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Crestal Bone Level Changes in Periodontally Healthy Patients Under Supportive Care: A 4-Year Retrospective Study
Fatma Soysal1, Caner Ozturk2, Mehmet Karadag3
1Department of Periodontology, Faculty of Dentistry, Ankara Medipol University, Ankara, Turkey.
Clinical Implant Dentistry and Related Research
|December 10, 2025
Summary
Long-term dental implant success depends on placement depth and implant geometry. Smoking is a significant modifiable risk factor for crestal bone loss, emphasizing personalized treatment and maintenance for optimal outcomes.
Area of Science:
- Dental Implantology
- Periodontology
- Biomaterials Science
Background:
- Crestal bone level (CBL) changes after implant placement can be physiological or pathological.
- Monitoring marginal bone remodeling is crucial for long-term peri-implant bone stability.
- Identifying risk factors for bone loss is essential for successful implant outcomes.
Purpose of the Study:
- To assess changes in crestal bone level (CBL) and crestal bone remodeling (CBR) over four years.
- To identify risk factors influencing CBL and CBR in periodontally healthy patients.
- To evaluate the impact of systemic, surgical, site-related, and prosthetic variables on bone stability.
Main Methods:
- Retrospective study of 97 patients with 142 implants.
- Radiographic evaluation at implant placement, prosthetic loading, 1 year, and 4 years post-loading.
- Calibrated digital measurements of CBL and CBR, analyzed using regression and correlation tests.
Main Results:
- Smoking was a consistent predictor of increased CBL loss (p < 0.001).
- Subcrestal implant placement showed less bone loss in early phases (p ≤ 0.003).
- Implant diameter significantly predicted bone loss in the late phase (p = 0.002).
Conclusions:
- Implant placement depth is key for initial stability; geometry and prosthetic design affect long-term outcomes.
- Smoking remains a significant, modifiable risk factor for crestal bone loss.
- Individualized treatment and maintenance strategies are vital for long-term dental implant success.
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