The purpose of this clinical investigation is to evaluate and compare the 3-dimensional radiographic crestal bone changes around 4 immediately placed and loaded implants supporting full arch fixed mandibular prosthesis in 2 groups of patients. The Test group comprises of patients with failing mandibular teeth needing extraction. ( due to caries, periodontal disease, fractures or prosthetic reasons).The Control group comprises of patients with a fully edentulous mandible presenting for fixed implant supported prosthesis with at least 6 months after the last extraction or bone grafting procedure. Stereolithographic bone model obtained from the patient’s DICOM files was used to fabricate the bone reduction guide and surgical guide.

This was a prospective non-randomized controlled clinical study in which the subjects were recruited by strict inclusion and exclusion criteria. Seventeen subjects were recruited for the study. 9 patients for the test group and 8 patients for the control group were treated. Four parallel implants were placed and a fixed provisional was placed within 24 hours after surgery. CBCT and periapical radiographs were taken at baseline, 3, 6 and 12 months and were compared between the 2 group. No clinically significant difference was found in the 3D crestal bone levels between the 2 groups for the different time intervals evaluated at a significance level P < 0.05. The study yielded important guidelines for implants placed in sites where extraction s were combined with alveoloplasty and immediately loaded. Crestal bone changes are minimal when these implants are placed greater than 2mm below the bone crest and when the buccal bone is greater than 3mm wide.

LLU Discipline

Implant Dentistry


Implant Dentistry


School of Dentistry

First Advisor

Lozada, Jaime L.

Second Advisor

Kan, Joseph

Third Advisor

Kim, Yoon Jeong

Fourth Advisor

Rice, Dwight

Fifth Advisor

Won, John

Degree Name

Master of Science (MS)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Dental Implantation - Endosseous -- Methods; Bone-Implant Interface; Alveolar Process; Cone-Beam Computed Tomography; Bone Remodeling

Subject - Local

Crestal bone changes; Alveoloplasty; Dental Implants; Fixed Mandibular Prosthesis



Page Count


Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives

Included in

Dentistry Commons