Anatomical Remodeling of Buccal Bone Plate in 35 Premaxillary Post-Extraction Immediately Restored Single TPS Implants: 10-Year Radiographic Investigation

Effectiveness of immediate implant placement into defective sockets in the esthetic zone: A systematic review and meta-analysis

STATEMENT OF PROBLEM

A defective socket is common after tooth extraction in the esthetic zone, but whether an implant can be immediately placed in a defective socket is unclear.

PURPOSE

The purpose of this systematic review and meta-analysis was to summarize relevant studies within the last 20 years on implant survival and changes in soft and hard tissues after immediate implant placement in esthetic areas with socket defects.

MATERIAL AND METHODS

A search was conducted for the relevant studies in the PubMed/Medline, the Cochrane Library, Web of Science, and Embase databases from January 2000 to March 2022. The literature review, data retrieval, and judgment whether the included studies had a risk of bias were handled independently by 2 reviewers, and a single-arm meta-analysis was performed using a statistical software program.

RESULTS

A total of 23 studies evaluating the immediate implant placement of 630 implants (9 studies without a flap and 14 studies with a flap) were included. A 98.1% implant survival rate (95% confidence interval (CI): 96.2%, 100.0%) was determined. Marginal bone loss (MBL) at 6, 12, and ≥24 months were 1.03 mm (95%CI: 1.02, 1.03), 0.72 mm (0.72, 0.73), and 1.15 mm (1.14, 1.16). Gingival recession at 12 months was 0.25 mm (95%CI: 0.17, 0.33). The pink esthetic score (PES) were 12.34 (95%CI: 12.16, 12.52) at 12 months and 12.58 (12.39, 12.76) at ≥24 months.

CONCLUSIONS

Current evidence shows that immediate implant placement into defective sockets in esthetic areas is feasible. Immediate implant placement can have a relatively good therapeutic effect in terms of implant survival rate, MBL, gingival recession, and PES.

Effect of Different Timings of Implant Insertion on the Bone Remodeling Volume around Patients' Maxillary Single Implants: A 2-3 Years Follow-Up

Background: To investigate the middle-term effect on bone remodeling of different timings for different implant placement (immediate versus delayed). Methods: Patients with an anterior maxillary failing tooth were treated by single-crown supported by dental implant. Subjects were retrospectively analyzed for 3 years and assigned to one of two predictor groups: nine immediate versus 10 delayed implant placement (1-2 months after tooth extraction). The crestal bone loss around dental implants was measured with the cone beam computerized tomography by fusing pre-operative and post-operative data. Results: The percentage of volume loss registered at 1-year follow-up (%ΔV) was of 7.5% for the immediate group, which was significantly lower (p-values ≤ 0.0002) than the loss of 24.2% for the delayed group. At 3 years, there was a significant difference (p-values = 0.0291) between the two groups, respectively, with a volume loss of 14.6% and 27.1%. When different times were compared, the percentage of the volume loss for the immediate group was different (p-value = 0.0366) between the first and third year (7.5% and 14.6%, respectively). For the delayed group, no significant difference was registered between the 1- and 3-year follow-up. Conclusions: The bone loss around dental implant-supported single-crown with different timing of insertion appeared higher for the delayed group than the immediate group.

Bone response after immediate placement of implants in the anterior maxilla: a systematic review

PURPOSE

The objective of this systematic review was to assess the three-dimensional changes in bone tissue after immediate installation of a single implant in a fresh extraction socket in the anterior maxilla.

METHODS

After defining a strategy, an electronic search was carried out using the databases PubMed, Embase, LILACS, Web of Science, Cochrane, and Scopus. In addition, the gray literature was also researched using Google Scholar and ProQuest. Two reviewers independently screened for eligible studies, assessed the methodological quality, and extracted the data. The inclusion criteria were observational studies and experimental studies that assessed bone response after the immediate installation of a single implant in a fresh extraction socket, immediately loaded or not, in the region between the maxillary canines. Studies were included in any language, with no publication date restrictions and with a minimum of 6 months of follow-up after the surgical procedure.

RESULTS

From a total of 3272 articles, only 12 studies met the inclusion criteria and were selected for the review. Bone remodeling after immediate installation of a dental implant was assessed using standardized periapical radiographs and cone beam computed tomography (CBCT).

CONCLUSION

It can be concluded that bone remodeling occurs after tooth extraction and immediate implant installation.

Rehabilitation of Postextractive Socket in the Premaxilla: A 12-Year Study on 27 Titanium Plasma Spray Resorbable Calcium Phosphate Coated Single Implants

OBJECTIVES

The purpose of this study was to evaluate the peri-implant bone tissue level on postextractive resorbable calcium phosphate coated single implants placed in premaxillary sites grafted with autologous bone, anorganic bovine bone (ABB), platelet-rich plasma (PRP), and keratinized epithelial connective graft over 12 years.

MATERIALS AND METHODS

A total of 27 patients received a postextractive single implant in premaxillary sites grafted with ABB and PRP. Two months later, a keratinized epithelial connective graft was applied and the implants loaded. Clinical and radiographical evaluations were performed at baseline, 6 and 18 months, 4 and 6 years after the implant insertion, and then every 2 years up to the 12th year.

RESULTS

After 12 years, a total of 22 implants (81.48%), were available for the final data analysis; the implants achieved a 100% cumulative survival rate, and only a mild degree of periodontal tissue inflammation was recorded. The radiographic evaluation revealed a physiological marginal bone remodeling over the follow-up.

CONCLUSION

Although a good preservation of the residual bone tissue in postextraction implant sites treated with keratinized epithelial connective tissue grafts was observed, the low number of treated cases does not allow us to propose this experimental protocol to all cases of bone defects but it certainly represents a new option. Further studies on a greater number of patients and using implants with different surface characteristics should be conducted for a better understanding of the indications of the proposed treatment.