Crestal bone stability after flapless placement of sloped implants with immediate temporization in edentulous mandible. A prospective comparative clinical trial.

OBJECTIVES: The purpose of this study was to evaluate crestal bone stability around sloped implants using the flapless procedure and compare it with conventional implants placed axially. MATERIALS AND METHODS: A total of 40 bone-level implants with platform switching were used for this study for 10 patients (4 males and 6 females) in edentulous mandible. Twenty mesial conventional implants were placed in upright position and 20 distal 30 degrees sloped implants tilted 30 degrees . Bone loss was estimated using radiographic imaging after a 6- and a 12-month follow-up period. Comparison of the bone loss in the distal and mesial region at both implantation angles were conducted to understand the nature and progression of crestal bone loss. RESULTS: Crestal bone loss around the sloped implants was 0.29 mm (SD = 0.292) on average, while around conventional implants it was 0.22 mm (SD = 0.202) after one-year follow-up. However, there was no significant difference in the average of crestal bone loss between two trial groups after 6 months (p < 0.243) and one-year (p < 0.614) follow-up. The results indicated a 100% implant survival rate after one-year follow-up. Additionally, three fixed prostheses needed realignment after fracturing during the follow-up time. CONCLUSION: Considering the limitations of this study, it can be presumed that sloped and conventional implants with platform switching and conical connection have the same potential for minimal crestal bone loss.