Immediate implant placement with or without socket grafting: A systematic review and meta‐analysis

Abstract

Objectives: To assess the effect of grafting the gap (SG) between the implant surface and alveolar socket on hard and soft tissue changes following single immediate implant placement (IIP).Materials and Methods: Two independent reviewers conducted an electronic literature search in Pubmed, Web of Science, Embase and Cochrane databases as well as a manual search to identify eligible clinical studies up to August 2021. Randomized controlled trials (RCTs) comparing IIP with and without SG were included for a qualitative analysis. Meta-analyses were performed when possible.Results: Out of 3627 records, 15 RCTs were selected and reported on 577 patients who received 604 single immediate implants (IIP + SG: 298 implants in 292 patients; IIP: 306 implants in 285 patients) with a mean follow-up ranging from 4 to 36 months. Two RCTs showed low risk of bias. Meta-analysis revealed 0.59 mm (95% CI [0.41; 0.78], p < 0.001) or 54% less horizontal buccal bone resorption following IIP + SG when compared to IIP alone. In addition, 0.58 mm (95% CI [0.28; 0.88], p < 0.001) less apical migration of the midfacial soft tissue level was found when immediate implants were installed with SG. A trend towards less distal papillary recession was found (MD 0.60 mm, 95% CI [À0.08; 1.28], p = 0.080) when SG was performed, while mesial papillae appeared not significantly affected by SG. Vertical buccal bone changes were also not significantly affected by SG. Insufficient data were available for meta-analyses on horizontal midfacial soft tissue changes, pink esthetic score, marginal bone level changes, probing depth and bleeding on probing.Based on GRADE guidelines, a moderate recommendation for SG following IIP can be made.Conclusion: SG may contribute to horizontal bone preservation and soft tissue stability at the midfacial aspect of immediate implants. Therefore, SG should be considered as an adjunct to IIP in clinical practice.

Immediate implant placement with or without immediate provisionalization: A systematic review and meta‐analysis

“…Recent meta‐analyses showed 0.58 and 0.41 mm less apical migration of the midfacial mucosa when combining IIP with grafting the buccal bone gap and CTG, respectively (Seyssens et al, 2021, 2022). The positive impact of IP on midfacial soft tissue level seems slightly higher, yet this should be interpreted with caution since the mean difference of 0.87 mm in favour of IP was only based on two RCTs.…”

“…Grafting the gap between the alveolar socket and implant with a bone replacement graft has been more extensively studied. A recent meta‐analysis based on four RCTs showed 0.58 mm less apical migration of the midfacial mucosa when grafting of the buccal bone gap was performed in conjunction to IIP (Seyssens et al, 2022). Essentially, grafting of the buccal bone gap is an alveolar ridge preservation procedure resulting in 0.59 mm or 54% less horizontal buccal bone resorption when compared to IIP alone (Seyssens et al, 2022).…”

Effect of the buccal gap width following immediate implant placement on the buccal bone wall: A retrospective cone‐beam computed tomography analysis

“…Grafting of the gap using deproteinized bovine bone mineral (DBBM) significantly reduces the bone dimensional changes that occurs following IIP. 12,14,16,19 The dimension of the buccal gap has been evaluated in previous studies. 9,10,16,20,21 These studies were, however, performed mostly, if not, only in premolar sites.…”

Buccal bone thickness assessment for immediate anterior dental implant planning: A pilot study comparing cone‐beam computed tomography and 3D double‐echo steady‐state MRI

“…However, a recent systematic review on this topic suggests that socket grafting is more beneficial when a thin buccal bone wall is present, whereas in the context of immediate implant planning, it is especially beneficial when horizontal bone preservation is sought at sites with a thin buccal bone wall. With regard to gap dimension on horizontal buccal bone resorption after performing immediate implants, there are controversial data suggesting potential benefit or no benefit in large horizontal gaps, while socket grafting is not considered to be able to reduce vertical bone changes 44 . However, based on recent research data, socket grafting is recommended in clinical practice as complement to immediate implant placement to preserve horizontal bone and stabilize soft tissue in the midfacial aspect of immediate implants.…”