Apparently, there is an enduring adaptive process surrounding the implant which sustains the rigid interface between alveolar bone and implant after non-destructive surgical and loading procedures. Like other body bones, and according to Wolff’s law, bone has the ability to differentiate with different stresses applied [22]. This reform is started from the time of surgical conduction of implant and continued to support the implant to withstand the uploading forces [8, 9, 23–25]. Greater bone modification may occur at the alveolar bone around implants in partially edentulous patients [26, 27]. Roberts et al. [28] described the situation and the process as the ankylosed tooth which acts without bracing the attachment to bone and carries a heavy load. The adaptive modeling of endosseous implants, as a response to load, is a massive build-up of immature buttress-like skeleton which then decrease externally as the interior layers become more mature [28].

Like ankylosed tooth, implant-supported fixed prosthetic treatment might have a preservative effect on residual alveolar bone [29]. A radiographic-based quantitative study carried by Ichikawa et al. [30] displayed an improvement of bone density and bone formation related to load applied after a short period of implant service. With transmandibular implant, bone maintaining [18] or even formation and the highest increase in the bone were recorded [31]. The study for 146 patients with severely resorbed ridge treated with transmandibular implant denoted bone formation with all cases during follow-up period extended 51 months [32]. Within 9-year follow-up for 81 patients, Dhima et al. [33] denoted about 0.94 mm growth of bone. In a different study, peri-implant bone density grew around implants after 5 years of follow-up [34]. Even with questionable histological bony condition, as in the maxilla with sinus lifting, favorable bone density is noticed [35, 36]. Follow-up for more than 3 years for 44 installed fixtures revealed a consistent bone formation and elevation of lining sinus mucosa without bone graft. [37] This goes with the conclusion of Lundgren et al. [38] as the replaceable bone window allows bone formation with the implant after sinus lift.