Crestal bone reactions to immediate implants placed at different levels in relation to crestal bone. A pilot study in...

The aim of the present study was to evaluate bone-to-implant contact (BIC) and bone remodeling dynamics after immediate implant placement at different levels in relation to the crestal bone.

The mandibular second, third, and fourth premolars of six Foxhound dogs were extracted bilaterally. Randomly, three implants were immediately placed in the hemi-arches of each dog, crestally or 2 mm subcrestally. Three dogs were allowed an 8-week submerged healing period, and the other three at 12-week submerged healing period. The animals were sacrificed at 12 weeks and samples were obtained. Biopsies were processed for ground sectioning. Histomorphometric analysis was carried out to compare BIC, bone neoformation, and bone remodeling.

All implants osseointegrated clinically and histologically. Healing patterns examined microscopically at eight and twelve weeks for both groups (crestal and subcrestal) yielded similar qualitative bone findings. The Total BIC mean value for the crestal group 44.52% at 8 weeks and 39.50% at 12 weeks, and for the subcrestal group was 47.33% at 8 weeks and 53.85% at 12 weeks%. There was less bone resorption in the subcrestal group (test) than in crestal group (control).

Within the limitations of this study, our findings suggest that apical positioning of the top of the implant does not jeopardize bone crest and peri-implant tissue remodeling. However, less resorption of the lingual crest may be expected when implants are placed 2 mm subcrestally. Moreover, higher BIC values were found in implants placed subcrestally.