A Study of 42 Partially Edentulous Patients with Single-Crown Restorations and Implants to Compare Bone Loss Between Crestal and Subcrestal Endosseous Implant Placement

BACKGROUND: The purpose of the study was to evaluate the influence of dental implant placement at different bone levels upon the resultant postoperative peri-implant bone loss. MATERIAL/METHODS: Forty-two partially edentulous patients seeking implant-supported single-crown restorations were screened followed by segregation into 2 groups (GP), GP E (equicrestal) and GP S (subcrestal) (n=21 each). Sixty endosseous implants (30 each) (Adin Tourage-S, Israel), size 3.5/8 and 4/10 mm for mandible, were placed using a 2-stage surgical procedure. At 4 to 6 months, straight abutments were attached followed by restoration (Vita Zahnfabrik, Germany). Crestal bone levels (mesial/distal) of implant fixtures were assessed at 5 time intervals (after surgery, and at 3, 6, 9, and 12 months) using digital radiography. Means and standard deviations were calculated, following which the differences were statistically analyzed using ANOVA at P value of <0.05. RESULTS: The mean annual bone loss for GP S (1.96 mm) was higher than GP E (1.10 mm). At all studied time intervals, the bone loss for implants in GP S was higher than in GP E (P<0.05). Between time intervals, lowest bone loss was observed on the distal side in GP E (0.11 mm/6–9 month) and the highest bone loss was observed on the distal side of GP S (0.6 mm/9–12 month). Differences in the means between the 2 groups on mesial and distal sides were statistically significant at all time intervals (P<0.05). CONCLUSIONS: Subcrestal implant placement was associated with more bone loss than when implants are placed at the crestal level.