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Objectives: To compare the impact of immediate and delayed implant placement upon the survival of implants and to investigate the differences in implant survival between immediate and delayed placement in adults. Methods: A search for the relevant literature was performed using the databases of CENTRAL, MEDLINE and Scopus. The studies found were limited to publications between 2014 and 2022, written in the English language, peer-reviewed, and were randomised trials or comparative studies. The quality of the evidence was assessed using the Cochrane Risk of Bias 2.0 and Risk of Bias in Non-randomised Studies—of Interventions appraisal tools and implant survival, and the primary outcome was meta-analysed using RevMan v.5.3. Results: A total of 10 studies were eligible for inclusion, including six randomised controlled trials and four non-randomised comparative studies. Five of the six randomised trials observed a low risk of bias, while the comparative studies had a moderate-to-serious risk of bias. The search strategy resulted in 341 implants placed immediately into fresh extraction sites (332 survived, 97.4%) and 359 implants inserted into delayed sites (350 survived, 97.5%). Conclusion: The meta-analysis demonstrated that there was no significant difference in the implant survival rates between immediately placed implants and implants placed using a delayed timing protocol (risk ratio 0.99; 95% CI 0.96, 1.02, Z = 0.75, p = 0.45). However, the detailed analysis showed that slightly more implant failures happened in the immediate dental implant placement group, with survival rates in some studies ranging between 90 and 95%, while the delayed placement group had survival rates of more than 95%.

Objective: To explore the use of Cone Beam Computed Tomography to evaluate morphometric properties of the Inter-Radicular Septum in maxillary first and second molar region. Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Dentistry, Combined Military Hospital, Rawalpindi Pakistan, from Jul to Dec 2023. Methodology: Cone Beam Computed Tomography scans of 177 patients, recruited via consecutive sampling technique were obtained and analyzed using NEWTOM software. Patients falling in the age range of 18-65 years, having first and second maxillary molars were included. The Inter-Radicular Septum morphometric properties of maxillary first and second molars were evaluated in coronal and axial plane. Inter-Radicular Septum widths and areas of M1 and M2 were compared at different levels by applying ANOVA/Kruskal Wallis test based upon data normality Results: Out of 177 patients, 118(66.7%) were males, while 59(33.3%) were females with mean age 40.49±1.33 years. Frequency of arrow shape of molars (M1&M2) was highest [119(67.2%) and 136(76.8%) respectively]. Mean difference of Inter-Radicular Septum widths across all levels was significantly varied with respect to shapes of Molar 1 and Molar 2 as well (p<0.05). Boat shape of molar 1 & 2 had greatest furcation angle (60.14+12.85 and 56.12+11.01 respectively) and the mean difference was significant across different IRS shapes (p<0.001 and p=0.034 respectively). Inter-Radicular Septum surface area required for implant placement was most prominent in buccal convergence shape in maxillary first molar and boat shape in maxillary second molar. Conclusion: Cone Beam Computed Tomography image analysis can serve as a  ..

Background Immediate implant placement in posterior teeth has become popular in recent years. However, only a few studies focused on evaluating the long-term success of immediate implant placement. Purpose To analyze the clinical outcomes of immediate implant placement in the posterior region with conventional loading with 3–5 years follow-up following the International Congress of Oral Implantologists (ICOI) Pisa Consensus Conference. Method The study was done in 25 bone-level implants (Straumann® SLActive® bone level tapered implant, Straumann®, Basel, Switzerland) in 19 patients who underwent immediate implant placement in a posterior tooth with conventional loading with 3–5 years follow-up. The overall success and survival of these placements were evaluated following the International Congress of Oral Implantologists (ICOI) Pisa Consensus Conference using chart records, clinical examination, radiographic evaluation, and outcomes measurement. Patient satisfaction was evaluated by using a numeric rating scale. The biological and technical status, modified Pink Esthetic Score (mPES), complications, and marginal bone change were also evaluated. The analysis was done using SPSS version 21 (SPSS Inc., Chicago, IL, USA). The data were analyzed using a paired samples t-test. Results It was found that 24 out of the 25 (96%) dental implants survived for an average of 57 ± 8.07 months. All of the 24 surviving dental implants were considered an operational success. The average mPES was 9.75 ± 0.44. The major prosthetic complications seen were: (1) proximal contact loss (41.67%), (2) loosening of the screw (8.33%), and (3) cement debonding (4.17%). Conclusions Immediate implant placement in a posterior tooth with conventional loading yields a predictable result with some complications. The most prominent complications were proximal contact loss, followed by loosening of the screw and cement debonding. The implant survival rate was 96% at a mean time follow-up of 4 years and 9 months.

Purpose This study aims to evaluate the clinical and radiographic outcomes of immediate versus delayed placement of 6–7 mm diameter implants in molar extraction sites. Materials and methods In this retrospective study, 46 patients requiring single implant restoration in the mandibular molar region were enrolled and divided into two groups: Immediate placement (IP) ( n  = 22) received immediate implant placement with Bio-Oss grafting, while Delayed placement (DP) ( n  = 24) underwent delayed implantation 4 months post-extraction following Secondary intention healing. All implants were submerged for 4 months before prosthetic loading, which was performed 4–6 months after implant placement.Primary outcome measures included primary and secondary implant stability (assessed via resonance frequency analysis, implant stability quotient [ISQ] values), buccal bone plate width, marginal bone level (MBL) changes, and peri-implant probing depth (PPD). All outcomes were assessed at four time points: immediately after implant placement, at 3 months, 6 months, and 12 months postoperatively. Results All 46 patients completed the 1-year follow-up with no reported implant or prosthetic failures. The Immediate placement (IP) demonstrated significantly lower insertion torque (mean: 25 ± 3.5 N·cm, range: 15–35 N·cm) compared to the delayed group (DP); mean: 35 ± 4.5 N·cm, range: 25–45 N·cm) ( p  = 0.021). However, no significant differences were observed in secondary stability at 6 months (IP): 77.8 ± 3.5 vs. (DP): 78.6 ± 3.4, p  = 0.521) or 12 months (IP): 78.7 ± 3.3 vs. (DP): 78.8 ± 3.6, p  = 0.649). Buccal bone plate thickness showed no significant differences between groups at 6 months (1.8 ± 0.23 mm vs. 1.7 ± 0.17 mm, p  = 0.510) or 12 months (1.7 ± 0.18 mm vs. 1.6 ± 0.12 mm, p  = 0.429). Marginal bone loss at 12 months was 0.15 ± 0.06 mm in (IP) and 0.12 ± 0.04 mm in (DP), with no statistically significant difference between the groups ( p  = 0.478 ). PPD was similar between groups (IP: 2.3 ± 0.27 mm vs. DP: 2.5 ± 0.24 mm, p  = 0.653). Conclusion Immediate placement of wide-diameter implants in mandibular molar regions demonstrated a 100% survival rate and favorable clinical outcomes comparable to delayed implantation over a 1-year follow-up period. The use of Bio-Oss bone grafting in immediate implantation appears beneficial for bone preservation. These findings suggest that immediate placement of wide-diameter implants can achieve clinical outcomes equivalent to delayed protocols in selected cases.

Objective: This review article aims to analyze the existing relevant literature comparing the clinical outcomes and underlining the most common complications associated with immediate, early, and delayed dental implant placement in order to determine the most favorable timing for achieving optimal functional and esthetic results for the patient. Methods: A comprehensive review of the literature was conducted using PubMed-MEDLINE and Cochrane Library and a number of keywords, including “dental implant placement timing”, “immediate implant”, “early implant”, “delayed implant”, “clinical outcomes”, “complications”, and “implant success”, focusing on studies comparing immediate, early, and delayed implant placement. The primary outcome variable was implant survival rate, while secondary outcome variables included implant success rate, complications, and patient-reported outcomes. Results: A total of 9774 articles were identified. The articles included a variety of studies, including randomized controlled trials, prospective cohort studies, and retrospective studies. Immediate implant placement was associated with a high survival rate (93.8–100%), but also with an increased risk of complications, such as gingival recession and implant exposure. Early implant placement (4–8 weeks or 12–16 weeks after extraction) showed similar survival rates (95–100%) and fewer complications compared with immediate placement. Delayed implant placement (more than 4 months after extraction) was the most commonly used protocol and demonstrated high survival rates (92–100%) with predictable outcomes. Implant success rates varied depending on the criteria used, but all types of placements showed acceptable success rates (83.3–100%). The choice of loading protocol (immediate, early, or conventional) also influences treatment outcomes. Conclusions: The timing of dental implant placement and loading should be individualized based on patient-specific factors, such as bone and soft tissue conditions, medical history, esthetic considerations, and patient preferences. Immediate placement can be successful in ideal conditions but requires careful patient selection and surgical expertise. Early and delayed placement offer more predictable outcomes and are suitable for a wider range of patients.

Introduction: Immediate implant placement (IIP) has become an attractive treatment for many patients. It reduces time and the number of appointments and protects soft and hard tissue, which, in many circumstances, leads to a better esthetic outcome. IIP with provisionalization (IIPP) may contribute to a more promising result due to the guidance of soft tissue and the preservation of the hard tissue. Indications for IIPP are quite strict, and cone beam computed tomography (CBCT) is a must for case selection. Objective: This case report will demonstrate how IIP with immediate provisionalization can result in a high esthetic outcome and no discomfort for the patient. Case presentation: A 50-year-old female presented for implant placement following the extraction of a superior central incisor due to a vertical fracture. IIPP has been used. Conclusion: IIPP can accomplish a stable esthetic result in the case of ideal three-dimensional implant positioning, a well-polished provisional restoration with an S-shaped buccal emergence profile, and by respecting the mesial and distal embrasure spaces for papilla maturity.

Computer-aided implantology has developed rapidly in recent years, this study aimed to compare the accuracy of guided-surgery between anterior immediate and delayed implantation, and simultaneously assess the effect of full-guided and half-guided templates on accuracy values. Seventy-six implants were inserted in 63 patients using full-guided or half-guided template in the anterior zone. Postoperative cone beam computed tomography (CBCT) was matched with preoperative planning to evaluate the deviation between actual and planned implants. No statistical difference was found in any deviation between immediate and delayed implantation (p > 0.05). In anterior immediate implantation, the global coronal, apical, depth and angular deviations of full-guided templates were all significantly lower than those of half-guided templates (0.66 ± 0.26 vs. 1.10 ± 0.76 mm, 0.96 ± 0.41 vs. 1.43 ± 0.70 mm, 0.46 ± 0.24 mm vs. 0.93 ± 0.79 mm and 1.69° ± 0.94° vs. 2.57° ± 1.57°). While in delayed implantation, full-guided templates only perform better with statistical significance on global apical and depth deviation (1.01 ± 0.42 vs. 1.51 ± 0.55 mm and 0.32 ± 0.26 vs. 0.71 ± 0.47 mm). After excluding the influence of depth deviation, the coronal and apical deviations between the two systems in immediate implantation and the apical deviations in delayed implantation had no statistical difference. Within the limit of this study, the results suggested the accuracy of guided-surgeries for anterior immediate and delayed implantations was comparable, and full-guided template was more accurate for immediate and delayed implantation.

Objective: A peri-implant gap or a “jumping gap” between an implant surface and the buccal bone can often complicate the successful integration of dental implants, impairing osseointegration and long-term implant stability. Although various techniques and materials are available for managing this gap, there is no consensus on the most effective approach. The current literature lacks standardized, evidence-based guidelines for selecting the optimal technique or material for managing peri-implant gaps, especially following immediate implant placement. This systematic review aims to evaluate the efficacy of various techniques and materials to manage the peri-implant gap to improve the implant stability, bone preservation, and esthetic outcomes using the PROSPERO registration number CRD42024508852. Methods: A comprehensive search of the MEDLINE, Embase, and Cochrane databases was conducted, and various studies were selected, including 11 randomized clinical trials that investigated different grafting materials and techniques for managing the gap between the implant and the buccal plate. The selected studies were assessed for the risk of bias, and the data were extracted based on primary outcomes such as implant stability, bone density, and esthetic parameters. Results: The findings indicate that xenografts and alloplastic grafts were superior in preserving bone volume compared to platelet-rich fibrin. Techniques like the socket shield and immediate provisional prothesis methods showed promise in maintaining soft tissue and bone integrity. However, heterogeneity across the studies limits definitive conclusions. Conclusions: Further high-quality research is needed to establish standardized guidelines for peri-implant gap management. The selection of techniques and materials should be tailored to individual patient needs.

Background and Objectives: The present systematic review and meta-analysis were conducted to evaluate and compare the long-term clinical outcomes of immediate implants placed into fresh sockets with and without periapical pathology. Materials and Methods: After the search and review of the literature in the electronic databases, 109 publications were achieved. The titles and abstracts of 66 publications were screened. After the evaluation of the full text of 22 publications, based on the inclusion criteria, six controlled clinical studies were included in this systematic review and meta-analysis. Results: The statistical calculation showed no heterogeneity among the studies included. The implant survival was 99.6% in the test (socket with periapical pathology) and control (socket without periapical pathology) groups of all the clinical trials. The results of the meta-analysis showed no statistically significant difference between test and control groups regarding the marginal bone level and the width of keratinized mucosa in all the studies. Other parameters indicating plaque level, bleeding on probing, and gingival recession also did not differ between test and control groups at the final follow-up in nearly all studies. Conclusions: Within the limitation of this systemic review and meta-analysis, the obtained data suggest that implants immediately placed into the extraction sockets of teeth exhibiting periapical pathology can be successfully osseointegrated for an extended period.