study directly compare Y-TZP and ATZ zirconia?
Can the in vitro results for SDS 2.2 and Nobel 2.2 be directly transferred to patients?
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.
Disclosure: This article was prepared by Swiss Dental Solutions. One of the study authors (E. Schnurr) is affiliated with Swiss Biohealth Clinic that belong to SDS group.
