Immediate Implant Placement in Damaged Extraction Sockets

A study published in Quintessence International found outcomes of immediate implant placement in damaged extraction sockets comparable to conventional implant placement.

This study aimed to observe whether immediate implant placement (IIP) into damaged extraction sockets is a successful modality for treating hopeless teeth that require extraction. An electronic search was carried out through four databases (PubMed/MEDLINE, Web of Science, Scopus, and ScienceDirect) to identify randomized controlled trials (2013-2023) to understand whether IIP in damaged sockets is a successful treatment. The focus question was, 'In a patient with a hopeless tooth that needs extraction with the indication for dental implant treatment, is IIP in damaged extraction sockets, compared to undamaged sockets or healed sites, an effective method for the replacement of hopeless teeth and achieving a favourable clinical result?'

Study Findings

The risk of bias was appraised and a meta-analysis using random effect was applied. Five studies with 135 patients and 138 implants were included. The implant survival rate was 100% for all studies and periods evaluated; the pink esthetic score (PES) scores had no statistically significant result for all articles that evaluated this parameter; two studies reported the soft tissue changes: one found no significant differences and the other showed that the test group experienced reduced soft tissue loss at the 1-year evaluation (measured with digital intraoral scanners); other two studies assessed the marginal bone loss, presenting no differences between groups.

The meta-analysis showed homogeneity between the studies. There was an equilibrium among the groups in the various studies included, and age tended to be lower in the test group. The buccal bone tissue and the pink esthetic score showed favouritism for the test group but without statistical significance. This study suggests that IIP in the presence of buccal bone defects can achieve comparable clinical and radiological outcomes to traditional methods in the short term of the limited studies available. The buccal aspect is not possible to be evaluated through radiographs. Bone regeneration was essential to reach optimal results. It is important to emphasize that IIP requires adherence to rigorous criteria to ensure functionally acceptable results.

Reference

Campi M, Leitão-Almeida B, Pereira M, Shibli JA, Levin L, Fernandes JCH, Fernandes GVO, Borges T. Immediate implant placement in damaged extraction sockets: a systematic review and meta-analysis of randomized controlled trials. Quintessence Int. 2024 Oct 1;0(0):0. doi: 10.3290/j.qi.b5768294. Epub ahead of print. PMID: 39351790.