Crestal bone stability after flapless placement of sloped implants with immediate temporization in edentulous mandible. A prospective comparative clinical trial

OBJECTIVES: The purpose of this study was to evaluate crestal bone stability around sloped implants using the flapless procedure and compare it with conventional implants placed axially. MATERIALS AND METHODS: A total of 40 bone‐level implants with platform switching were used for this study for 10 patients (4 males and 6 females) in edentulous mandible. Twenty mesial conventional implants were placed in upright position and 20 distal 30° sloped implants tilted 30°. Bone loss was estimated using radiographic imaging after a 6‐ and a 12‐month follow‐up period. Comparison of the bone loss in the distal and mesial region at both implantation angles were conducted to understand the nature and progression of crestal bone loss. RESULTS: Crestal bone loss around the sloped implants was 0.29 mm (SD = 0.292) on average, while around conventional implants it was 0.22 mm (SD = 0.202) after one‐year follow‐up. However, there was no significant difference in the average of crestal bone loss between two trial groups after 6 months (p < 0.243) and one‐year (p < 0.614) follow‐up. The results indicated a 100% implant survival rate after one‐year follow‐up. Additionally, three fixed prostheses needed realignment after fracturing during the follow‐up time. CONCLUSION: Considering the limitations of this study, it can be presumed that sloped and conventional implants with platform switching and conical connection have the same potential for minimal crestal bone loss.