Effect of Cover Screws and Healing Abutments on Marginal Bone Loss

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