Comparison of clinical outcomes of immediate versus delayed placement of dental implants: A systematic review and meta‐analysis

Abstract

Objective: Two focused questions were addressed: Focused question (Q1) 1) Are there any differences between immediate and delayed placement in terms of (i) survival rate, (ii) success rate, (iii) radiographic marginal bone levels, (iv) height/(v)thickness of buccal wall, (vi) peri-implant mucosal margin position, (vii) aesthetics outcomes and (viii) patient reported outcomes? Focused question 2 (Q2) What is the estimated effect size of immediate implant placement for all parameters included in Q1? Materials and methods: An electronic search (MEDLINE, EMBASE, The Cochrane Central Register of Controlled Trials and OpenGray) and hand search were conducted up to November 2019. Randomised controlled trials (RCT) with delayed implant placement as controls were eligible in the analysis for Q1. Immediate dental implant arms RCTs, controlled clinical trials (CCTs) and prospective case series of immediate implant placement were eligible in the analysis for Q2.Results: Six papers (RCTs) were included in the analysis for Q1 and 53 papers ( 22RCTs, 11 CCTs and 20 case series) for Q2. Q1: Meta-analyses did not show any significant difference in implant survival, but it did for bone levels and PES scores at 1 year post-loading, favouring the immediate group. Q2: Meta-analyses showed that immediate implants had a high survival rate (97%) and presented high PES scores (range 10.36 to 11.25). Information regarding marginal bone loss and gingival/papillary recession varied among all included studies. Conclusion:Similar survival rate was found between immediate and delayed implants.Immediate implants presented threefold early complications and twofold delayed complications. Success criteria should be reported more consistently, and the incidence/type of complications associated with immediate implants should be further explored. Radiographic bone loss. (Mmesial, D-Distal) Gingival margin recession immediate (mm) PES immediate Papilla fill immediate Pat. Reported outcomes No No No No No M mean gain of 0.18 ± 1.38 mm, D mean gain of 0.34 ± 1.40 m Mean recession of 0.29 ± 0.74 mm 11.25 ± 1.36 at 5 years Mesial mean recession of 0.05 ± 0.64 mm and Distal 0.16 ± 0.63 mm, No 0.72 ± 0.13 (SE) No No No No MAX imp. 1.36 ± 0.78(SD). MND imp. 1.54 ± 0.91(SD).

Selection criteria for immediate implant placement and immediate loading for single tooth replacement in the maxillary esthetic zone: A systematic review and meta‐analysis

“…The estimated weighed mean overall survival rate for Type 1A protocols for single implants in the maxillary esthetic zone is 97.7%, which is consistent with other systematic reviews (Atieh et al, 2009;Cosyn et al, 2019;Gallucci et al, 2018;Garcia-Sanchez et al, 2022;Pommer et al, 2021;Slagter et al, 2014;Zhou et al, 2021).…”

Is alveolar ridge preservation an overtreatment?

“…Plasma rich in growth factors (PRGF) was the only grafting material that resulted in a higher percentage of more new bone formation than unassisted socket healing. 33 The use of bone grafts and substitutes for ARP assumes that they will act as an osteoconductive scaffold which will support blood clot stability during the early phases of healing and/or promote osteoinductive factors that will induce osseous formation by the differentiation of mesenchymal cells into osteoblasts. Ideally, bone grafts or bone substitutes should be progressively resorbed and substituted by the newly formed bone.…”

“…Nine out of the 34 investigated grafts, including the most extensively researched forms of xenografts (deproteinized bovine bone mineral with or without collagen) and allografts (FDBA) achieved significantly less new bone formation than the empty nongrafted sockets, while 25 grafting materials achieved similar amounts of new bone formation. Plasma rich in growth factors (PRGF) was the only grafting material that resulted in a higher percentage of more new bone formation than unassisted socket healing 33 …”

Critical review on bone grafting during immediate implant placement

“…Four months after implant placement, the horizontal crest dimension showed significant changes during healing mainly in the buccal aspect of the alveolar crest where this reduction was 1.1 mm (29%) in the test group and 1.6 mm (38%) in the control group, being more pronounced at sites in the anterior maxilla with thinner buccal bone wall. This study A recent systematic review 19 performed meta-analysis to assess the impact of grafting the gap between the implant surface and socket wall on implant survival rates. A survival range of 97%-98% was noted in the grafted group with follow-up periods ranging 2-5 years and a range of 94%-100% in the nongrafted group with follow-up ranging 2-10 years.…”