Effect of Cover Screws and Healing Abutments on Marginal Bone Loss

Comparison of Cover Screws and Healing Abutments During Implant Placement on Marginal Bone Loss: A Randomized Clinical Trial

This randomized clinical trial aims to compare the effects of using a cover screw or a healing abutment during dental implant placement on short-term marginal bone loss. Participants receiving dental implants will be randomly assigned to either the cover screw group or the healing abutment group. Marginal bone levels around the implants will be evaluated radiographically at baseline and at the 3-month follow-up. The study aims to determine whether the healing approach used at the time of implant placement affects marginal bone level changes during the early healing period.

Preservation of peri-implant marginal bone is an important factor for the long-term success of dental implants. Following implant placement, different healing approaches can be used. In submerged healing, a cover screw is placed and the implant remains beneath the soft tissue during the healing period. In transmucosal healing, a healing abutment is connected to the implant and extends through the soft tissue during healing.

This randomized clinical trial compares the short-term effects of these two healing approaches on peri-implant marginal bone levels. Eligible participants undergoing dental implant treatment will be randomly allocated to either the cover screw group or the healing abutment group.

Peri-implant marginal bone levels will be assessed using periapical radiographs obtained with the paralleling technique at baseline and at the 3-month follow-up. Marginal bone level changes from baseline to 3 months will be measured radiographically and compared between the two groups. The primary objective is to determine whether the use of a cover screw or a healing abutment at the time of implant placement affects marginal bone loss during the early healing period.

Inclusion Criteria:

• Age between 18 and 65 years
• Systemically healthy individuals
• Non-smokers
• Adequate alveolar bone height and width for implant placement without the -need for bone augmentation or regenerative procedures
• Adequate keratinized mucosal width (>2 mm) at the planned implant site
• Indication for dental implant treatment

Exclusion Criteria:

• Presence of systemic disease or medical conditions that may contraindicate -implant surgery or affect bone healing
• Current smoking or use of tobacco products
• Insufficient alveolar bone height or width requiring bone augmentation or regenerative procedures at the implant site
• Keratinized mucosal width ≤2 mm at the planned implant site
• Presence of conditions that preclude standard dental implant placement
• Inability or unwillingness to attend the 3-month follow-up visit