Bone-level implant
Also known as: Bone level implant, BL implant
An implant designed so that its platform, and therefore the implant–abutment interface, sits at or close to the crestal bone, with the transmucosal portion formed by a separate abutment.
Key facts
| Classification | A two-piece design in which the implant–abutment connection is positioned at the bone crestVerified spec[1] |
|---|---|
| How it differs | Differs from a tissue-level implant, in which an integral transmucosal collar holds the implant–abutment interface away from the bone, at soft-tissue levelVerified spec[1] |
| Typical use | Commonly chosen where the vertical position of the restoration margin needs to be controlled separately from the position of the implant body — for example in the visible upper front region, where the abutment can be selected after healing. |
| Clinical evidence | In most studies included in a 2020 systematic review, the difference in marginal bone loss between bone-level and tissue-level implants was not statistically significant over one to five yearsClinical evidence |
| Limitations | Because the joint between implant and abutment sits at or near the crest, the microgap and the connection are close to the bone. That proximity is the mechanism usually proposed for early crestal remodelling, and it is why platform switching is discussed most often in relation to bone-level designs. |
| Terminology | The literature uses "bone-level", "two-piece" and "submerged" almost interchangeably, but they describe three different things: bone-level is a platform position, two-piece is a component count, and submerged is a healing protocol. |
Overview
A bone-level implant is one whose top sits level with the bone rather than protruding through the gum, so the connection to the crown is made by a separate abutment fitted afterwards. The practical appeal is control: the restorative dentist chooses the height, angle and emergence of the abutment once healing has settled, which matters most where the gum line is visible. The trade-off usually discussed is that the implant–abutment joint sits close to the bone crest, and it is that proximity — not the material or the brand — that the platform switching literature is concerned with. It is worth separating two claims that are often merged: that bone-level and tissue-level designs place the connection in different places, which is a design fact, and that one produces less bone loss than the other, which is a clinical question. On the second, a 2020 systematic review found no statistically significant difference in most of the studies it included.
Sources
Numbers match the citations beside each claim above.
Clinical evidence
- [1]Radiological Outcomes of Bone-Level and Tissue-Level Dental Implants: Systematic Review — International Journal of Environmental Research and Public Health (PMC), 2020. Accessed 2026-07-21.