This multicenter randomized controlled split-mouth study evaluated clinical conditions and marginal bone level changes after one year for hybrid versus moderately rough implants placed in the mandibles of periodontally compromised patients. The primary objective was to compare radiographic bone level change at one year using standardized radiographs.
The study was conducted at three centers and enrolled thirty-nine periodontally compromised patients. Each patient received both implant types in a split-mouth design: two tissue-level implants were placed in the mandible at premolar and molar sites, and healing caps were applied. After a 3-month healing period, implants were restored with fixed partial dentures (FPD).
Allocation to implant types was randomized within patients. The primary outcome measure consisted of radiographic assessments performed at the one-year follow-up. Standardized individualized X‑ray aiming devices were used to obtain reproducible radiographs for marginal bone level measurements.
Radiographic marginal bone levels were measured for mesial and distal pocket bone and mesial and distal proximal bone at baseline and at the one-year assessment. The change in bone level over time constituted the primary radiographic endpoint. Statistical comparisons between implant types were performed, with reported p-values for each measured site.
In total, thirty-nine patients were randomized to receive both implant types in a split-mouth fashion. Thirty-six patients completed the one-year follow-up; three patients did not complete the study. All implants were tissue-level designs from the same manufacturer groups described as hybrid and moderate rough. Implant placement was performed in premolar and molar mandibular sites, followed by a three-month healing period and subsequent restoration with FPDs.
The reported survival rate for both implant types at one year was 94.4% ± 3.8% (95% CI 87.0%–100%). The implants that were lost failed to achieve osseointegration. No difference in overall survival was reported between the two surface types at the one-year time point.
At one year, no statistically significant differences were found between hybrid and moderately rough implants for changes in bone level at any measured site. Reported p-values were:
These data indicate that within the first year after placement and loading, the two implant surface types produced comparable radiographic marginal bone behavior in this cohort of periodontally compromised patients.
The report includes reference to implant stability measurements over time (ISQ values), depicted in study figures. The full numerical ISQ data and their statistical comparisons were presented graphically in the original article. The study noted that the lost implants had not achieved osseointegration; no additional clinical outcome differences were reported between groups at one year.
The article includes several illustrative figures: images comparing the hybrid and moderately rough implants, scanning electron microscopy (SEM) imagery of implant surface type H, an individualized X‑ray aiming device used for standardized radiography, and a plot showing ISQ value development over time. These figures support the radiographic and stability assessments described.
After one year of follow-up, there were no statistically significant radiographic or clinical differences between hybrid and moderately rough implants in periodontally compromised patients treated in a split-mouth design. Both implant types achieved similar survival rates, and marginal bone changes did not differ significantly at measured sites.
The authors emphasize that peri-implant diseases may manifest after longer periods, and therefore longer-term follow-up is important before definitive recommendations about surface choice in this population can be made.
The presented results cover only the first year after implant placement and loading. The authors explicitly note that peri-implant disease often appears later than one year; extended observation is necessary to assess longer-term differences. A three-year evaluation was planned to provide further data. Details such as the exact number and reasons for the three non-completers and detailed per-patient bone changes were reported in the full article but are not elaborated here.
The authors declared no conflicts of interest for this trial.
References and identifiers available in the original publication include PMID 42494067, PMCID PMC13396534, and DOI 10.1111/cid.70172. The original trial was published in Clinical Implant Dentistry and Related Research, August 2026.