Immediate implants following tooth extraction. A systematic review

Abstract

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.

Comparative Evaluation of Clinical and Radiological Outcomes of Immediate and Delayed Dental Implant Rehabilitation: A Prospective Study

“…Most papers contained only data on implant loss, but did not provide useful information on implant failure or hard and soft tissue changes. Their data match the results of the present review, in which most of the articles reported data on implant survival rates but not on implant success rates, according to the criteria described by Albrektsson et al 7 Depending on the degree of damage of the extraction socket and of the shape as well as the diameter of the extracted root, some portion of the implants could remain exposed and/or there might remain a residual gap between the implant and the bony wall. Since alveolar bone will remodel after tooth extraction, the degree of bone resorption is difficult to predict and could leave some portion of the implants exposed, determining a poor esthetic outcome.…”

“…6 Over time, clinical experience has provided the criteria for immediate implant treatment success: atraumatic tooth extraction, sterilization and minimal invasive surgical approach, as well as implant primary stability. 7 Quirynen et al focused their review on immediate vs delayed implant placement. Most papers contained only data on implant loss, but did not provide useful information on implant failure or hard and soft tissue changes.…”

“…The survival rates of postextraction implants are high and comparable with those of implants placed in healing sites. 7,11 A few reviews [3][4][5] evaluating the efficacy of immediate implants have been published over the years, but so far evidence was inconclusive. It would be of great benefit to know whether the number of surgical sessions, treatment time, and patient discomfort may be reduced using immediate implants without compromising on the success of the implant therapy.…”

“…Smaller distances could heal spontaneously. 7,14 Based on review of the literature tackled, immediate implant placement following tooth extraction might be a viable alternative to delayed placement. However, it requires a careful case selection and a specific treatment protocol because it is a very sensitive technique and more difficult to execute than a conventional protocol.…”

Peri-implant bone changes in immediate and non-immediate root-analog stepped implants—a matched comparative prospective study up to 10 years

“…They as well as Ortega-Martínez et al clearly demand more studies evaluating the bone situation for the future [28]. This question was the motivation for our study.…”