Ten patients, seven females, and three males, aged 42.4 ± 11.99 years (range, 28 to 64 years), with either a first mandibular or second mandibular molar edentulous area, who required a single nonsubmerged implant participated in this study, as shown in Table 2. The implants used for all patients were 10 mm long and 5 mm in diameter. All patients completed the follow-up. None of the implants failed during the study period.

The mean ISQ values were shown in Table 3. There was a statistically significant decrease in the mean ISQ values between 1 and 3 weeks (P < 0.05). The ISQ values recovered to the initial ISQ values at 4 weeks and slight increased at 6, 8, 10, and 12 weeks (Fig. 2). There was a significant increase in the mean ISQ values at 6, 8, 10, and 12 weeks when compared with 3 weeks. The mean lowest ISQ values, recorded at 1 week, were 65.6 ± 2.70. According to the independent samples t test, there were no statistically significant differences in the mean ISQ values with gender and bone quality.

The median values of the GCF and PICF volume are shown in Table 4. At the implant site (test group), the PICF volume continuously decreased with time (Fig. 3). However, according to the Friedman test, there were no significant differences in the median values of the crevicular fluid volume in the control or the test group at each measurement. Both ALP and OC molecules were detectable in GCF and PICF samples. The median values of the ALP and OC levels are shown in Table 5. In the control group, there was no significant difference in the ALP or the OC levels at each measurement. In the test group (implant site), the ALP level decreased at 1–4 weeks and then increased at 6, 8, 10, and 12 weeks (Fig. 4). However, according to the Friedman test, there was no statistically significant difference in the ALP level of the test group at each measurement. Furthermore, according to the Mann-Whitney U test, there was no statistically significant difference in the ALP level between the control and the test group at each measurement.

At the implant site, the OC level continuously increased with time. According to the Friedman followed by Wilcoxon signed-rank tests, there was statistically significant increase in the OC level at 6, 8, 10, and 12 weeks when compared with 1 week (P < 0.05, Fig. 5). Furthermore, according to the Mann-Whitney U test, there was a statistically significant difference in the OC level between the control and the test group at 6, 8, 10, and 12 weeks.

Correlations between ALP or OC levels and ISQ values were examined, as shown in Figs. 6 and 7. During 1–12 weeks, there was a statistically significant correlation between ALP levels at the implant site and ISQ values (r = 0.226; P < 0.05). There was a statistically significant correlation between OC levels at the implant site and ISQ values at 1–12 weeks (r = 0.245; P < 0.05). Correlations between ALP and OC levels are shown in Fig. 8. At all measurements from week 1 to week 12, the ALP levels were moderately correlated with the OC levels at the implant site, the control site, and the pooled samples of the control and implant sites (r = 0.615, 0.602, and 0.521, respectively, P < 0.001).