Immediate implant placement in molar extraction sockets: a systematic review and meta-analysis

Abstract

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.

Immediate implant placement in fresh extraction sockets

“…Unlike studies on drilling in healed alveolar ridges, many studies on implant placement in extraction sockets have focused on single-rooted teeth such as premolars and those found in the esthetic zone [10][11][12] . However, in recent years, many studies on IIP in fresh extraction sockets of molars have been performed [13][14][15] .…”

“…Bone grafting at the gap is recommended to improve bone contact to the implant surface and decrease gingival recession resulting from horizontal bone resorption 22 - 24 . Although, there is not enough evidence supporting the need for augmentation at the gaps and the kinds of augmentation procedures 25 , many studies have shown that bone grafting improves implant survival and success rates 15 .…”

Immediate implant in the posterior region combined with alveolar ridge preservation and sealing socket abutment: A retrospective 3D radiographic analysis

“…Replacement of a hopeless molar with a dental implant is one of the most frequent therapeutic modalities in implant dentistry 1 and this tooth replacement modality has shown predictable long‐term outcomes with high survival rates and successful results 2,3 . Because of the increased interest in shortening the overall treatment time and in order to reduce the invasiveness of surgical interventions, 4 immediate implant placement (Type 1) was proposed by several authors and different surgical protocols have been explored 5‐7 . Although immediate implant placement in molar areas has shown high survival rates of 96.6% 7 clinical data from literature remains limited.…”

“…Because of the increased interest in shortening the overall treatment time and in order to reduce the invasiveness of surgical interventions, 4 immediate implant placement (Type 1) was proposed by several authors and different surgical protocols have been explored 5‐7 . Although immediate implant placement in molar areas has shown high survival rates of 96.6% 7 clinical data from literature remains limited. To add to that, immediate implant placement does not counteract the post extraction bone resorption as widely described in the literature 8‐12 while alveolar ridge preservation (ARP) techniques with the use of space filling biomaterials have proven to significantly limit bone remodeling after extraction and preserve, at least partially, the contour of the alveolar ridge 13 .…”

Biological Oriented Immediate Loading: A New Mathematical Implant Vertical Insertion Protocol, Five-Year Follow-Up Study

“…The immediate loading after tooth extraction was introduced in 1976 as an alternative to the classic delayed implant placement described by Branemark [ 2 ], and it is widely described in literature [ 3 , 4 ]. This procedure seems to preserve the integrity of the socket itself [ 5 ], providing favorable results with outcomes similar to implants placed in healed edentulous ridge [ 6 ].…”