Does implant depth affect bone loss in people with thin gums?

The Influence of Vertical Implant Position With Immediate Temporization on Marginal Bone Loss in Cases With Thin Soft Tissue Phenotype: A Randomized Controlled Clinical Trial

This trial will test whether placing a single delayed dental implant 2 mm below the bone versus at bone level leads to less marginal bone loss and better soft-tissue esthetics and patient satisfaction in adults with thin gum phenotype missing one upper front or premolar tooth.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 30 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Cairo University (other)
• Drugs / interventions: chemotherapy
• Locations: 1 site (Cairo)
• Trial ID: NCT07483086 on ClinicalTrials.gov

What this trial studies

Adults with a single missing upper anterior or premolar tooth and a thin soft tissue phenotype will receive a delayed implant with immediate temporization placed either at the crestal bone level or 2 mm subcrestally. Preoperative CBCT will be used to confirm bone dimensions, and participants will return about every three months for clinical checks, radiographs, and measurements. Primary outcomes include marginal bone loss and implant survival; secondary outcomes include soft-tissue quality, esthetic measures, and patient satisfaction. The trial is being conducted at the Oral Medicine and Periodontology department, Faculty of Dentistry, Cairo University, Egypt.

Who should consider this trial

Good fit: Adults over 18 with a single missing upper anterior or premolar tooth, a thin soft tissue phenotype, adequate bucco‑lingual and mesio‑distal bone dimensions, good oral hygiene, and willingness to attend a one‑year follow‑up.

Not a fit: Patients with inadequate bone volume or quality, active local infection, poor wound healing, heavy smoking or parafunctional habits, or other conditions excluded from the protocol are unlikely to benefit from the interventions tested here.

Why it matters

Potential benefit: If successful, subcrestal implant placement could preserve crestal bone, improve soft-tissue esthetics, and reduce visible recession or peri-implant complications for patients with thin gums.

How similar studies have performed: Previous studies have reported mixed results—some suggest subcrestal placement may help preserve peri‑implant tissues, but the evidence remains inconclusive and debated.

Eligibility criteria

Inclusion Criteria:

* Patients with single missing upper anterior or premolar teeth
* Patients with minimum buccolingual width of 6 mm and mesiodistal width of 6 mm
* Patients with thin soft tissue phenotype
* Patients with healthy systemic conditions.
* Patients older than 18 years.
* Good oral hygiene.
* Cooperative patients who accept a one-year follow-up period.
* Patients who consent to being part of the study (sign an informed consent form).
* Adequate inter-arch space for implant placement.
* Favorable occlusion (no traumatic occlusion).
* Absence of allergy to the prescribed medications.

Exclusion Criteria:

* Patients with inadequate bone volume and/ or quality
* Patients with local root remnants
* Patients with inadequate wound healing
* Patients with signs of acute infection related to the area of interest.
* Patients with habits that may jeopardize the implant longevity and affect the results of the study such as parafunctional habits (Lobbezoo et al., 2006).
* Heavy smokers (more than 10 cigarettes per day) (Lambert, Morris and Ochi, 2000).
* Metabolic diseases such as diabetes or hyperthyroidism as well as systemic medications such as chemotherapy or bisphosphonates
* Pregnant or nursing women.
* Uncooperative patients.

Where this trial is running

Cairo

• Cairo University — Cairo, Egypt (RECRUITING)

Conditions: Vertical Implant Position, Delayed Implant Placement With Immediate Loading, Tooth Loss / Rehabilitation, Vertical position, subcrestal, crestal, delayed implant placement with immediate loading, vertical dental implant position