Title	Transmucosal Dental Implant Placement with Bone Augmentation Shows No Difference in Bone Levels or Soft Tissue Indices from Submerged Dental Implant Placement with Bone Augmentation
Clinical Question	In patients receiving dental implant placement with lateral bone augmentation, does a transmucosal dental implant show a significant difference in bone levels and soft tissue indicators in comparison to a submerged dental implant?
Clinical Bottom Line	In patients receiving dental implants in conjunction with lateral bone augmentation, submerged dental implant placement may offer no benefit over non-submerged placement as measured by bone level and soft tissue indicators.
Best Evidence
PubMed ID Author / Year Patient Group Study type (level of evidence) 22697581 Cordaro/2013 52 dental implants with bone augmentation: 27 submerged, 25 non-submerged Randomized Controlled Trial Key results The study shows no significant difference between the two groups after 2 years of follow-up. Bone resorption was found in both groups (0.37 ± 0.49 mm in the submerged group and 0.54 ± 0.76 in the non-submerged group; P < 0.001). Probing depths (2.5 vs. 2.4 mm), bleeding on probing (BOP-positive sites: 8.8% vs. 11.5%) and clinical attachment loss (2.8 vs. 2.4 mm) were not significantly different between the submerged and the non-submerged groups, respectively.
Evidence Search	submerged[All Fields] AND non[All Fields] AND submerged[All Fields] AND ("dental implants"[MeSH Terms] OR ("dental"[All Fields] AND "implants"[All Fields]) OR "dental implants"[All Fields] OR ("dental"[All Fields] AND "implant"[All Fields]) OR "dental implant"[All Fields]) AND ("bone and bones"[MeSH Terms] OR ("bone"[All Fields] AND "bones"[All Fields]) OR "bone and bones"[All Fields] OR "bone"[All Fields]) AND augmentation[All Fields]
Comments on The Evidence	Validity: This article directly compared the two groups as part of a secondary analysis of an ongoing larger clinical trial. The study was conducted in 12 centers, and the sample was randomly distributed between submerged and non-submerged placement. The study used a retrospective assessment of patients completing 2 years of evaluation of the implant in aesthetic (anterior) area, limiting definitive conclusions that can be be drawn from this comparative report. Perspective: It is commonly thought that submerged dental implant placement is preferred if lateral bone augmentation is required in conjunction with implant placement. Based on this retrospective comparative study, both options (submerged and non-submerged) appear to have similar clinical outcomes.
Applicability	This information offers the dentist some guidance as to whether or not to submerge dental implants placed in an aesthetic (anterior) area in conjunction with lateral bone augmentation.
Specialty	(General Dentistry) (Oral Surgery) (Periodontics)
Keywords	Implant, submerged implant, non-submerged implant, bone augmentation, one-stage implant, two-stage implant
ID#	2737
Date of submission	06/24/2014
E-mail	a.alblaihess@hotmail.com
Author	Abdulaziz A. Alblaihess
Co-author(s)	Mohamad K. Alhadlaq, Shreya Ruxmohan
Co-author(s) e-mail	kakao86@msn.com, ruxmohan@livemail.uthscsa.edu
Faculty mentor	Thomas Oates, DMD, PhD
Faculty mentor e-mail	OATES@uthscsa.edu
Basic Science Rationale (Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) None available
Comments and Evidence-Based Updates on the CAT (FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) None available