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Updated: Mar 26, 2026

Real-Time Dynamic Navigation System for the Precise Quad-Zygomatic Implant Placement in a Patient with a Severely Atrophic Maxilla
Published on: October 18, 2021
Crestal Bone Changes Around Implants with Implant-Abutment Connections at Epicrestal Level or Above: Systematic
Purpose:
The aim of this systematic review and meta-analysis was to evaluate crestal bone changes around implants when placing the implant-abutment connection at the crestal bone level or above.
Materials And Methods:
Medline (Pubmed), EMBASE, and Cochrane Library up to January 2014 were electronically and hand searched for any publications that evaluated radiographic crestal bone changes around nonsubmerged, rough-surfaced implants placed in healed sites in humans and loaded for a minimum of 1 year.
Results:
The search yielded 1,122 publications; 1,106 could not be included. After 16 full-text articles were read and subjected to inclusion and exclusion criteria, four were included. The mean difference was -0.29 mm (95% CI, -0.58 mm to -0.01 mm). Heterogeneity between studies was observed (I2 = 95%). Significantly more crestal bone change was seen in the epicrestal implant-abutment (bone level) connection group when compared to implants with the prosthetic connection above the crestal bone level (tissue level) (P < .00001).
Conclusion:
Dental implants at bone level show significantly less crestal bone change after 1 year of loading than tissue-level implants.
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