Background: Immediate implants are frequently employed in the anterior maxillary area. However, the installation of dental implants simultaneously with tooth extraction can also provide with benefits in the posterior areas with a reduction in time prior the recovery of the masticatory function. Results previously reported in the literature show high-survival and success rates for implants placed in extraction sockets in molar areas; however, this topic has received limited systematic analysis. Material and methods: Electronic and manual literature searches were performed by two independent reviewers in several databases , including MEDLINE, EMBASE, and Cochrane Oral Health Group Trials Register, for articles up to January 2019 reporting outcomes of immediate implants placed in molar areas. Primary outcomes included survival and success rates, as well as marginal bone loss. Secondary outcomes included the influence of implant position, type of implant connection, grafting protocol, flap or flapless approach, implant diameter, surgical phase, presence of buccal plate, and loading protocol. Results: Twenty studies provided information on the survival rate, with a total sample of 1.106 implants. The weighted mean survival rate of immediate implants after 1 year of follow-up was 96.6%, and the success rate was 93.3%. On the other hand, marginal bone loss was 1.29 ± 0.24 mm. Secondary outcomes demonstrated that grafting the gap and the loading protocol have an effect on survival and success rates. Similarly, the presence or absence of the buccal bone affect crestal bone levels. Meta-analysis of 4 investigations showed a weighted mean difference of 0.31 mm ± 0.8 IC 95% (0.15-0.46) more marginal bone loss at immediate implant placement versus implants in healed sites (p < 0.001) I 2 = 15.2%. Conclusion: In selected scenarios, immediate implant placement in molar extraction socket might be considered a predictable technique as demonstrated by a high survival and success rates, with minimal marginal bone loss.

Abstract:Diabetes is cons idered to be a genetica lly and environmenta lly based chronic metabolic and vascular syndro me cau sed by a partial or total insulin defici enc y with alt era tion in the metaboli sm ofl ipids, ca rboh ydrat es and prot eins culm inating wi th di fferent mani festat ion s in differ ent organ isms . In humans hyp erglycem ia is the main con sequence of defects in the secretion and/or action of insulin , and its deregulation can produce secondary lesio ns in various organs , especially kidneys , eye s, nerves, blood ve ssel s and immune systems , Periodo ntal d iseas e is an entity of loc ali zed infec tion that inv olves too th-supporting tissues.

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