Standard dental implants require sufficient bone and spacing, which may not be available in all patients. To address these limitations, narrow diameter implants (≤3.5 mm) have been introduced as a less invasive alternative, especially useful for medically compromised patients or those avoiding bone grafts. However, narrow implants made of pure titanium have shown long-term biological and technical concerns.
The introduction of titanium-zirconium (TiZr) alloy has improved mechanical strength, and several studies have demonstrated favorable outcomes with narrow TiZr implants. Yet, evidence remains limited regarding their exclusive use in high-load posterior (molar) regions. Prior studies report conflicting failure rates, potentially linked to prosthetic design and occlusal forces, but lack quantitative analysis of bite forces or prosthetic angles.
Emergence angle, prosthetic platform width, and implant-abutment connection may all influence implant stability and peri-implant tissue health. A newly introduced TorcFit™ connection may offer better stress distribution and torque resistance, but its clinical relevance-especially in narrow implants used for molars-remains untested.
Aged ≥ 18 years.
Require replacement of single missing molar tooth with dental implant in fully healed sites.
Controlled oral hygiene (full-mouth plaque and bleeding scores ≤ 25% at baseline).
Intact adjacent teeth and opposing dentition.
Localized/generalized periodontitis.
Any medical condition that may contraindicate implant treatment (Bornstein et al., 2009).
Bone metabolic disease and/or taking medications that affect bone metabolism.
Long term use of non-steroidal anti-inflammatory medications.