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Statement of problem: Implant abutment connection may affect the stresses and strains induced at the peri-implant area and influence crestal bone resorption around implants at different levels of crestal placement. Materials and Methods: Implants were divided into two groups: internal hexagon (Legacy™ 2, Implant Direct) and conical hybrid connection (AnyRidge; MEGAGEN). Each group was further subdivided into three subgroups depending on the location of surgical placement (subcrestal, crestal, or supracrestal) of the implant platform. Each case was evaluated radiographically and linear measurements of bone resorption were made from the implant's apex to the first point of bone-to-implant contact at prostheses loading and after 6, 12, 24 and 36 months. Data were collected, tabulated and statistically analyzed using t Student test and ANOVA test followed by Tukey’s test. Results: No Statistical significant differences were found between the main tested two groups (P ≥ 0.05), however there were statistical significant differences between the position groups with the conical hybrid subcrestal group showing the lowest values of peri-implant bone after three years of prostheses insertion. Conclusions: Conical hybrid implant abutment connection showed less crestal bone resorption around implants than internal hexagon implant abutment connection in any position of placement. Subcrestal implant surgical positioning showed the less crestal bone resorption followed by supracrestal. Crestal implant positioning should be avoided whenever possible.

Three years follow up study of the effect of implant abutment connection on bone resorption around implants placed at different crestal levels