ABSTRACT Objective To evaluate the relationship between cone‐beam computed tomography (CBCT)‐derived bone microstructure parameters and marginal bone loss (MBL) around platform‐switched subcrestal implants over 1–8 years. Methods A retrospective analysis assessed 142 platform‐switched implants in 100 patients. CBCT‐based bone microstructure parameters—bone volume (BV), tissue volume (TV), bone volume fraction (BV/TV), bone surface (BS), bone surface fraction (BS/BV), trabecular thickness (Tb.Th), and trabecular separation (Tb.Sp)—were measured in peri‐implant and cervical regions. Radiographic MBL was evaluated at baseline (T0: prosthetic insertion) and follow‐ups (T1: 1–3 years post‐loading, T2: 3–8 years post‐loading). Associations between bone microstructure parameters and MBL were analyzed using Generalized estimating equations (GEE). Results GEE analysis of 142 implants from 100 patients, adjusting for covariates, linked baseline bone microstructure to MBL at T0, T1 and T2. No significant associations were found at T0 or T1 ( p > 0.05). At T2, cervical bone microstructure parameters were not significant. However, peri‐implant parameters were predictive: BV/TV was protective (B = −1.028, p = 0.0125), while BS/BV (B = 0.008, p = 0.0384) and Tb.Sp (B = 1.214, p = 0.0270) were significant risk factors for long‐term MBL. Conclusion Peri‐implant BV/TV, BS/BV and Tb.Sp might be critical predictors of long‐term MBL progression in platform‐switched subcrestal implants, while cortical bone thickness has limited impact. CBCT‐based bone microstructure analysis could aid MBL risk prediction and clinical management. Trial Registration This study has been registered in the Chinese Clinical Trial Registry, with the registration number ChiCTR2500098567
Dong et al. (Sun,) studied this question.