Comparison of Bone Density and Crestal Bone Loss Between Immediately Temporized and Submerged Implants in the Posterior Mandible: A Radiovisiographic Study

<b>Purpose:</b> This study aimed to evaluate and compare alveolar bone density and crestal bone loss (CBL) around immediately temporized implants (ITIs) and conventionally placed submerged implants (CIs) in the posterior mandible using radiovisiography (RVG). <b>Methods:</b> In this prospective, randomized, split-mouth clinical study, nine patients with bilateral posterior mandibular edentulism were enrolled. A bone-level implant was placed bilaterally in each patient. One side received an immediate temporized, while the contralateral side received a CI. Standardized RVGs were obtained at baseline, 3 months, and 6 months. Alveolar bone density and CBL were measured using ImageJ software. Data were analyzed using paired <i>t</i>-tests with significance set at <i>p</i> < 0.05. <b>Results:</b> No statistically significant differences in alveolar bone density or CBL were observed between the ITI and conventional groups at any follow-up interval. Mean alveolar bone densities were higher in the ITI group at all intervals (baseline: 136.22 ± 36.23, 3 months: 137.03 ± 34, 6 months: 136.28 ± 34.59) compared to the conventional group (baseline: 136.56 ± 24.26, 3 months: 126.53 ± 34.93, 6 months: 119.95 ± 43.35). At 3 months, the ITI group exhibited greater CBL (0.22 ± 0.63 mm) than the conventional group (0.15 ± 0.83 mm). However, at 6 months, the ITI implants exhibited less CBL (- 0.07 ± 0.47 mm) compared to the conventional implants (0.19 ± 0.78 mm). <b>Conclusion:</b> Immediate temporization under nonfunctional loading did not negatively affect peri-implant bone compared to conventional submerged healing. These results support its clinical use in appropriately selected cases.