Objectives: The aim of this article is to review the current state of immediate implants, with their pros and contras, and the clinical indications and contraindications.
Material and Methods: An exhaustive literature search has been carried out in the COCHRANE library and MEDLINE electronic databases from 2004 to November 2009. Randomized clinical trials and clinical trials focused on single implants placed in fresh extraction sockets were included and compared. A meta-analysis could not be performed due to heterogeneity of the data.
Results: Twenty studies out of 135 articles from the initial search were finally included, which summed up a total of 1139 immediate implants with at least a 12-month follow-up. Our results have been compared with other current available papers in the literature reviewed that obtained similar outcomes.
Discussion: Immediate implants have predictable results with several advantages over delayed implant placement. However, technical complications have been described regarding this technique. Also, biomaterials may be needed when the jumping distance is greater than 1mm or any bone defect is present.
Conclusions: Few studies report on success rates rather than survival rates in the literature reviewed. Short-term clinical results were described and results were comparable to those obtained with delayed implant placement. Further long-term, randomized clinical trials are needed to give scientific evidence on the benefits of immediate implants over delayed implant placement.
Key words:Immediate implants, fresh socket, dental implants, gap, jumping distance, implant stability.
When comparing ridge preservation with NH, only 3 studies encountered a greater amount of newly formed bone in the ridge preservation group, whereas the rest did not find statistically significant differences or even observed a greater percentage of newly formed bone in the control group. Therefore, more studies are needed to determine whether the use of graft materials enhances new bone formation in contrast to NH alone and to determine the most effective bone grafting material.
Immediate loading did not impair early stages of bone healing and crestal bone modelling at two-piece implants in fresh extraction sockets in the beagle dog; however, bone resorption occurred in all specimens in both groups.
Background
Many studies have addressed socket preservation, though fewer publications considering buccal wall loss can be found, since the literature typically considers sockets with four walls. A systematic review was made on the influence of type II buccal bone defects, according to Elian’s Classification, in socket grafting materials upon volumetric changes in width and height.
Material and Methods
An electronic and manual literature search was conducted in accordance to PRISMA statement. The search strategy was restricted to randomized controlled trials (RCTs) and controlled clinical trials (CCTs) describing post-extraction sockets with loss of buccal wall in which alveolar ridge preservation (ARP) was carried out in the test group and spontaneous healing of the socket (SH) was considered in the control group.
Results
The search strategy yielded 7 studies. The meta-analysis showed an additional bone loss of 2.37 mm in width (
p
> 0.001) and of 1.10 mm in height (
p
> 0.001) in the absence of ARP. The reconstruction of the vestibular wall was not evaluated in any study. The results also showed moderate to great heterogeneity among the included studies in terms of the changes in width and height.
Conclusions
Despite the heterogeneity of the included studies, the results indicate a benefit of ARP versus SH. Further studies are needed to determine the volumetric changes that occur when performing ARP in the presence of a buccal bone wall defect.
Key words:
Alveolar ridge preservation, buccal wall defect, volumetric changes, bone loss, meta-analysis.
This case report shows the possibility of achieving partial soft tissue coverage over an implant-supported restoration with the combined use of an acellular dermal matrix and a coronally positioned flap. A novel technique is presented that allowed advancing the flap over the graft in a single-tooth restoration where enough keratinized tissue was present preoperatively.
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