Evaluation and Comparison of Crestal Bone Loss Around Dental Implants Placed Using Conventional Drilling, Bone Expansion, and Ridge Split Techniques: An In Vivo Study.

INTRODUCTION

Tooth loss is often followed by alveolar ridge resorption, which may compromise implant placement and long-term stability. Different implant site preparation techniques, such as conventional drilling, bone expansion, and ridge split procedures, are used to manage varying ridge conditions. These techniques may influence peri-implant bone remodeling in different ways. This study aimed to evaluate and compare crestal bone loss around dental implants placed using conventional drilling, bone expansion, and ridge split techniques.

MATERIALS AND

METHODS

This prospective clinical comparative study included 72 implant sites in patients aged 25-55 years who required implant-supported rehabilitation. The implant sites were divided into three groups based on the implant site preparation technique used: conventional drilling (CD), bone expansion (BE), and ridge split (RS), with 24 implants in each group. Crestal bone levels were evaluated using cone-beam computed tomography immediately after implant placement and at 3, 6, and 12 months of follow-up. Mesial and distal crestal bone loss were measured and analyzed statistically using one-way analysis of variance (ANOVA) with Tukey's post hoc test for intergroup comparisons and repeated-measures ANOVA for intragroup comparisons. Categorical variables were compared with the chi-square test. Statistical significance was set at p < 0.05.

RESULTS

Crestal bone loss increased progressively over time in all three groups. Intergroup comparison revealed statistically significant differences in both mesial and distal crestal bone loss at 3, 6, and 12 months (p < 0.001). The ridge split group demonstrated the highest bone loss, followed by the bone expansion group, while the conventional drilling group showed the least bone loss at all time intervals. Pairwise comparisons between all groups were also statistically significant (p < 0.001). Intragroup analysis showed a significant increase in crestal bone loss over time within each group (p < 0.001), except for the comparison between 6 and 12 months in the conventional drilling group, which was not statistically significant (p > 0.05).

Conclusion

Implant site preparation techniques significantly influence peri-implant crestal bone remodeling. Conventional drilling demonstrated the least crestal bone loss, whereas ridge split procedures showed greater bone remodeling during the follow-up period.