Titanium implants have long been established as reliable in dental implantology; however, zirconia implants are now being explored as a metal-free substitute. This investigation assessed how zirconia implant macrodesign and bone density influence initial implant stability. Two zirconia systems—Neodent® Zi Ceramic and Straumann® PURE Ceramic—were evaluated using polyurethane blocks simulating varying bone densities (10, 15, 20, 30, and 40 PCF). Each implant type underwent repeated insertion and removal. Resonance frequency analysis (RFA) was performed using the Osstell® Beacon to record stability. Statistical evaluation included the Shapiro–Wilk, t-test, Mann–Whitney U, and Kruskal–Wallis tests, with p < 0.05 considered significant.
The tapered Neodent® Zi Ceramic Implant produced consistently higher ISQ readings across all densities than the Straumann® PURE Ceramic Implant (p = 0.035). Moreover, reduced foam density was linked to lower stability outcomes (p < 0.05). The findings demonstrate that both implant macrogeometry and bone quality have a substantial effect on primary stability. Tapered implants achieved superior initial fixation compared with cylindrical ones, emphasizing the need to consider design configuration and bone density when optimizing implant stability in practice.
