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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.

This case report describes a digital workflow for a computer-aided design/computer-assisted manufacturing (CAD/CAM) healing abutment used in immediate implant placement in the esthetic zone. The design of the healing abutment was based on the existing tooth anatomy in order to provide anatomical support to the gingival tissues and to preserve the gingival contours of the natural tooth. This approach enhances the esthetic outcome of the definitive implant restoration. The surgical procedure including the guided bone regeneration is simplified, postoperative morbidity is reduced, and excessive occlusal loading during healing is limited. [ABSTRACT FROM AUTHOR]

Background: This study aims to compare the long-term success rates of immediate implant placement and delayed implant placement in patients with periodontally compromised teeth. Materials and Methods: A total of 30 patients presenting with periodontally compromised teeth requiring extraction and subsequent implant placement were enrolled in this retrospective study. Patients were divided into two groups based on the timing of implant placement: Group A (immediate implant placement) and Group B (delayed implant placement). Implants were placed according to standard protocols. Patient records were reviewed for implant survival, peri-implant bone loss, and prosthetic complications. Data were statistically analyzed using appropriate tests. Results: The mean follow-up period was 5 years. In Group A, the implant survival rate was 90%, while in Group B, it was 83%. The mean peri-implant bone loss was 1.5 mm in Group A and 2.2 mm in Group B. Prosthetic complications were observed in three cases in Group A and five cases in Group B. The differences in implant survival and bone loss between the two groups were not statistically significant (P > 0.05). Conclusion: Both immediate implant placement and delayed implant placement demonstrated comparable long-term success rates in patients with periodontally compromised teeth [ABSTRACT FROM AUTHOR]

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%. [ABSTRACT FROM AUTHOR]

Background. There is no standard protocol for immediate implant placement and subsequent loading in the smile zone. We aimed to evaluate the long-term outcomes of simultaneous implant placement, soft tissue grafting, and immediate prosthetic loading in the esthetic zone. Methods. Thirty-five implants were placed in the maxillary aesthetic zone. Twenty-two patients were evaluated using the Pink Esthetic Score (PES) and White Esthetic Score (WES). Also, the degree of peri-implant bone resorption and patient survey were applied for the esthetic and functional outcomes. Results. The esthetic and harmonizing outcomes were achieved according to the mean total PES/WES value (17.9 ± 2.0). The mean overall PES was 8.5 ± 1.66. The papilla level had the highest mean score (1.8 ± 0.36). Furthermore, the combination of root convexity/color and soft tissue color and texture was one of the key values in evaluating the effectiveness of this method (the mean value was 1.5 ± 0.5). The mesial and distal papillae were 1.6 ± 0.5 and 1.8 ± 0.4, respectively. None of the 35 implants reached below 6 points (which is considered an esthetically unsatisfactory result). The mean WES score was 9.5 ± 0.57. The average degree of total peri-implant bone resorption was 1.05 ± 0.3 mm after 12 months. According to the questionnaire, all the patients smiled without hesitation and were satisfied with the treatment (100%). Conclusion. This study showed that restoring one or more teeth in the smile zone using the concept of one-stage implant placement, soft tissue flap augmentation, and loading with provisional crowns was an esthetically successful and predictable method. [ABSTRACT FROM AUTHOR]

Abstract Background To explore the influence of cross-sectional type and morphological parameters at the mandibular molar sites on lingual plate perforation (LPP) during the immediate implant placement (IIP). Methods 181 implants were virtually placed in the mandibular molar sites on the cone beam computed tomography (CBCT). Each cross-section of the implantation site was divided into the Undercut (U)/Parallel (P)/Convex (C) types. Morphologically relevant parameters were measured on the cross-sections, including width of the upper end (Wb), width of the lower end (Wc), vertical height (V), angle between the natural crown axis and the alveolar bone axis (∠β), LC depth (LCD), LC height, and angle between the horizontal line and the line connecting the most prominent point and the most concave point of lingual plate (∠α). Besides, the distance from the end of the virtual implant and the lingual bone plate of the cross-section (DIL) was calculated. Relationships between all the morphologically relevant parameters and the DIL were further analyzed. Results A total of 77 (42.5%) cross-sections were classified as U-type, which was the most common one, accounting for 63% of the second molar regions. All LPP cases and most of the nearly LPP (87.9%) cases occurred at the U-type cross-sections, and the relationship between the DIL and the morphological parameters can be expressed by a multivariate linear equation. Conclusions The occurrence rate of U-type cross-sections in the second molar region was very high, and the risk of LPP should be considered during IIP. Except for the U-type, significant large LCD, small Wc, and large ∠β were the important relevant factors. CBCT and multivariate linear equations could help to assess the LPP risk and provide a reference for implant placement design pre-surgery.

Aim: The aim of this study was to evaluate and compare the stress distribution patterns in immediately placed and loaded conventional and customized three-dimensional (3D) printed dental implants by 3D finite element analysis. Materials and Methods: Twelve 3D finite element models [Group A-3 models; Group B-9 models] with 72 test conditions which were modeled and compared from customized 3D printed dental implants [Group A] and 3 commercially available implant systems [Group B] (Straumann, Ankylos, and Astratech) using “SolidWorks”. All models were embedded in extraction socket models of the maxillary central incisor (CI) and Canine (C), Mandibular 1st Premolar. An occlusal loading by axial and nonaxial force of 100 N and 150 N at 30°C and 45°C was applied on the abutment using the “ANSYS” Suite. Customized 3D printed dental implant (Group A) for maxilla (Max.) CI, Max. C, and mandibular 1st premolar (PM) socket model was compared with three commercial available dental implant systems (Group B) for Max. CI, Max. C, and mandible (Mand.) 1st PM socket model to understand the stress distribution patterns. Results: With increasing oblique loads, von Mises stresses were reduced for the customized group as compared to conventional implants. Increased axial loads caused proportionate increase in the stresses for both groups, yet remained under the physiologic limits in all test conditions. Higher stresses were observed in cortical bone than in cancellous bone at bone–implant contact in general. Marked reduction in von Mises stress was observed at the boundary between compact and cancellous bone. Customized 3D printed implants performed better for oblique loads and comparable for axial load stress distribution in comparison to conventional implant systems in Max. CI and C, Mand. 1st PM. Conclusion: Thus, customized 3D printed implants appear a promising alternative for immediately placed immediately loaded protocols, with additional benefits in specific clinical situations.

Immediate function has become an accepted treatment modality for fixed restorations in completely edentulous jaws. Guided implant surgery is considered as a safe and minimally invasive flapless procedures. A total of 26 patients (10 males and 16 females, mean age 50.0+/- 15.5 years) were enrolled in the present retrospective clinical study, 265 implants post-extractive were installed, immediately loaded by means of a provisional fixed full arch. In our present study, a total of 265 SKY classic fast @ fix implants from Bredent were used for the reconstruction in 3 cases of both jaws, for the reconstruction of a single jaw in 5 cases, for the reconstruction of the maxilla in 6 cases and for the reconstruction of the mandible in 5 cases. Within the limits of this study, complete-arch fixed reconstruction by means of guided surgery and immediate loading of implant placed in fresh extraction sockets appears to be a reliable and successful procedure. Further long-term prospective studies on a larger sample of patients are needed to confirm these positive outcomes.

Abstract Purpose This study aimed to compare the accuracy of fully guided between dynamic and static computer-assisted implant surgery (CAIS) systems for immediate implant placement in the esthetic zone. Methods A total of 40 qualified patients requiring immediate implant placement in the esthetic zone were randomly and equally assigned to either static CAIS group (n = 20) or dynamic CAIS groups (n = 20). Global deviations at entry, apex, and angular deviation between placed and planned implant position were measured and compared as primary outcomes. Secondary outcomes were the deviation of implant placement at mesial–distal, labial–palatal, and coronal–apical directions. Results For the immediate implant placement, the mean global entry deviations in static and dynamic CAIS groups were 0.99 ± 0.63 mm and 1.06 ± 0.55 mm (p = 0.659), while the mean global apex deviations were 1.50 ± 0.75 mm and 1.18 ± 0.53 mm (p = 0.231), respectively. The angular deviation in the static and dynamic CAIS group was 3.07 ± 2.18 degrees and 3.23 ± 1.67 degrees (p = 0.547). No significant differences were observed for the accuracy parameters of immediate implant placement between static and dynamic CAIS systems, except the deviation of the implant at entry in the labial–palatal direction in the dynamic CAIS group was significantly more labial than of the static CAIS (p = 0.005). Conclusions This study demonstrated that clinically acceptable accuracy of immediate implant placement could be achieved using static and dynamic CAIS systems. Trial registration ChiCTR, ChiCTR2200056321. Registered 3 February 2022, http://www.chictr.org.cn/showproj.aspx?proj=151348

Abstract Purpose To assess implant success and survival of immediately placed and restored progressive-type implants in the esthetic zone. Material and methods A total of n = 21 patients (21 implants) had received an immediate placement of a tapered, two-part implant with a progressive thread design (PL) for a single tooth replacement in the anterior maxilla. An immediate ‘non full-functional loaded’ restoration was provided upon adequate primary stability on a final patient-specific abutment (one abutment-one time concept). The final restoration was provided at 12 weeks (baseline). Implant survival and success (e.g. bleeding on probing—BOP, probing pocket depth—PD, mucosal recession—MR, pink esthetic score—PES) as well as patient- reported outcomes (PROM`S) were recorded at 6 and 12 months. Results An adequate primary implant stability (i.e. insertion torque > 35 Ncm) was obtained at all but one sites. At 12 months, implant survival (n = 20 patients) amounted to 100%. Non-significant changes to baseline were noted for mean BOP (2.5 ± 28.2%), PD (− 0.26 ± 0.73 mm), and MR (0.0 ± 0.4 mm) values. PES values amounted to 12.9 ± 1.14 and 13.2 ± 0.84 at 6 and 12 months. Technical and mechanical complications were not observed. Patients expressed an overall high satisfaction. Conclusions The presented immediacy protocol was associated with high survival and success rates on the short-term. Graphical Abstract

Background: The morphologic and dimensional alveolar bone is significant for resorption in the first 3 months after tooth removal because they restrict treatment outcomes with respect to function and esthetic. Following teeth extraction, the width and height of the alveolar ridge contour are reduced in both the horizontal and vertical dimensions. Following implant placement, the gingival morphology should be changed minimally compared to pre-extraction. Surrounding natural-like tissue is also an ultimate goal of the dental implant treatment, which is correlated with the cervical third contour on the anatomical tooth, for comfortable cleansing, food impaction avoidance, and esthetics. Purpose: To evaluate the peri-implant soft tissue changes after immediate implant placement (IIP) with the use of a customized titanium healing abutment in the posterior teeth. Method: Digital impressions using the intraoral scanner (MEDIT i500) were taken from 30 patients. Customized titanium healing abutments were designed and milled before extraction. Flapless extractions were done using surgical guides, 32 immediate implants placement were done in posterior areas, and healing abutments were placed. Soft tissues were scanned during pre-operation, and post-surgery during the 1st, 3rd, and 6th months. A 3D analysis program (Final Surface) evaluated the gingival margin distance, height, contour width, and volume in each period. SPSS was used to analyze the data with a p-value = 0.05. The between-time interval comparisons were done and the analysis was done using a Multivariate test. Results: Customized titanium healing abutments used in immediate implantation maintained optimal peri-implant mucosa. In intermittent periods, there was no significant reduction in all aspects of the margin distances and heights. During the entire period, the margin height reduction on the buccal, lingual, mesial, and distal was 0.63 mm, 0.93 mm, 0.08 mm, and 0.24 mm, respectively, and contour width reduction on the buccal, lingual, and buccolingual was 0.59 mm, 0.43 mm, and 1.03 mm, respectively. There was a significant reduction in the total buccolingual contour width in the 1st month and total volume in the 3rd to 6th months. Conclusions: Immediate implant placement with customized titanium healing abutment can achieve the optimal peri-implant mucosa and this protocol is an alternative for soft tissue management. [ABSTRACT FROM AUTHOR]

Immediate implant placement is considered the treatment of choice for single tooth replacement in the esthetic area. However, this treatment is associated with several critical drawbacks related to the inadequate assessment/management of the soft and hard peri‐implant tissues and their subsequent remodeling, resulting in peri‐implant soft‐tissue defects that can lead to impaired esthetic outcomes in time. We describe in detail how the mucogingival approach to immediate implant placement ensures a standard result regardless of the baseline soft‐hard tissue situation. Fully guided implant placement guarantees an adequate three‐dimensional implant placement, the flap design makes it possible to perform bone augmentation with complete visibility of the area being treated, allows soft tissue augmentation with proper fixation of the connective tissue graft, and the placement of an immediate provisional ensures stabilization of the peri‐implant tissues throughout the healing period. [ABSTRACT FROM AUTHOR]

Background: The anatomical characteristics of the maxillary labial alveolar bone play a crucial role in the treatment planning of immediate implant placement. The sagittal root position (SRP) and alveolar bone concavity are closely related to anatomical characteristics in determining the ideal implant position. This study evaluated the SRP and labial alveolar bone concavity in the maxillary anterior teeth area. Methods: Cone-beam computed tomography images of 120 samples involving 720 teeth were uploaded to the medical imaging software. The SRP was classified as Class I, II, III, or IV, and the concavity of labial alveolar bone was measured. A T test was performed to compare measurements between the central and lateral incisors, between the central incisors and canines, and between the lateral incisors and canine. Results: The majority of the SRPs of the maxillary anterior teeth were class I (engaging the labial cortical plate) with frequencies of 98.3%, 85.8%, and 81.7% for the canines, lateral incisors, and central incisors, respectively. In terms of concavity of labial alveolar bone in maxillary tooth area, canines also had the largest mean value (139.5°), followed by lateral incisors, whereas central incisors has the smallest mean value (131.7°). The results of the T test revealed a significant difference (p < 0.001) in labial alveolar bone concavity between central and lateral incisors, between central incisors and canines, and between lateral incisors and canines. Conclusion: Most maxillary anterior teeth were classified as Class I SRP, Class III SRP was the least prevalent, and the concavity of the labial alveolar bone significantly differed between the central and lateral incisors, between the central incisors and canines, and between the lateral incisors and canines. In addition, the canines had the highest mean alveolar bone concavity angle, indicating that less concavity in the canines area. [ABSTRACT FROM AUTHOR]

For several years, the implant-level impression procedure started by removal of the healing abutment, followed by connection of the impression coping to the implant. Encode Complete (Encode, Biomet 3i, Biomet 3i, Palm Beach Gardens, FL) was introduced to eliminate implant-level impressions by offering a healing abutment-level impression protocol. This report illustrated the treatment of a single tooth in the anterior esthetic zone using Encode Complete. A 23-year-old female patient reported to the prosthodontics clinic complaining of a fractured maxillary anterior tooth that was deemed nonrestorable. After immediate implant placement, soft tissue preservation and temporization of the implant, healing abutment level impression was made. The codes embedded on the occlusal surface communicated the implant depth, hex-orientation, platform diameter, and interface. The definitive Encode gold-plated titanium abutment was anatomically designed virtually with customized margin, contour, taper, and emergence profile. The milling process was initiated, and the virtual design data were sent to the Robocast Center for analog placement in the original Encode master cast. The definitive abutment was placed on the master cast using Robocast technology, followed by the fabrication of the final porcelain fused to zirconia cement-retained all ceramic crown. The abutment was secured to the implant with a Gold-Tite abutment screw, followed by the final cement-retained implant crown placement. Recall visits were obtained at 1 week, 1 month, 3 months, and 1 year after final prosthesis insertion. [ABSTRACT FROM AUTHOR]

Background: The socket shield technique (SST) could address the challenges in immediate implant placement by minimizing post-extraction bone resorption while maintaining soft tissue levels. This study aimed to summarize the available evidence and systematically assess the effectiveness of SST immediate implant placement regarding all outcomes (bone loss, esthetics, implant stability, probing depth, complications, and survival rate). Methods: We searched seven electronic databases through April 2023 to identify randomized clinical trials that assessed the effect of immediate implant placed with SST (test group) versus other implant placement protocols without SST. The risk of bias was assessed using Cochrane's randomized trial quality assessment Tool (RoB 2.0). Random-effects meta-analysis was conducted, with mean difference and 95% confidence intervals (MD, 95% CI) as effect estimates. We used the GRADE approach to assess the certainty of evidence. Results: Twelve RCTs, involving 414 immediate implants, placed in 398 patients, were included. Meta-analyses revealed that the immediate implants placed with SST had a statistically significant decrease in horizontal (MD = −0.28, 95% CI [−0.37, −0.19], p < 0.0001), vertical (MD = −0.85, 95% CI [−1.12, −0.58], p < 0.0001), and crestal (MD = −0.35, 95% CI [−0.56, −0.13], p = 0.002) bone loss, as well as probing depth (MD = −0.64, 95% CI [−0.99, −0.29], p = 0.0003). Additionally, SST had a significant increase in implant stability (MD = 3.46, 95 % CI [1.22, 5.69], p = 0.002) and pink esthetic score (MD = 1.60, 95% CI [0.90, 2.30], p < 0.0001). Only two studies reported shield exposure incidences in the SST group; however, all studies revealed no implant failure and a 100% survival rate. The evidence certainty was assessed as very low. Conclusions: Based on limited evidence, SST was more effective in minimizing bone resorption and improving implant stability and esthetic outcomes than conventional immediate implant placement. Still, SST could not be recommended as a routine clinical protocol due to the lack of a standardized surgical approach; thus, further high-quality RCTs are required to support this conclusion. [ABSTRACT FROM AUTHOR]

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Purpose: To investigate the accuracy of a novel sleeveless implant surgical guide by comparing it with a conventional closed-sleeve guide and a freehand approach. Materials and methods: Custom resin maxillary casts with corticocancellous compartments were used (n = 30). Seven implant sites were present per maxillary cast, corresponding to healed (right and left first premolars, left second premolar and first molar) and extraction sites (right canine and central incisors). The casts were assigned into three groups: freehand (FH), conventional closedsleeve guide (CG) and surgical guide (SG) groups. Each group comprised 10 casts and 70 implant sites (30 extraction sites and 40 healed sites). Digital planning was used to design 3D printed conventional and surgical guide templates. The primary study outcome was implant deviation. Results: At extraction sites, the largest difference between groups occurred in angular deviation, where the SG group (3.80 ± 1.67 degrees) exhibited ~1.6 times smaller deviation relative to the FH group (6.02 ± 3.44 degrees; P = 0.004). The CG group (0.69 ± 0.40 mm) exhibited smaller coronal horizontal deviation compared to the SG group (1.08 ± 0.54 mm; P = 0.005). For healed sites, the largest difference occurred for angular deviation, where the SG group (2.31 ± 1.30 degrees) exhibited 1.9 times smaller deviation relative to the CG group (4.42 ± 1.51 degrees; P < 0.001), and 1.7 times smaller deviation relative to the FH group (3.84 ± 2.14 degrees). Significant differences were found for all parameters except depth and coronal horizontal deviation. For the guided groups, there were fewer significant differences between healed and immediate sites compared to the FH group. Conclusion: The novel sleeveless surgical guide showed similar accuracy to the conventional closed-sleeve guide. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this cone beam computed tomography (CBCT) study was to assess bone volume changes in molar sites after modified immediate implant placement with xenografts. Materials and Methods: This prospective study was performed between June 2015 and September 2016. Surgical procedures included modified implant site preparation, atraumatic tooth extraction, implant placement, and bone grafting with deproteinized bovine bone mineral. CBCT scans were taken at the day of surgery and 6 months after surgery. Horizontal and vertical bone dimensional changes were evaluated through these two CBCTs, including variations of horizontal bone thickness (HBT), vertical bone height (VBH), and the distance from the implant platform to the tip of the intradental bone peak (DIP). Results: Fifteen patients with 17 hopeless molars were included, and no implant was lost during the observation period. With measurements at five different parallel levels (0, 1, 2, 4, and 6 mm apical to the implant platform), the mean HBT in millimeters and percentage between these two time points ranged from --0.88 (33%) to --0.03 (0.7%) buccally and --0.45 (12%) to --0.02 (0.4%) lingually. The change of VBH was greater buccally (0.74 ± 0.32 mm, P < .01) than lingually (0.40 ± 0.17 mm). DIP was reduced 0.46 ± 0.27 mm mesially and 0.39 ± 0.21 mm distally. Conclusion: In molar sites, flapless modified immediate implant placement with deproteinized bovine bone is a predictable treatment. However, the dimensional change of the ridge should still be expected, and buccal bone resorption is more evident than lingual. [ABSTRACT FROM AUTHOR]

The implant cannot preserve the surrounding bone from resorption when placed in the extraction socket. After teeth extraction, a change in the bony architecture of the anterior region makes oral rehabilitation difficult by an implant. This leads us to explore such a critical issue and the relevant data were collected from Pubmed, Google Scholar, and Cochrane database and reviewed. Socket shielding technique is intentional retention of the buccal segment of root fragment during the implant placement in the extraction socket. Socket shielding is an effective procedure in minimizing the buccal bone resorption along with minimizing the buccal contour changes it is minimally invasive as the bone graft is optional thus reducing the cost of the treatment procedure. The limited studies were available to support the routine clinical use of the socket shielding technique. Socket shielding seems to become the non-invasive technique for the preservation of hard and soft tissue by dental implant especially in the esthetic zone in the future. Therefore studies should be carried out on a large population to obtained more précised results related to the socket shielding technique.

Objective To investigate the effect of immediate and delayed implant placement on dimensional changes in hard and soft tissues as well as esthetic outcomes. Methods A total of 40 maxillary single anterior teeth with a dehiscence defect on the labial bone (≤4 mm) were categorized into two groups according to the timing of implant placement: immediate implant placement (n = 20) or delayed implant placement (n = 20). Guided bone regeneration (GBR) was conducted at the sites using a flap approach, and the implants were given immediate provisionalization. Implant survival rates, dimensional changes in hard and soft tissues during the six- and twelve-month follow-ups, and pink esthetic scores (PESs) were measured. Results The implant survival rates in both groups were 100%, and no complications occurred during the follow-up time. There was no significant difference between the two groups at the measurement sites in the dimensional change of hard and soft tissues during the six- and twelve-month follow-ups. The largest resorption was observed at the implant neck, with a loss of (1.29 ± 0.71) mm in the immediate implant placement group and (1.43 ± 0.19) mm in the delayed implant placement group. The mean PES scores were (10.95 ± 1.51) for the immediate implant placement group and (11.05 ± 1.23) for the delayed implant placement group. Conclusion Immediate implantation or delayed implantation combined with GBR and immediate provisionalization might both be a prospective treatment strategy for a maxillary single anterior tooth with a dehiscence defect on the labial bone.

Immediate tooth replacement therapy (ITRT), immediate implant placement, and provisional restoration in maxillary anterior postextraction sockets has become an established therapeutic option for replacing teeth in the esthetic zone. The most important prerequisite for ITRT is achieving adequate primary stability, which enables the placement of the provisional restoration. Different strategies have been proposed to enhance primary stability. The implant macro design with subcrestal angle correction illustrated in this article is a novel approach to consider, as it may solve known challenges of ITRT, such as negotiating the balance between achieving primary stability for the provisional restoration and the optimal positioning of the implant platform relative to the bone morphology. [ABSTRACT FROM AUTHOR]

Background: To explore the influence of cross-sectional type and morphological parameters at the mandibular molar sites on lingual plate perforation (LPP) during the immediate implant placement (IIP). Methods: 181 implants were virtually placed in the mandibular molar sites on the cone beam computed tomography (CBCT). Each cross-section of the implantation site was divided into the Undercut (U)/Parallel (P)/Convex (C) types. Morphologically relevant parameters were measured on the cross-sections, including width of the upper end (Wb), width of the lower end (Wc), vertical height (V), angle between the natural crown axis and the alveolar bone axis (∠β), LC depth (LCD), LC height, and angle between the horizontal line and the line connecting the most prominent point and the most concave point of lingual plate (∠α). Besides, the distance from the end of the virtual implant and the lingual bone plate of the cross-section (DIL) was calculated. Relationships between all the morphologically relevant parameters and the DIL were further analyzed. Results: A total of 77 (42.5%) cross-sections were classified as U-type, which was the most common one, accounting for 63% of the second molar regions. All LPP cases and most of the nearly LPP (87.9%) cases occurred at the U-type cross-sections, and the relationship between the DIL and the morphological parameters can be expressed by a multivariate linear equation. Conclusions: The occurrence rate of U-type cross-sections in the second molar region was very high, and the risk of LPP should be considered during IIP. Except for the U-type, significant large LCD, small Wc, and large ∠β were the important relevant factors. CBCT and multivariate linear equations could help to assess the LPP risk and provide a reference for implant placement design pre-surgery. [ABSTRACT FROM AUTHOR]

Background: The fixture thread depth reportedly influences the primary stability of dental implant, but its effect on the positional accuracy in immediate implant placement has not been reported previously. Materials and Methods: Fifty‐six single‐rooted, anterior and premolar teeth were extracted from six human cadavers, followed by installing either regular‐threaded implants (RT group, N = 30) or deep‐threaded implants (DT group, N = 26) completely relying on the surgical guide. Optical impressions taken after osteotomy and fixture installation were superimposed with the preoperative virtual planning data to measure the vertical, angular, platform and apex deviations that occurred during osteotomy and installation. Results: While the osteotomy deviations were similar between the two groups, the angular and apex deviation of the DT group (2.67 ± 2.56°; 1.04 ± 0.49 mm, respectively) were significantly larger than those of the RT group (1.61 ± 1.04°; 0.67 ± 0.41 mm, respectively) during installation (p <.05). When the installation deviations were analysed in the anterior and premolar areas separately, the angular, platform and apex deviations of the DT group (3.05 ± 3.26°; 0.75 ± 0.32 mm; 1.08 ± 0.56 mm, respectively) were significantly larger than those of the RT group (1.56 ± 0.73°, 0.59 ± 0.28 mm; 0.62 ± 0.38 mm, respectively) in the anterior site (p <.05), whereas there was no significant intergroup difference in the premolar site. Conclusion: In immediate‐implant surgery, using an implant with a deeper thread might increase the deviations during installation, especially in the anterior area. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the clinical, radiographic, and esthetic outcomes of immediate implant placement with buccal bone dehiscence in the anterior maxilla. Methods: In this case series, implants were inserted immediately after tooth extraction in sockets with buccal bone dehiscence. Guided bone regeneration (GBR) with a papilla preservation flap and simultaneous connective tissue grafting (CTG) was used. The following outcome variables were measured: mid‐facial mucosal recession, probing depth, bleeding on probing, Pink Esthetic Score (PES), marginal bone loss, and thickness of buccal bone plate (TBP). Results: 12 patients were recruited. Stable mid‐facial mucosal level (−0.03 ± 0.17 mm) and excellent soft‐tissue esthetic outcomes (PES, 9.17 ± 0.72) were achieved at 1 year. The TBP at platform level was 2.01 ± 0.31 mm at 1‐year follow up with a resorption rate of 28.90% ± 15.14%. Conclusions: Immediate implant placement using GBR performed with a papilla preservation approach and simultaneous CTG is a feasible treatment procedure in compromised extraction sockets in the anterior region. Favorable esthetic outcomes and buccal bone thickness were obtained. Further studies were needed to evaluate the long‐term tissue alteration. [ABSTRACT FROM AUTHOR]

Introduction: Immediate implant placement in conjunction with partial extraction therapy has been shown to result in functional osseo‐ and dento‐integration with partial preservation of the periodontal ligament (PDL) in humans. Strategic buccal root retention for PDL preservation is a biologically driven procedure that maintains alveolar ridge dimensions and esthetics, while allowing for implant placement. The aim of this study was to conduct a systematic review of longitudinal clinical outcomes of PDL‐mediated ridge preservation in conjunction with implant placement in adults, compared with conventional immediate implant placement with total extractions. The primary outcome for this study was marginal bone level (MBL) changes after strategic buccal root retention implant placement techniques. Materials and Methods: To address a predefined PICOS question, a systematic search of randomized clinical trials and cohort studies with at least 10 participants per group and a minimum 12‐month follow‐up was conducted. A two‐phase systematic selection strategy, data extraction, and risk of bias assessment, was performed independently and in duplicate. Randomized trials were quantitatively analyzed in a meta‐analysis. Results: Ten human studies fulfilled the predefined criteria and were included; three clinical trials and seven cohort studies, for a total of 506 patients and 587 implants. PDL‐mediated implant placement of single‐rooted periodontally healthy teeth was found to reduce marginal peri‐implant bone loss and buccal plate changes as compared to conventional immediate implants across studies, while implant survival and success rates were comparable between the two procedures. A meta‐analysis found that bone changes were significantly less when retention of the buccal root section was performed as compared to total extractions (standardized mean difference: [−4.53, −0.11]); the three clinical trials were, however, largely heterogeneous (I2: 93.1%; Q = 28.98, p < 0.001). Conclusion: Strategic retention of the buccal root section has a benefit in terms of dimensional ridge stability over conventional immediate implantation when implemented in carefully selected cases of single‐rooted teeth. [ABSTRACT FROM AUTHOR]

Self-tapping implants with self-cutting flutes may influence primary stability, especially for the immediate implant placement and restoration protocol in which implants are affixed to the bone in the apical portion. Screw geometry differs between brands, and the effect of apical design on its clinical outcomes remains unclear. This study is aimed at investigating the influence of cutting flute shape (spiral, straight, and without flute) on primary stability by using a dynamic experimental test. Six types of dental implants were designed using computer-aided design and computer-aided manufacturing technology, consisting of three types of cutting flute shapes along with two types of screw features. A dynamic mechanical test was performed using a cyclic loading scheme. The mechanical behaviors of resistance to lateral load (RLL), maximum force, and energy dissipation were compared between groups. In the dynamic test, implants without cutting flute also exhibited higher values in RLL, maximum force, and energy dissipation. The aggressive thread implant with straight flute displayed higher RLL and had a significantly higher values in RLL (p = 0.033) at the threshold point of bone–implant interface breakdown. The implants without cutting flutes exhibited higher primary stability. Straight flute design would improve RLL for aggressive thread implant. [ABSTRACT FROM AUTHOR]

The aim of this systematic review was to evaluate the benefit of ridge preservation (RP) with minimally invasive (MI) approaches with or without concomitant implant placement on morbidity, esthetics, and patient‐related outcomes. Three Internet sources were used to search for appropriate papers. The search strategy was designed to include any clinical study published on RP with MI approaches such as flapless surgery, socket shield and socket sealing techniques and, use of biological agents. Characteristics of the individual studies, regarding methodological aspects, quantitative and qualitative data were extracted. The potential risk of bias was estimated, and the acquired evidence was graded. Independent screening of 860 reports resulted in 26 included original articles. Nine publications evaluated MI approaches for RP without concomitant implant placement. Eleven studies evaluated interventions for RP with immediate implant placement (IIP). Six studies compared RP with IIP vs RP without IIP. This systematic review found that MI approaches in most of the studies failed to improve clinical variables regarding morbidity, esthetics, and patient‐related outcomes. Based on the limited number of studies analyzed and the methodological discrepancies observed, it is not possible to confirm that MI approaches promote a significant benefit when applied to RP procedures. [ABSTRACT FROM AUTHOR]

Purpose: Innovations in macroimplant design, specifically ultrawide implants 7.0 mm or greater in diameter, have allowed immediate molar replacement. This is a retrospective study assessing the survival rates of ultrawide diameter implants (7.0, 8.0, 9.0 mm) immediately placed into molar extraction sockets. Implants were followed up to 144 months postplacement. Materials and methods: A retrospective study was conducted of all patients treated in a private surgical practice between January 1, 2008 and December 31, 2020, who received ultrawide dental implants (7.0, 8,0, 9.0 mm.) placed immediately into molar extraction sockets. Wide diameter healing abutments were placed on all implants at the time of surgery. Abutments and crown restorations were fabricated after at least 4 months of unloaded healing. Patient age, sex, implant location and implant diameters were examined for survival. Insertion torque values at the time of placement and time in function were also evaluated. Biometric statistics were computed with p‐values (<0.05. Descriptive and bivariate statistics were computed; p‐values were set at 0.05. Results: Five hundred forty‐four patients (225 males; 319 females) average age 62.5 years (range 27 to 95) had 563 implants placed. Five hundred thirty‐five of five hundred sixty‐three (535/563) implants survived; 28 failed [clinical survival rate (CSR) 95.03%]. Number and time in function were: 0 to 12 years 100%; 0 to 9 years 85%; 0 to 6 years 69%; 0 to 3 years 35% or 10 to 12 years 16%; 7 to 9 years 16%; 4 to 6 years 34%; 0 to 3 years 35%. No significant differences were found between sex and implant failures (p = 0.22). Maxillary (266/285; 93.3%) and mandibular (269/278; 96.8%) implant CSRs were not significantly different. Three implant diameters were used: 7.0 mm (206/563) [36.6%]; 8.0 mm (267/563) [47.4%]; 9.0 mm (90/563) [15.9%]. Clinical survival rates were: 7.0 mm (201/206) [97.6%]; 8.0 mm (252/267) [94.4%]; 9.0 mm (82/90) [91.1%]. Mean age for patients with failed implants did not show any significant differences (p = 0.1398). Fifteen of the 28 failed implants failed within 120 days of surgical placement (prior to definitive restoration; [53.6%]; 4 implants failed between 4 and 12 months [14.3%]; 9 implants failed at least 1‐year postloading [32.1%]. Conclusions: The results of this long‐term retrospective study regarding ultrawide diameter implants suggested that these implants were viable treatment options for immediate molar replacement following tooth extraction in either jaw with an unloaded healing protocol. High clinical survival rates were reported over a 144‐month (12‐year) timeframe. [ABSTRACT FROM AUTHOR]

Objectives: Simplification and standardization of interventions are critical challenges to improving performance in implant dentistry. This study aimed to systematically identify and schematically present the evidence base of the implant dentistry surgical interventions for the anterior maxilla as a basis for further development and standardization. Methods: Electronic searches were conducted in PubMed, Embase and Cochrane CENTRAL. Primary clinical studies reporting surgical interventions in the anterior maxilla, with a sample size of at least ten patients, were included. Bibliometric information and study details were extracted. Descriptive analysis and a mind map approach were used to describe the documentation of different surgical interventions. Results: Two hundred and seventy‐two studies reporting on 9001 patients were included. Within the past two decades, the number of literatures on implant placement in the anterior maxilla has increased dramatically (7 studies before 2005, 151 studies after 2016). Overall, the evidence map identified six primary operations and 33 variations. For hopeless tooth extraction, immediate implant placement was the most frequently reported (141 studies, 4670 patients); flapless implant placement with hard tissue augmentation and immediate provisionalization was the most commonly reported variation (33 studies, 987 patients). Type 3/4 implant placement (62 studies, 1902 patients) and implant site augmentation (33 studies, 788 patients) were frequently reported for missing teeth. Geographical differences were observed, with type 2 placement studies almost exclusively from Europe. Conclusions: Research on immediate implant placement was the most reported surgical intervention in the anterior maxilla. Hard tissue augmentation was frequently reported simultaneously with or before implant placement. Immediate provisionalization was mainly used for type 1 implant placement. The finding that six primary operations with 33 variations have been reported indicates the need for additional research to simplify and consolidate the surgical approach. [ABSTRACT FROM AUTHOR]

Objective: A scarf‐shaped connective tissue graft can be placed at the facial and proximal aspect of the peri‐implant soft tissue zone during immediate implant placement and provisionalization (IIPP) procedures in the esthetic zone to optimize implant esthetics without the need of flap reflection. This retrospective study evaluated soft tissue stability after scarf‐connective tissue graft (S‐CTG) in conjunction with IIPP procedures in the esthetic zone. Materials and Methods: Patients who received IIPP with S‐CTG with a minimum 1‐year follow‐up were evaluated. Mid‐facial gingival level (MFGL) change and mid‐facial gingival thickness (MFGT) change were measured and compared at the pre‐op (T0), IIPP + S‐CTG surgery (T1), follow up appointment with MFGT measurement (T2), and latest follow‐up appointment (T3). Implant success rate and graft necrosis were also recorded. Results: A total of 22 IIPP and S‐CTG procedures in 20 patients were evaluated in the study. After a mean follow‐up of 8.2 years (3.9–13.4) (T3), all implants remained osseointegrated (22/22 [100%]), with statistically insignificant mean midfacial gingival level change of −0.19 mm (−1.5 to 0.8). Statistically significant difference in midfacial gingival thickness (MFGT) was noted (2.5 mm [1.8–3.5 mm]) after a mean follow‐up time (T2) of 2.3 years (1–8.6) when compared with MFGT at baseline (1.1 mm [0.6–1.3 mm]) (T1). Necrosis of S‐CTG during initial healing phase was noted in 9% (2/22) of the sites. Conclusions: Within the confines of this study, scarf‐connective tissue graft at time of immediate implant placement and provisionalization can thicken the gingiva and maintain the gingival level at the critical soft tissue zone. Clinical Significance: Managing the soft tissue zone is as important as that of the hard tissue zone for peri‐implant esthetics. Connective tissue graft is one of the methods that can enhance the final esthetic outcomes. This retrospective study has demonstrated that Scarf‐CTG technique is an effective treatment modality to maintain soft tissue stability. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the impact of immediate and delayed zirconia implant placement on crestal bone loss and the clinical outcomes achieved with this approach 1 year after prosthetic loading. Further objectives were to evaluate the influence of age, sex, smoking, implant dimensions, platelet-rich fibrin application and location of the implants in the jawbone on the crestal bone level. Materials and methods: Clinical and radiographic analysis were performed to evaluate the success rates for both groups. The data were analysed statistically through a linear regression analysis. Results: No significant difference was found between immediate and delayed implant placement concerning the amount of crestal bone loss. Sex, age, bone augmentation, diabetes and prosthetic complications did not have a statistically significant influence; only smoking had a negative and statistically significant influence on crestal bone loss (P < 0.05). Conclusions: Immediate or delayed placement of one-piece zirconia implants may be a good alternative to the use of titanium implants concerning success and survival. [ABSTRACT FROM AUTHOR]

Copyright of Implantologie is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In implant treatment, the reduction and structural changes in the alveolar ridge that occur after tooth extraction limit the length, width, and placement position of the implant body, impair esthetics, and, in some cases, make implant placement difficult. To solve these problems, an alveolar ridge preservation (ARP) technique, which is performed simultaneously with tooth extraction, generally aims to promote bone regeneration and prevent alveolar ridge reduction by filling the extraction socket with bone graft material and then covering it with a barrier membrane to protect against the invasion of epithelial tissue. The extraction socket provides a favorable environment for bone regeneration throughout the healing period because the blood supply is abundant, and it effectively retains the bone graft material by using the remaining bone wall of the socket. In recent years, advances in bioengineering technology have led to the development of graft materials with various biological properties, but there is currently no clear consensus regarding the selection of surgical techniques and materials depending on the condition of the alveolar ridge. This review will provide a comprehensive survey of the evidence accumulated to date on ARP, present many cases according to the clinical situation, and discuss various treatment options.

This study evaluated the prophylactic effect of localized biomimetic minocycline and systemic amoxicillin on immediate implant placement at infected extraction sites. Twelve mongrels with six implants each were randomly assigned to five groups: uninfected negative control (Group N); infected with oral complex bacteria (Group P); infected and treated with amoxicillin one hour before implant placement (Group A); infected and treated with minocycline during implant placement (Group B); and infected and treated with amoxicillin one hour before implant placement and with minocycline during implant placement (Group C). Radiographic bone level, gingival index (GI), probing depth (PD), papillary bleeding index (PBI), and removal torque (RT) were recorded. There was no significant difference between Groups A, B, and C for bone loss. Group A showed the highest RT, the lowest PBI, and significantly lower GI and PD values than Group P. Group B exhibited significantly higher RT value than Group N and significantly smaller PD value than Group P at 6 w postoperatively. Localized minocycline could improve implant success by reducing bone loss and increasing RT and systemic amoxicillin could maintain the stability of the peri-implant soft tissue. However, combined use of these two antibiotics did not augment the prophylactic effect.

Background: Single-tooth replacement in the esthetic zone with a dental implant remains a challenge for clinicians. One challenge is the difficulty of creating a natural tissue profile in the cervical of the implant restoration. In a healed edentulous ridge, multiple surgeries along with hard- and soft-tissue augmentation will be required to gain sufficient tissue volume, thus significantly increasing the patient morbidity. Immediate implant placement, combined with a customized healing abutment, can potentially overcome these difficulties. Case Report: This case report describes the treatment of a patient with a subgingival fracture of the upper central incisor with an implant placement immediately after tooth extraction, xenograft gap filling, and nonfunctional provisional restoration to seal the extraction socket. The incisor had previously undergone root canal treatment and had been restored using a fiber post and ceramic crown. Conclusions: The use of the immediate implant placement with a nonfunctional provisional restoration (immediate implant placement and immediate provisionalization) technique preserves the tissue profile and volume during the implant healing period. This provides the clinician with a natural soft-tissue profile for implant restoration, without the need for an additional surgery.

Anterior immediate implant placement (IIP) has many biological and esthetic challenges, including inevitable soft and hard tissue loss after extraction. Previous literatures have discussed the facial bone architecture and defective socket classification. However, none of them discussed the depression of the cervical root area which can be seen frequently after IIP in type IIB and U-shaped defective sockets. In our limited experiences, we found that the labial interproximal bone edges of type IIB and U-shaped defect dominated the esthetic result after IIP. With more labial projection of the interproximal bone present, better esthetic result could be expected in the facial aspect. With adequate evaluation of this osseous scalloping before IIP, both patient and clinician could have a comprehensive understanding of the final esthetic result. This article also detailed the process of patient selection, diagnosis, surgical options, and executions required to achieve functional and esthetic success with IIP and provisionalization.

Aim: This systematic review and meta-analysis aimed at checking influences of immediate provisionalization on the primary esthetic outcome by Pink Esthetic Score (PES) as well as other secondary soft tissue outcomes such as bleeding on probing, probing depth, plaque index, mesial papillary recession, distal papillary recession, and midfacial mucosal recession of the peri-implant mucosa around immediately placed implants in the anterior maxilla. Setting and Design: This systematic review and meta-analysis was evaluated using the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Materials and Methods: The relevant studies were found in the databases such as MEDLINE (PubMed), the Cochrane Central Register of Controlled Trials, Science Direct, and Google Scholar. The search was restricted to studies published in English only, with no time constraints. A second hand search was conducted on individual journals and study reference lists. The Evidence Project risk-of-bias tool was used to assess the risk of bias in included studies. The level of evidence was determined using the GRADEpro GDT: GRADEpro Guideline Development Tool (software). McMaster University, 2020 (developed by Evidence Prime, Inc.,) Statistical Analysis Used: The statistical meta-analysis was conducted by using Review Manager (RevMan) (Computer Program). Version 5.4. Copenhagen: The Nordic Cochrane Centre, the Cochrane Collaboration, 2020. Results: Nine studies were finalized. Seven studies were selected out of nine in the meta-analysis for PES. The results of the current meta-analysis for primary outcome observed that immediate implant placement (IIP) followed by immediate provisionalization improves the esthetic outcome, with forest plot favoring immediate provisionalization and demonstrating a statistically significant difference (mean difference [MD] =1.54, [95% confidence interval (CI): 0.82–2.27], P < 0.0001). Statistically insignificant result was observed for secondary outcomes; bleeding on probing (MD = 4.00, [95% CI: −1.15–9.15], P = 0.13), probing depth (MD = 0.17, [95% CI: −0.13–0.48], P = 0.26), plaque index (MD = −1.00, [95% CI: −7.56–5.56], P = 0.77), mesial papillary recession (MD = −0.10, [95% CI: −0.31–0.10], P = 0.33), midfacial mucosal recession (MD = −0.47, [95% CI: −1.01–0.07], P = 0.09). However, for distal papillary recession (MD = −0.32, [95% CI: −0.50–−0.13], P = 0.0007), the result was statistically significant with forest plot favoring immediate provisionalization. Conclusion: When the implant is placed in the esthetic zone, IIP with immediate provisionalization provides the best gingival (pink) esthetics.

Purpose: To examine cone beam computed tomography (CBCT) anatomical findings, such as the concavity of the ridge and angulation of the tooth and alveolar ridge, either facial or palatal, in order to assess the potential clinical risks of performing flapless implant surgery. Materials and Methods: CBCT images that met the inclusion criteria were examined. All images in maxillary anterior areas (canine to canine), facial bone thickness at 3 and 5 mm from the cementoenamel junction (CEJ), angulation of the tooth and alveolar ridge (Angle T: the angulation between the long axis of the tooth and the palatal plane; Angle D: the angulation between the long axis of the tooth and the midline of the ridge), the deepest point of facial concavity, the distance from the deepest point of facial concavity to the apex of the tooth and alveolar bone crest, nasopalatine canal, dehiscence, and fenestrations were measured and statistically analyzed. Results: In total, 21 patients (12 women and 9 men) with a mean age of 55.9 years who met the inclusion criteria were included in the analysis. Data from 21 patients, 6 image sections per patient (total of 126 CBCT images) were analyzed. The mean value of facial bone thickness was 0.99 mm and 0.60 mm at 3 and 5 mm from CEJ, respectively. The distance from the deepest point of facial concavity to the apex of the tooth and alveolar bone crest was 2.79 and 11.29 mm, respectively. In canine areas, the mean values of facial bone thickness were larger at 3 mm but thinner at 5 mm. Also, canines were found to have a larger Angle D and a higher incidence of fenestration and dehiscence. Conclusion: Based on the findings, fenestration and a larger Angle D were associated with thinner facial bone thickness at 5 mm, and the tooth types also had an impact. Hence, for immediate implant surgery without flap elevation, besides anatomical structures, both angulation of the tooth and the alveolar ridge also need to be assessed. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the buccopalatal volumetric tissue change that occurs following flapless single-tooth immediate extraction placement in the esthetic area and to analyze the role of four different variables. Materials and Methods: Patients in need of a single-tooth replacement in the anterior maxillary or mandibular area (premolar to premolar) were recruited for the study. Patients were treated using four different therapeutic modalities: group 1 (healing abutment), group 2 (healing abutment + bone graft), group 3 (provisional restoration) and group 4 (provisional + bone graft). Alginate impressions were taken the day of implant insertion before tooth extraction (T0), at 1 month (T1), at 3 months (T2), and at 6 months (T3). Buccopalatal dimension (BPD) was measured on the study casts at 1, 3, and 5 mm apical to the free gingival margin and compared between T0 and T1 and T2 and T3. Results: Seventy-seven patients were included in the study, 29 men and 48 women with a mean age of 54 years (range: 24 to 76 years) and 80 implants were inserted. Thirteen implants were inserted in group 1, 13 in group 2, 20 in group 3, and 34 in group 4. The BPD contraction was more evident for group 1, smaller in group 2 and group 3, and minimal in group 4. Repeated measures analysis of variance (ANOVA) and post hoc tests were used. The data analyzed were considered statistically significant with a level of α = .05. The interaction effect P value was numerically zero. Conclusion: The results of this study seem to indicate that volumetric tissue changes after immediate extraction placement in the esthetic area can be minimized if a provisional is immediately connected and a bone graft is inserted simultaneously [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to compare the accuracy of fully guided between dynamic and static computer-assisted implant surgery (CAIS) systems for immediate implant placement in the esthetic zone. Methods: A total of 40 qualified patients requiring immediate implant placement in the esthetic zone were randomly and equally assigned to either static CAIS group (n = 20) or dynamic CAIS groups (n = 20). Global deviations at entry, apex, and angular deviation between placed and planned implant position were measured and compared as primary outcomes. Secondary outcomes were the deviation of implant placement at mesial–distal, labial–palatal, and coronal–apical directions. Results: For the immediate implant placement, the mean global entry deviations in static and dynamic CAIS groups were 0.99 ± 0.63 mm and 1.06 ± 0.55 mm (p = 0.659), while the mean global apex deviations were 1.50 ± 0.75 mm and 1.18 ± 0.53 mm (p = 0.231), respectively. The angular deviation in the static and dynamic CAIS group was 3.07 ± 2.18 degrees and 3.23 ± 1.67 degrees (p = 0.547). No significant differences were observed for the accuracy parameters of immediate implant placement between static and dynamic CAIS systems, except the deviation of the implant at entry in the labial–palatal direction in the dynamic CAIS group was significantly more labial than of the static CAIS (p = 0.005). Conclusions: This study demonstrated that clinically acceptable accuracy of immediate implant placement could be achieved using static and dynamic CAIS systems. Trial registration ChiCTR, ChiCTR2200056321. Registered 3 February 2022, http://www.chictr.org.cn/showproj.aspx?proj=151348 [ABSTRACT FROM AUTHOR]

Immediate implant placement is considered a well-accepted procedure due to its advantages and predictable survival rates. However, data on immediate implantation in posterior sockets with infection and bone defects are limited. The purpose of this clinical report was to describe 3 cases of hopeless posterior teeth with periapical infection and relatively large destruction that were successfully treated with immediate implant placement. The mean follow-up time was 22 months. On the basis of correct clinical decision and treatment procedure, immediate implant placement may be a reliable treatment option for compromised posterior sockets. [ABSTRACT FROM AUTHOR]

Purpose: To assess implant success and survival of immediately placed and restored progressive-type implants in the esthetic zone. Material and methods: A total of n = 21 patients (21 implants) had received an immediate placement of a tapered, two-part implant with a progressive thread design (PL) for a single tooth replacement in the anterior maxilla. An immediate 'non full-functional loaded' restoration was provided upon adequate primary stability on a final patient-specific abutment (one abutment-one time concept). The final restoration was provided at 12 weeks (baseline). Implant survival and success (e.g. bleeding on probing—BOP, probing pocket depth—PD, mucosal recession—MR, pink esthetic score—PES) as well as patient- reported outcomes (PROM'S) were recorded at 6 and 12 months. Results: An adequate primary implant stability (i.e. insertion torque > 35 Ncm) was obtained at all but one sites. At 12 months, implant survival (n = 20 patients) amounted to 100%. Non-significant changes to baseline were noted for mean BOP (2.5 ± 28.2%), PD (− 0.26 ± 0.73 mm), and MR (0.0 ± 0.4 mm) values. PES values amounted to 12.9 ± 1.14 and 13.2 ± 0.84 at 6 and 12 months. Technical and mechanical complications were not observed. Patients expressed an overall high satisfaction. Conclusions: The presented immediacy protocol was associated with high survival and success rates on the short-term. [ABSTRACT FROM AUTHOR]

Aim: The present pilot RCT aimed to investigate the influence of a connective tissue graft (CTG) in combination with the immediate implant placement (IIP) on hard and soft tissue healing, without a bone replacement graft in the gap between the implant and the socket walls. Materials and Methods: Thirty patients requiring extraction of one anterior tooth (from premolar to premolar) were randomly assigned to one of the two treatment groups (test: IIP + CTG; control: IIP). Cone‐beam computed tomography and optically scans were performed before tooth extraction and at 6‐month follow‐up. Then, DICOM files were superimposed in order to allow the evaluation of osseous ridge and buccal bone changes, while the superimposition of DICOM and Standard Tessellation Language files allowed for evaluating of soft tissue contour. For testing the differences between the two groups, the non‐parametric test as Wilcoxon rank‐sum test, was used. Results: Twenty‐six of the 30 enrolled patients attended the 6‐month follow‐up visit. The four patients of the control group that were lost to follow‐up were analysed under the intention‐to‐treat principle. No statistically significant differences between the groups were observed for the vertical buccal bone resorption (p =.90), as well as for the horizontal buccal bone resorption at all measured levels. Significant differences were found between the test and control groups in the horizontal dimensional changes of osseous ridge at the most coronal aspect (p =.0003 and p =.02). Changes in tissue contour were between −0.32 and −0.04 mm in the test group and between −1.94 and −1.08 mm in the control group, while changes in soft tissue thickness varied between 1.33 and 2.42 mm in the test group and between −0.16 and 0.88 mm in the control group, with statistically significant differences for both variables at all measured levels. At 6 months, the mean volume increase was 6.76 ± 8.94 mm3 and 0.16 ± 0.42 mm3 in the test and control groups, respectively, with a statistically significant difference. Conclusions: The findings of the present study indicate that the adjunct of a CTG at the time of IIP, without bone grafting, does not influence vertical bone resorption. Within the limits of this study, it can be suggested that the adjunct of a CTG at the time of IIP, without bone grafting, reduces the horizontal changes of the alveolar ridge. Moreover, it allows maintenance of the tissue contour due to an increase in soft tissue thickness. [ABSTRACT FROM AUTHOR]

Copyright of Implantologie is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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Objective: To evaluate the accuracy of immediate implant placement in fresh extraction sockets in the maxillary aesthetic zone using a dynamic computer-assisted implant surgery system (dCAIS), with the evaluation of possible deviations versus freehand placement., Methods: A total of 18 implants were placed by an experienced surgeon in fresh extraction sockets of anterior teeth in 6 maxillary models. Nine implants were placed using the dCAIS system and 9 implants were placed using the conventional freehand technique. The following outcome parameters were measured and compared: positional deviation at entry, apex point and angular deviations between planned and placed implant position. Surgery time was measured for each procedure. Descriptive and statistical analyses were performed on all outcome parameters., Results: Global entry deviations were not significantly different between the two techniques (p = 0.078). dCAIS resulted in significantly more accurate implant placement in terms of global apex deviation with values of 1.28±0.36 mm and angular deviations with values of 1.29±0.64°, compared to 2.06±0.60 mm and 5.05±2.54° with freehand placement (p < 0.001). The dental implant placement time was approximately three times longer when using dCAIS (10.99 ± 3.43 min) versus freehand (3.25± 0.63 min) (p < 0.001)., Conclusions: dCAIS achieved more precise immediate implant placement in terms of apex deviation and angulation than freehand placement, but increased the surgery time., Clinical Significance: dCAIS provides greater accuracy in the placement of immediate implants in the maxillary aesthetic zone following prosthetic-driven digital planning compared to freehand surgery., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Markus Neuschitzer, Jorge Toledano-Serrabona, Javier Bara-Casaus, and Adrià Jorba-Garcia declare that they have no competing interests. - Rui Figueiredo reports grants, personal fees and non-financial support from MozoGrau (Valladolid, Spain), Dentaid SL (Cerdanyola del Vallès, Spain), Inibsa Dental (Lliçà de Vall, Spain) and Avinent SA (Santpedor, Spain), grants from Mundipharma Research (Cambridge, UK), and personal fees from BioHorizons Iberica (Madrid, Spain), Dentsply implants Iberia (Barcelona, Spain), Septodont SAS (Saint-Maur-des-Fossés, France) and Araguaney Dental (Barcelona, Spain) outside the submitted work. In addition, he has participated as an investigator in clinical trials sponsored by Geistlich (Wolhusen, Switzerland). - Eduard Valmaseda-Castellón reports personal fees and non-financial support from MozoGrau (Valladolid, Spain). He is the Director of the Avinent-University of Barcelona research agreement (Càtedra UB-Avinent), with Avinent (Santpedor, Spain), and has received personal fees from BioHorizons Ibérica (Madrid, Spain), Inibsa Dental (Lliça de Vall, Spain) and Dentsply implants Iberia (Barcelona, Spain) outside the submitted work. In addition, he has participated as an investigator in clinical trials sponsored by Mundipharma (Cambridge, UK) and Geistlich (Wolhusen, Switzerland)., (Copyright © 2024. Published by Elsevier Ltd.)

Objectives: The aim of this study was to observe whether immediate implant placement (IIP) into damaged extraction sockets is a successful modality for treating hopeless teeth that require extraction., Data Source: 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 favorable clinical result?' 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 period evaluated; the pink esthetic score (PES) scores had no statistically significant result for all articles that evaluated this parameter; the soft tissue changes was reported by two studies: 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 pink esthetic score showed favoritism for the test group but without statistical significance., Conclusion: 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.

The aim of this case study is to present our treatment method for the restoration of traumatic lesions of teeth following a bicycle accident. Four upper incisors were injured; thus, special consideration was required in timing of the treatment sequence. The prognosis for teeth #11, 12, and 22 was discouraging; furthermore, due to accident, tooth #21 suffered additional rotation and discolouration. In order to preserve the original form and the aesthetics of the mucosa as well as the height of the interdental papillae, immediate implant placement in combination with the socket shield technique were chosen. To accommodate the timing and the state-of-art realisation of the surgical procedure, placements of the three implants were divided into two separate sessions . Whilst immediate replacement of tooth #11 was possible, the placement of the two other implants was only feasible after a healing period of three months. Temporary crowns were placed to preserve aesthetic mucosal margins and the emergence profiles prior to impression, which was taken using individualised custom impression copings. A pressable ceramic veneer was chosen to hide the discolouration of tooth 21. The outcome shows suitable aesthetic, stable soft tissues, preserved emergence profiles, metal-free screw-retained implant crowns, and a veneer, all of which confirm the correct choice for the treatment modality.