In-patient comparison of marginal bone loss after 4 months in immediately loaded, submucosal, and transmucosal dental implants using 3D scanning: a prospective clinical trial.
Armin Sokolowski, Martin Lorenzoni, Elisabeth Steyer, Felix Marschner, Anke Pichler, Alwin Sokolowski
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Abstract
Objectives: This prospective observational study aimed to evaluate the clinical outcomes and impact of different treatment protocols - immediate loading using a round gold bar retained overdenture on two implants, submucosal healing, and transmucosal healing - on circumferential marginal bone levels around dental implants.
Materials and methods: 20 patients requiring six implants in the edentulous lower jaw were included. Within each patient, 2 implants were assigned to submucosal healing, transmucosal healing, or immediate loading protocols. Marginal bone loss (MBL) was evaluated using 3D scanning at implant placement and after 4 months while raising a full-thickness flap. Periotest values (PTVs), the oral health impact profile (OHIP-14) and regular clinical evaluations were conducted for up to 2 years.
Results: The submucosal group exhibited the least mean vertical MBL (-0.22 mm), significantly lower than the immediate (-0.39 mm) and transmucosal (-0.36 mm) groups (P = .001). Peri-implant bone surface area reduction was lowest in the submucosal group (-0.87 mm²) compared to the transmucosal (-4.58 mm²) and immediate (-6.66 mm²) protocols (P = .002). One submucosal healed implant and two immediately loaded implants were lost. Immediate loading provided high patient comfort and demonstrated successful outcomes both in terms of clinical data (PTVs, MBL) and patient-reported outcome measures (OHIP-14, VAS).
Conclusions: Submucosal and transmucosal healing protocols resulted in better marginal bone preservation compared to immediate loading. Although immediate loading enhanced patient comfort, it was associated with higher marginal bone loss.
Clinical relevance: This study highlights the potential advantages of submucosal healing for marginal bone preservation and supports the use of three-dimensional scanning for precise bone loss evaluation, guiding clinical decision-making in implantology.
期刊介绍：
The journal Clinical Oral Investigations is a multidisciplinary, international forum for publication of research from all fields of oral medicine. The journal publishes original scientific articles and invited reviews which provide up-to-date results of basic and clinical studies in oral and maxillofacial science and medicine. The aim is to clarify the relevance of new results to modern practice, for an international readership. Coverage includes maxillofacial and oral surgery, prosthetics and restorative dentistry, operative dentistry, endodontics, periodontology, orthodontics, dental materials science, clinical trials, epidemiology, pedodontics, oral implant, preventive dentistiry, oral pathology, oral basic sciences and more.
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