Peri-implant marginal bone topography at the uncover stage: a classification proposal and retrospective observational study

Most studies have examined early crestal bone loss/remodeling on radiographs after the first year of loading and subsequent late bone loss. Limited research has investigated the patterns of bone remodeling in 360 degrees during the initial stages of implant healing. This study aimed to classify peri-implant marginal bone remodeling patterns at the implant uncovering stage. A total of 74 patients with 106 implants were included. At uncovering stage under an operating microscope, peri-implant bone conditions were recorded and categorized into four types: Type 1A (facial or lingual remodeling ≤ 2 mm with intact interproximal bone), Type 1B (facial or lingual remodeling ≤ 2 mm with interproximal remodeling ≤ 2 mm), Type 2 (circumferential remodeling ≤ 2 mm), and Type 3 (bone remodeling > 2 mm at any site). Results showed that 43% of implants exhibited no bones loss, while 57% presented various degree of bone remodeling, of which 58% Type 1A, 18% Type 1B, 17% Type 2, and 7% Type 3 in this specific cohort. Multinomial logistic regression identified ridge preservation history, simultaneous guided bone regeneration, and age as significant predictors of the bone remodeling variations. This new classification provides a framework for assessing early bone remodeling pattern and could serve as a foundation for future studies exploring the relationship between early remodeling, peri-implantitis risk, and long-term implant outcomes.