Purpose: This research was aimed to study tooth implant splinting concept as aprosthetic treatment planning for mandibular distal extension precision attachment RPD. Radiographic evaluation of supporting alveolar bone.  Materials and Methods: 5 patients of completely edentulous maxillary arch against mandibular bilateral distal extension ridges were selected for mesial implant placement at first premolar area utilizing 2 stage surgical protocol. After 3 months the healing abutment was attached correctly to fixture. Full crown preparation for tooth abutment then implant level impression was made. On the cast preparation of implant abutment by milling technique was done. Splinted crowns with patrix of extracoronal attachment were constructed. Altered cast impression technique was made utilizing metallic RPD framework. After processing the partial denture, plastic matrix of light retention was inserted and picked up functionally during cementaion of splinted crowns. Crestal alveolar bone height change of splinted abutment and distal extension ridge were radiographically evaluated immediately before and after 6, 12 months of denture insertion. Results: 1) Crestal alveolar bone height change including tooth and implant splinted abutments and distal extension ridge showed significant resorption along the interval periods of study. 2) There is no significant difference in crestal alveolar bone height change when comparing the mesial surface to the distal surface of abutment tooth. Alternatively, the distal surface of implant abutment exhibited a significant increase in crestal alveolar bone resorption compared to mesial one along the interval period of study. 3) Distal part of the ridge exhibited greater crestal alveolar bone resorption than mesial part. 4) Abutment teeth were found less alveolar bone resorption compared to either implant or ridge after 12 months of denture insertion. Conclusions:1) The splinted abutment canine was preserved with implant assisted vario-stud snap extracoronal attachment RPD regarding alveolar bone height change.  2) Although vario-stud snap extracoronal attachment with shear distributor that direct force along the long axis of splinted abutment, tooth implant splinting concept was not to preserve crestal implant alveolar bone from resorption.