Contact Info

Peter Merian-Weg 12

Phone: +41 61 965 11 11


Clinical review: The Straumann® Bone Level Tapered Implant. More than primary stability. The new tapered standard.

  • Straumann® Bone Level Tapered Implant - Clinical review
  • Straumann® Bone Level Tapered Implant - Clinical review

The Straumann® Bone Level Tapered Implant offers excellent primary stability in soft bone and fresh extraction sockets. The tapered form adequately compresses the underprepared osteotomy. It also lets you effectively master your patient’s limited anatomy such as facial undercut, converging root tips, concave jaw structure or narrow atrophied ridges. Building on the clinically proven features of the Straumann® Bone Level Implant, our Bone Level Tapered Implant introduces the powerful combination of Roxolid®, SLActive®, Bone Control Design™, CrossFit® connection, prosthetic diversity, plus a tapered implant body.

Primary stability of dental implants, defined as the stability at the time of implant placement, is an important prerequisite for achieving successful osseointegration (Branemark et al., 1977; Meredith, 1998). High primary stability prevents micromovements of the implant and therefore warrants its rigidity. This is important since the implant should not be subjected to micromotion of more than 50 – 150 μm during the healing phase in order to avoid fibrous tissue encapsulation (Cameron et al., 1973; Szmukler-Moncler et al., 1998). Straumann® Bone Level Tapered Implants have an apically tapered implant body and show excellent primary stability in soft bone and fresh extraction sockets. A study demonstrated that for tapered implants the initial stability is secured over the bone remodeling stages (Rokn et al., 2011). One reason for this is that the tapered implant body design allows for preparing the site with tools one size smaller than the diameter of the implant, thus increasing the resistance to implant insertion. The lateral compression of the bone around the underprepared osteotomy walls leads to a continuous increase of insertion torque, an important observation especially for soft bone types as increasing peak torque values have been correlated to increased implant stability during the healing phase (Molly, 2006).

Straumann® Bone Level Tapered Implant - Clinical review


The current global tapered design implants market is continuously growing (Fig. 1). More and more dental experts use tapered implants. The trend is driven by the growing patient demand for the immediate restoration of esthetics and function, but with simpler, more cost-effective and less time-consuming treatment procedures.

Current global tapered design implants market trends.

Fig. 1: Current global tapered design implants market trends (iData Research Inc., 2013; Millenium research group, 2015).

Surface modifications play an important role in the speed of osseointegration and thereby influence implant strength as well as aging resistance and success of immediate and early loading protocols (Buser et al., 1991; Coelho et al., 2011; Dos Santos et al., 2011; Elias et al., 2008; Shalabi et al., 2006). Straumann® SLActive® is a chemically modified hydrophilic surface which is clinically proven to accelerate the osseous healing (Buser et al., 2004; Lang et al., 2011; Oates et al., 2007; Schwarz et al., 2007). The hydrophilic and chemically active properties of SLActive® provide a larger accessible surface area for increased blood protein adsorption (Kopf et al., 2015), greater osteoblast differentiation and increased production of bone-building osteocalcin (Zhao et al., 2005) as well as stimulated blood vessel growth (Schwarz et al., 2008). Beyond that, studies with Roxolid® SLActive® implants indicate that the osseointegration properties are even superior to those of titanium SLActive® implants (Gottlow et al., 2012; Lang et al., 2011; Oates et al., 2007; Wen et al., 2013). Roxolid® is a unique metal alloy composed of ~15 % zirconium and ~85 % titanium, the only two metals commonly used in implantology that do not inhibit the growth of osteoblasts (Steinemann, 1998). Interestingly, titanium-zirconium alloys like Roxolid® have a better biocompatibility than titanium (Ikarashi Y et al., 2005) and an up to 40 % higher fatigue strength than comparable titanium implants (Bernhard N. et al., 2009). Straumann® Bone Level Tapered Implants from Roxolid® and with the SLActive® surface speed up the process of new bone formation upon the implant and thereby shorten the critical transition phase between primary and secondary stability.

Immediate function can offer many potential advantages such as reduced number of surgical procedures and an immediate esthetic and functional solution (Cordaro et al., 2012). Patients who have regained an important piece of their quality of life, may be more tempted to evaluate the treatment as success. It could be demonstrated that Straumann® Bone Level implants with SLActive® surface can successfully be used in early treatment protocols (Bornstein et al., 2010; Buser et al., 2013b; Nicolau et al., 2011). The micro-gap of the Straumann® CrossFit® connection is extremely small and reduces inflammation, which helps to preserve bone (Cochran et al., 2013; Heitz-Mayfield et al., 2013; Jung et al., 2008). Even in poor-quality bone, survival rates are comparable with those from conventional or delayed loading. The mean bone-level change is not deemed to be clinically significant and compared well with the typical bone resorption observed in conventional implant loading. Thus, the Straumann® Bone Level Tapered Implant is suitable for placement into fresh extraction sockets or into bone of low quality (Akkocaoglu et al., 2005) and can be successfully used in conjunction with immediate and early loading protocols.


A recent global survey among dental experts from 19 countries showed that there is a high level of satisfaction with the Straumann® Bone Level Tapered Implant (average rating 8.5 out of 10). The reason for satisfaction is mainly due to the ease of use, the advantages of the Roxolid® material and the SLActive® surface.

Straumann® Bone Level Tapered Implant - Clinical review

Fig. 2: Female patient presenting with a prior oral-antral fistula. The fistula with the prior implant was obturated and the ­Straumann® Bone Level Tapered Implant offered the opportunity to avoid sinus involvement. Courtesy of Dr. Robert L. Holt.

Many patients have difficult health conditions which could compromise the treatment outcome of the implant therapy. Especially in challenging indications, the use of an implant system which is clinically proven and backed by scientific literature is mandatory to minimize the risk of treatment failure. The Straumann® Bone Level Tapered Implant mimics the shape of a natural tooth root which is advantageous with anatomic constraints (Fig. 2), including facial undercuts, converging root tips, concave jaw structure or narrow atrophied ridges. A high predictability of implant placement in augmented sites could be shown (Chiapasco et al., 2012a; Chiapasco et al., 2012b; Santing et al., 2013). Treatment of irradiated patients in the head and neck area showed 100 % survival rate after 14 months (Heberer et al., 2011) and of patients with poorly controlled type II diabetes, 98 % survival rate after 16 weeks were reported (Khandelwal et al., 2013). Immediate loading of overdentures supported by two implants reached 99 % survival rate after up to 40 months (Stoker and Wismeijer, 2011). Additionally, the tapered design is of advantage for full-arch fixed restorations, as the temporary prosthesis is often placed at the day of surgery. For this indication, Straumann® Bone Level Tapered Implants provide the primary implant stability which is needed for reliable anchorage of the temporary prosthesis in the bone. From an esthetic point of view, Straumann® Bone Level Implants have demonstrated excellent esthetic results and high patient satisfaction in daily dental practice (Filippi et al., 2013; Furze et al., 2012). Pleasing esthetic outcomes after early loading with healthy and stable peri-implant soft tissues in the anterior maxilla even after 9 years have been reported (Buser et al., 2013a; Buser et al., 2013c; Buser et al., 2009; Buser et al., 2011). Thererfore, Straumann® Bone Level Roxolid® SLActive® Implants have been tested in very challenging indications and successful treatment outcomes have been documented.

Akkocaoglu M, Uysal S, Tekdemir I, Akca K, Cehreli MC (2005). Clin Oral Implants Res 16(2):202-209. — Bernhard N., Berner S., De Wild M., Wieland M. (2009). Forum Implantologicum 5(30). — Bornstein MM, Wittneben JG, Bragger U, Buser D (2010). J Periodontol 81(6):809-818. — Branemark PI, Hansson BO, Adell R, Breine U, Lindstrom J, Hallen O et al. (1977). Scand J Plast Reconstr Surg Suppl 16:1-132. — Buser D, Broggini N, Wieland M, Schenk RK, Denzer AJ, Cochran DL et al. (2004). J Dent Res 83(7):529-533. — Buser D, Chappuis V, Bornstein MM, Wittneben JG, Frei M, Belser UC (2013a). J Periodontol 84(11):1517-1527. — Buser D, Chappuis V, Kuchler U, Bornstein MM, Wittneben JG, Buser R et al. (2013b). J Dent Res 92(12 Suppl):176S-182S. — Buser D, Chappuis V, Kuchler U, Bornstein MM, Wittneben JG, Buser R et al. (2013c). J Dent Res 92(12 Suppl):176S-182S. — Buser D, Halbritter S, Hart C, Bornstein MM, Grutter L, Chappuis V et al. (2009). J Periodontol 80(1):152-162. — Buser D, Schenk RK, Steinemann S, Fiorellini JP, Fox CH, Stich H (1991). J Biomed Mater Res 25(7):889-902. — Buser D, Wittneben J, Bornstein MM, Grutter L, Chappuis V, Belser UC (2011). J Periodontol 82(3):342-349. — Cameron HU, Pilliar RM, MacNab I (1973). J Biomed Mater Res 7(4):301-311. — Chiapasco M, Casentini P, Zaniboni M, Corsi E (2012a). Clin Oral Implants Res 23(9):1012-1021. — Chiapasco M, Casentini P, Zaniboni M, Corsi E, Anello T (2012b). Clin Oral Implants Res 23(10):1136-1141. — Cochran DL, Mau LP, Higginbottom FL, Wilson TG, Bosshardt DD, Schoolfield J et al. (2013). Int J Oral Maxillofac Implants 28(2):494-502. — Coelho PG, Granato R, Marin C, Teixeira HS, Suzuki M, Valverde GB et al. (2011). J Mech Behav Biomed Mater 4(8):1974-1981. — Cordaro L, Torsello F, Chen S, Ganeles J, Bragger U, Hammerle C (2012). Clin Oral Implants Res. — Dos Santos MV, Elias CN, Cavalcanti Lima JH (2011). Clin Implant Dent Relat Res 13(3):215-223. — Elias CN, Oshida Y, Lima JH, Muller CA (2008). J Mech Behav Biomed Mater 1(3):234-242. — Filippi A, Higginbottom FL, Lambrecht T, Levin BP, Meier JL, Rosen PS et al. (2013). Quintessence Int 44(7):499-512. — Furze D, Byrne A, Donos N, Mardas N (2012). Quintessence Int 43(2):127-134. — Gottlow J, Dard M, Kjellson F, Obrecht M, Sennerby L (2012). Clin Implant Dent Relat Res 14(4):538-545. — Heberer S, Kilic S, Hossamo J, Raguse JD, Nelson K (2011). Clin Oral Implants Res 22(5):546-551. — Heitz-Mayfield LJ, Darby I, Heitz F, Chen S (2013). Clin Oral Implants Res 24(3):243-249. — iData Research Inc. (2013). Dental Implant Market, Europe, 2009 – 2019. European Markets for Dental Implants, Final Abutment and Computer Guided Surgery. — Ikarashi Y, Toyoda K., Kobayashi E, Doi H., Yoneyama T. (2005). Materials Transactions 46(10):2260-2267. — Jung RE, Jones AA, Higginbottom FL, Wilson TG, Schoolfield J, Buser D et al. (2008). J Periodontol 79(2):260-270. — Khandelwal N, Oates TW, Vargas A, Alexander PP, Schoolfield JD, Alex MC (2013). Clin Oral Implants Res 24(1):13-19. — Kopf BS, Ruch S, Berner S., Spencer ND, Maniura-We­ber K (2015). Journal of Biomedical Materials Research. — Lang NP, Salvi GE, Huynh-Ba G, Ivanovski S, Donos N, Bosshardt DD (2011). Clin Oral Implants Res 22(4):349-356. — Meredith N (1998). Int J Prosthodont 11(5):491-501. — Millenium research group (2015). Dental Implants & Final Abutments 2014 and 2015. Millennium Report. — Molly L (2006). Clin Oral Implants Res 17 Suppl 2:124-135. — Nicolau P, Korostoff J, Ganeles J, Jackowski J, Krafft T, Neves M et al. (2011). Clin Implant Dent Relat Res. — Oates TW, Valderrama P, Bischof M, Nedir R, Jones A, Simpson J et al. (2007). Int J Oral Maxillofac Implants 22(5):755-760. — Rokn A, Ghahroudi AR, Mesgarzadeh A, Miremadi A, Yaghoobi S (2011). J Dent (Tehran ) 8(4):186-200. — Santing HJ, Raghoebar GM, Vissink A, den HL, Meijer HJ (2013). Clin Oral Implants Res 24(8):941-948. — Schwarz F, Ferrari D, Herten M, Mihatovic I, Wieland M, Sager M et al. (2007). J Periodontol 78(11):2171-2184. — Schwarz F, Sager M, Ferrari D, Herten M, Wieland M, Becker J (2008). J Clin Periodontol 35(1):64-75. — Shalabi MM, Wolke JG, Jansen JA (2006). Clin Oral Implants Res 17(2):172-178. — Steinemann SG (1998). Periodontol 2000 17:7-21. — Stoker GT, Wismeijer D (2011). Clin Implant Dent Relat Res 13(4):255-261. — Szmukler-Moncler S, Salama H, Reingewirtz Y, Dubruille JH (1998). J Biomed Mater Res 43(2):192-203. — Wen B, Zhu F, Li Z, Zhang P, Lin X, Dard M (2013). Clinical Oral Implants Research:n/a. — Zhao G, Schwartz Z, Wieland M, Rupp F, Geis-Gerstorfer J, Cochran DL et al. (2005). J Biomed Mater Res A 74(1):49-58
By | 2017-08-17T08:29:53+00:00 February 24th, 2016|Clinical Cases, Dental Implants, Science, Trends|0 Comments

Leave A Comment