Real science

You deserve 
real science

A minipig in vivo study funded by Straumann was published, comparing Nobel Biocare’s TiUltra™ implant surface against Straumann’s SLA® and SLActive® implant surfaces.1,2
Their conclusions are now being used for a marketing campaign by Straumann.

Overview
In 2022, the effect of implant surface and implant geometry on de novo crestal bone formation and osseointegration was investigated.

In 2024, the effect of implant surface on osseointegration and crestal bone formation in a grafted dehiscence defect minipig model was studied.

Scientific studies

We question the fairness of the study's comparisons and the validity of their marketing

Biased comparison

Do you know that in this study, the NobelActive TiUltra™ implants did not have original cover screws?
In the images, you can see the gap introduced by the use of a non-original cover screws with NobelActive® TiUltra™. The gap between the implant and the abutment/cover screw can lead to bacterial leakage, resulting in bone loss.3,4

Implants comparison

Here's what happens when a non-original screw is used on an implant.

 

Read between the lines. 
The measurements and marketing don't match.

Straumann's marketing claims that their graphics illustrate the measured bone growth (white lines). However, they do not correlate with the results that were actually published. 

We’ve added the correct new bone height (NBH) results in red, revealing that the differences between SLActive® and TiUltra™ were exaggerated.

 

Underpowered study

Only one study, with no more than eight samples per group

As basic statistical principles indicate, the sample size is too small for a reliable comparison.6 Therefore, the study is underpowered. So, the study conclusion, “significantly superior levels of osseointegration (dBIC) and coronal bone apposition (fBIC) in the dehiscence defect” in SLA® and SLActive® groups cannot be substantiated.

An underpowered study lacks enough samples to draw a clinically meaningful conclusion.
A p-value above 0.05 suggests there is no real difference between groups.

Statistically non-significant endpoints
There was no statistical significance of multiple endpoints, including New Bone Height (NBH) and Bone Area to Total Area (BATA). These results are notably absent from Straumann’s marketing.

Incorrect statistical method
Even more concerning, the statistical methods used were not appropriate for several endpoints, and no correction was made for multiple testing across 10 interdependent measures—dramatically increasing the likelihood of false positives.

In a study where sample sizes are too small, non-original components are used, key endpoints are statistically non-significant, and incorrect statistical methods are used, do you have confidence in their conclusions?

Nobel Biocare believes you and your patient deserve the real science.

 

REAL SCIENCE

  • Clinical outcomes with TiUltra™ surfaces

    Read the latest data on TiUltra™ surfaces, featuring more than 1,270 patients, 2,000 implants, and 12 clinical studies.

  • Nobel Biocare SciConnect

    Sciconnect

    Get the latest updates on implant dentistry science, our solutions, innovations and educational events.  SciConnect is where patient-centric innovations and clinical science meet.

  • Nobel Biocare implant design

    Our Story

    Nobel Biocare is about you, for your patient. That’s a promise based on over 65 years’ R&D in implantology

References

1.Shahdad S, Bosshardt D, Patel M, et al. Benchmark performance of anodized vs. sandblasted implant surfaces in an acute dehiscence type defect animal model. Clin Oral Implants Res. 2022 Nov;33(11):1135-1146.

2. Shahdad S, Rawlinson S, et al. Osseointegration of Anodized vs. Sandblasted Implant Surfaces in a Guided Bone Regeneration Acute Dehiscence-Type Defect: An In Vivo Experimental Mandibular Minipig Model. Clin Oral Implants Res. 2024 Oct 10. doi: 10.1111/clr.14369. Epub ahead of print. PMID: 39387129.

3. Zipprich H, Miotke 5, Hmaidouch R, Lauer HC. A new experimental design for bacterial microleakage investigation at the implantabutment interface: an in vitro study. Int J Oral Maxillofac Implants 2016;31(1):37-44.

4. Karl M, Taylor TD. Effect of cyclic loading on micromotion at the implant-abutment interface. Int J Oral Maxillofac Implants, 2016;31(6):1247-1263.

5. Sasada Y, Cochran DL. Implant-Abutment Connections: A Review of Biologic Consequences and Peri-implantitis Implications. Int J Oral Maxillofac Implants. 2017 Nov/Dec; 32(6):1296-1307.

6. Lau F, Kuziemsky C, editors. Handbook of eHealth Evaluation: An Evidence-based Approach [Internet]. Victoria (BC): University of Victoria; 2017 Feb 27. PMID: 29431951.