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Background: Immediate implant placement (IIP) has shown predictable outcomes when specific requirements are met. The aim of the present study was to radiographically evaluate the dimensions of mandibular incisors and the alveolar bone to further determine the feasibility of IIP in this area. Materials and methods: A total of 404 intact mandibular incisor CBCT images from 101 patients (42 males, 59 females; mean age 49 ± 16.84 years) were analyzed. The mesiodistal tooth width and the distance between the incisal edge (IE), cementoenamel junction (CEJ), facial bone crest (bo, root apex (RA), and fenestration point (F) were registered, together with the alveolar bone width at 1 and 3 mm below BC. Finally, the angular discrepancy between the dental and the alveolar bone long axis (BLA) was recorded as the tooth torque (TT). Results: The CEJ to BC distance was 3.23 ± 1.67 mm. The RA to F mean distance was 15.02 ± 3.97 mm. The mean alveolar bone buccolingual widths at 1 and 3 mm below the facial BC were 7.12 ± 0.82 and 6.32 ± 0.71 mm in the lateral and central incisors, respectively (P < 0.001). The buccolingual width was less than 6 mm in more than 33% of the central incisors, but only in 3% of the lateral incisors, displaying increased alveolar width. The average was 165.66 ± 7.47 degrees. Conclusions: The results presented in this study point toward the need for careful consideration of the requirements for anterior mandibular IIP for success and predictability purposes. [ABSTRACT FROM AUTHOR]

Background: Dental implants are becoming a popular treatment of choice. Immediate implant placement with immediate loaded full-arch fixed dental prostheses (IPILFFDP) presents an attractive solution for edentulous and partially edentulous patients because of its high success rate, reduction in overall treatment time, and improved esthetics. However, whether it can minimize the risk of temporomandibular disorder (TMD) has not been previously studied. Objective: To quantitatively evaluate the temporomandibular joint (TMJ) morphology changes before and after IPILFFDP, using cone beam computed tomography (CBCT). Methods: Twelve participants without TMJ symptoms undergoing IPILFFDP were included in the study. Preoperative and 1-year postoperative assessment of CBCT scans were performed on 18 items related to TMJ and vertical dimensions. Mimics software was used for data analysis. T-test, Pearson, and Spearman correlation analyses were performed. Results: There were no significant differences in bilateral joints between pre and post IPILFFDP. Compared with pre-treatment CBCT, post-treatment CBCT showed a significant increase in posterior joint space. There was an approximately 2 mm increase in the vertical dimension after IPILFFDP, which is correlated with an increase in the medial joint space. Conclusions: For patients without TMJ-related signs and symptoms, the IPILFFDP could keep the neuromuscular memory of patient's facial muscles and occlusion, and use adapted centric posture as a guide, which led to more precise restoration of the original jaw position and may shed light in future related clinical studies. [ABSTRACT FROM AUTHOR]

Background/Objectives: The primary aim of this retrospective clinical study was to assess the success and bone gain achieved by using the Fibrinogen-Induced Regeneration Sealing Technique (F.I.R.S.T.) in different indications. Methods: In this single-center retrospective clinical study, F.I.R.S.T. was performed in the following indications: alveolar ridge preservation (ARP), immediate implant placement, and horizontal and vertical guided bone regeneration (GBR) with simultaneous dental implant placement. F.I.R.S.T. is a modified approach to GBR characterized by the application of a porcine cortical lamina, as a long-term resorbable bone barrier to cover the bone defect, and a fibrin sealant for easy adaptation of the xenogenic bone graft material and the fixation of the collagenic bone barrier. Patients with uncontrolled systemic diseases, medications, or diseases that may alter bone metabolism; local inflammation; poor oral hygiene; and heavy smoking were excluded from this study. Horizontal and vertical bone gain (HBG and VBG) were measured by comparing postoperative and preoperative cone beam computed tomography (CBCT) reconstructions. Patients were recalled for controls and oral hygiene treatment every 6 months. Results: Altogether, 62 patients (27 male, 35 female, age 63.73 ± 12.95 years) were included in this study, and 105 implants were placed. Six implants failed during the 50.67 ± 22.18-month-long follow-up. Cumulative implant survival throughout the groups was 94.29 %. In the immediate implant group, HBG was 0.86 mm (range: −0.75–8.19 mm) at the 2 mm subcrestal level, while VBG was 0.87 ± 1.21 mm. In the ARP group, HBG was 0.51 mm (range: −0.29–3.90 mm) at the 2 mm subcrestal level, while VBG was −0.16 mm (range: −0.52–0.92 mm). In the horizontal GBR group, HBG was 2.91 mm (range: 1.24–8.10 mm) at the 2 mm subcrestal level. In the vertical GBR group, VBG was 4.15 mm (range: 3.00–10.41 mm). Conclusions: F.I.R.S.T. can be utilized successfully for bone augmentation. The vertical and horizontal bone gains achieved through F.I.R.S.T. allow for implant placement with adequate bone width on both the vestibular and oral aspects of the implant. [ABSTRACT FROM AUTHOR]

Background: Robotic computer-assisted implant surgery (r-CAIS) is a revolutionary innovation in oral implantation; however, the clinical feasibility of r-CAIS for immediate implant placement (IIP) in posterior teeth has not been verified. Thus, this study aimed to evaluate the accuracy of r-CAIS for IIP in posterior tooth regions. Methods: Patients with posterior teeth to be extracted and indicated to undergo r-CAIS were evaluated. The patients had positioning markers installed in the oral cavity and underwent cone-beam computed tomography (CBCT). Subsequently, minimally invasive tooth extractions were performed, and an individualised surgical plan was generated in the robotic software. After marker registration, implantation surgery was performed by the robotic arm under the supervision and assistance of the surgeons. Finally, the deviations between the planned and placed implants were evaluated based on preoperative and postoperative CBCT data. Results: A total of 12 patients were evaluated. No adverse events occurred during the surgery. The mean global coronal, global apical, and angular deviations were 0.46 ± 0.15 mm (95%CI:0.36 to 0.56 mm), 0.46 ± 0.14 mm (95%CI:0.37 to 0.54 mm), and 1.05 ± 0.55° (0.69 to 1.40°), respectively. Conclusions: Under the limited conditions of this study, the r-CAIS exhibited high accuracy in posterior teeth IIP surgery. Further multicentre randomised controlled studies are required to confirm the feasibility of this technology. [ABSTRACT FROM AUTHOR]

Soft tissue management for immediate implant placement in the esthetic zone is crucial for successful treatment outcomes. Several surgical and restorative techniques have been proposed to treat unesthetic implant soft tissue defects or dehiscence. However, there is a scarcity of clinical evidence on addressing complications associated with through‐and‐through soft tissue defect (TTSD). In this case, a 61‐year‐old female patient, who underwent immediate implant placement at the right central incisor 3 months prior, presented with chronic peri‐implant mucosal infection and soft tissue recession of TTSD in 2015. The palatal pedicle connective tissue flap (PPCTF) was utilized to provide horizontal and vertical soft tissue augmentation and to cover the defect in combination with the labial contour collapse. At the 8‐year follow‐up, favorable white and pink esthetic outcomes were observed, and the pink esthetic score (PES) for soft tissue around the implant achieved 9 points, indicating satisfactory esthetic and functional results. The findings from this case study suggest that soft tissue augmentation techniques, such as PPCTF grafts, can provide a reliable and innovative method for both soft tissue augmentation and reconstruction of TTSD, resulting in long‐lasting functional and esthetic outcomes and stable ideal PES scores. [ABSTRACT FROM AUTHOR]

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Abstract Background Dental implants are becoming a popular treatment of choice. Immediate implant placement with immediate loaded full-arch fixed dental prostheses (IPILFFDP) presents an attractive solution for edentulous and partially edentulous patients because of its high success rate, reduction in overall treatment time, and improved esthetics. However, whether it can minimize the risk of temporomandibular disorder (TMD) has not been previously studied. Objective To quantitatively evaluate the temporomandibular joint (TMJ) morphology changes before and after IPILFFDP, using cone beam computed tomography (CBCT). Methods Twelve participants without TMJ symptoms undergoing IPILFFDP were included in the study. Preoperative and 1-year postoperative assessment of CBCT scans were performed on 18 items related to TMJ and vertical dimensions. Mimics software was used for data analysis. T-test, Pearson, and Spearman correlation analyses were performed. Results There were no significant differences in bilateral joints between pre and post IPILFFDP. Compared with pre-treatment CBCT, post-treatment CBCT showed a significant increase in posterior joint space. There was an approximately 2 mm increase in the vertical dimension after IPILFFDP, which is correlated with an increase in the medial joint space. Conclusions For patients without TMJ-related signs and symptoms, the IPILFFDP could keep the neuromuscular memory of patient’s facial muscles and occlusion, and use adapted centric posture as a guide, which led to more precise restoration of the original jaw position and may shed light in future related clinical studies.

Abstract Background Robotic computer-assisted implant surgery (r-CAIS) is a revolutionary innovation in oral implantation; however, the clinical feasibility of r-CAIS for immediate implant placement (IIP) in posterior teeth has not been verified. Thus, this study aimed to evaluate the accuracy of r-CAIS for IIP in posterior tooth regions. Methods Patients with posterior teeth to be extracted and indicated to undergo r-CAIS were evaluated. The patients had positioning markers installed in the oral cavity and underwent cone-beam computed tomography (CBCT). Subsequently, minimally invasive tooth extractions were performed, and an individualised surgical plan was generated in the robotic software. After marker registration, implantation surgery was performed by the robotic arm under the supervision and assistance of the surgeons. Finally, the deviations between the planned and placed implants were evaluated based on preoperative and postoperative CBCT data. Results A total of 12 patients were evaluated. No adverse events occurred during the surgery. The mean global coronal, global apical, and angular deviations were 0.46 ± 0.15 mm (95%CI:0.36 to 0.56 mm), 0.46 ± 0.14 mm (95%CI:0.37 to 0.54 mm), and 1.05 ± 0.55° (0.69 to 1.40°), respectively. Conclusions Under the limited conditions of this study, the r-CAIS exhibited high accuracy in posterior teeth IIP surgery. Further multicentre randomised controlled studies are required to confirm the feasibility of this technology.

Purpose: To evaluate the hard and soft tissue alterations of immediate implant placement and provisionalization with customized definitive abutments in the esthetic zone. Materials and Methods: Single unsalvageable maxillary anterior teeth were replaced with immediate implant placement and provisionalization with definitive abutments in 22 participants. Digital impressions and CBCT images were obtained presurgery, immediately after surgery, and 6 months after surgery. Horizontal and vertical buccal bone changes in thickness and height (HBBT, VBBH), vertical changes for the gingiva margin, mesial and distal papilla height, and horizontal changes for soft tissue (HCST) were analyzed using a 3D superimposition method. Results: Twenty-two participants completed the study. No implant failed, and there were no mechanical or biologic complications for any patients. At 6 months after surgery, the mean HBBT changes at 0, 1, 2, 3, 5, 7, 10, 11.5, and 13 mm were -0.92 ± 0.73, -0.83 ± 0.53, -0.82 ± 0.49, -0.70 ± 0.64, -0.65 ± 0.47, -0.50 ± 0.51, -0.15 ± 0.45, -0.10 ± 0.57, and -0.00 ± 0.64 mm, respectively. The mean VBBH change was -0.61 ± 0.76 mm. The mean HCSTs at -3, -2, -1, 0, 1, 2, and 3 mm sub- and supra-implant shoulder were -0.65 ± 0.54, -0.70 ± 0.56, -0.65 ± 0.51, -0.61 ± 0.56, -0.47 ± 0.54, -0.47 ± 0.59, and -0.46 ± 0.59 mm, respectively. The mean gingiva margin recession was -0.38 ± 0.67 mm. The mean mesial papilla height recession was -0.03 ± 0.50 mm. The mean distal papilla height recession was -0.12 ± 0.56 mm. Conclusion: The definitive abutment used with immediate implant placement and provisionalization could potentially maintain the buccal bone thickness and height. For the facial soft tissue, it also benefited the maintenance of the midfacial gingival margin position and papilla height during the 6-month follow-up. [ABSTRACT FROM AUTHOR]

Objectives Methods Results Conclusions This study investigated the accuracy of robotic computer‐assisted implant surgery (r‐CAIS) for immediate implant placement.Twenty cases with 20 implant sites were selected based on predefined inclusion criteria. The preparation of the implant bed and implant placement followed the standardized dental implant robotic surgery protocol. Postoperative cone‐beam computed tomography scans were conducted to assess possible discrepancies between actual and planned implant positions.The r‐CAIS technology for immediate implant placement exhibited a mean global coronal deviation of 0.71 ± 0.27 mm (95% CI: 0.58–0.83 mm), a mean global apical deviation of 0.69 ± 0.26 mm (95% CI: 0.56–0.81 mm), and an angular deviation of 1.27 ± 0.47° (95% CI: 1.05–1.49°). A substantial number of deviations were observed buccally at both coronal (90%) and apical (95%) levels, with a consistent tendency for buccal deviation.The r‐CAIS technology proved a promising approach for immediate implantation in the anterior region, with satisfactory clinical outcomes. However, an optimized surgical protocol for r‐CAIS technology is required for particular implant sites like extraction sockets or bone defects. [ABSTRACT FROM AUTHOR]

Background. Rehabilitation in the anterior region requires specific conditions for success, such as the presence of papilla, emergence profile, and balance between pink and white esthetic. Objectives. This systematic review aimed to evaluate the esthetic risk associated with immediate implant placement with immediate restoration in the anterior superior area, where the facial bone plate may be absent or deficient. Materials and methods. The search was done in PubMed, Embase, Cochrane, Lilacs, Scopus, Scielo, and Google Scholar databases. The investigation involved clinical studies and observational studies published between January 2012 and July 2023. Studies were excluded if there was less than 12-month follow-up, no immediate restoration or facial defect, heavy smokers, or systemic disease. The risk of bias was assessed using the ROBINS-I and Modified-Cochrane RoB tools. Results. Twelve studies were included in this systematic review. The thinner the facial plate, the higher the alveolus's risk of gingival recession or shrinkage. There was an increased interproximal recession when the thin phenotype was associated with flap surgery. An increase in pink esthetic score (PES) was reached when immediate implant placement (IIP) and immediate restoration were done. Soft tissue augmentation achieved more gingival-level stability. Regardless of the initial phenotype, an esthetic outcome was delivered. The risk of bias was high in 1 study and moderate in 3 studies. Conclusions. It is possible to conclude that esthetic results and increased final PES or patient satisfaction index in IIP treatments associated with immediate restoration could be obtained even in buccal bone wall defects or gingival recession, regardless of their extension. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to compare the accuracy of dental implant placement in a single tooth gap, including the postextraction site and healed site, using a task‐autonomous robotic system and a dynamic navigation system. Materials and Methods: Forty partially edentulous models requiring both immediate and conventional implant placement were randomly divided into a robotic system group and a navigation system group. The coronal, apical, and angular deviations of the implants were measured and assessed between the groups. Results: The deviations in immediate implant placement were compared between the robotic system and dynamic navigation system groups, showing a mean (±SD) coronal deviation of 0.86 ± 0.36 versus 0.70 ± 0.21 mm (p =.101), a mean apical deviation of 0.77 ± 0.34 versus 0.95 ± 0.38 mm (p =.127), and a mean angular deviation of 1.94 ± 0.66° versus 3.44 ± 1.38° (p <.001). At the healed site, significantly smaller coronal deviation (0.46 ± 0.29 vs. 0.70 ± 0.30 mm, p =.005), apical deviation (0.56 ± 0.30 vs. 0.85 ± 0.25 mm, p <.001), and angular deviation (1.36 ± 0.54 vs. 1.80 ± 0.70 mm, p =.034) were found in the robotic system group than in the dynamic navigation group. Conclusions: The position in both immediate and conventional implant placement was more precise with the task‐autonomous robotic system than with the dynamic navigation system. Its performance in actual clinical applications should be confirmed in further trials. [ABSTRACT FROM AUTHOR]

This study aimed to compare implant stabilities between the immediate and early loaded, immediately placed bone‐level tapered dental implants in the maxilla and to evaluate marginal bone loss (MBL), oral health‐related quality of life (OHRQoL), and patient satisfaction at a 2‐year follow‐up. A pilot, prospective, randomized, controlled clinical trial was conducted on 24 maxillary failing dentition patients. The bone‐level tapered implants of 12 patients were immediately loaded with temporary restorations, while the other 12 patients did not receive any kind of temporization. Implant‐supported screw‐retained complete porcelain‐fused‐to‐metal prostheses were delivered to all patients in the seventh postoperative week. The insertion torque values of implants assigned to the immediate and early loading groups were 33.0 ± 4.87 and 29.26 ± 8.31 Ncm, respectively. The dynamics of implant stability changes from implant placement up to a 2‐year follow‐up were similar for both groups (Penguin®, p = 0.268; Ostell®, p = 0.552), while the MBL was at submillimeter level. The cumulative implant survival rate was 91.80% for immediately loaded implants and 97.22% for early loaded implants, without significant difference (p = 0.162). The total score on the Oral Health Impact Profile questionnaire significantly decreased over time in both groups, indicating improvement in OHRQoL (p < 0.001), and the high level of patient satisfaction remained after 2 years of function regardless of a loading protocol. Both loading protocols, immediate and early, of six immediately placed bone‐level tapered dental implants are an adequate treatment choice for fixed rehabilitation of the maxillary failing dentition. [ABSTRACT FROM AUTHOR]

Background: The aim of this narrative review was to provide insights into the influence of the morphological characteristics of the anatomical structures of the upper jaw based on cone beam computed tomography (CBCT) analysis on the immediate implant placement in this region. Material and Methods:To conduct this research, we used many electronic databases, and the resulting papers were chosen and analyzed. From the clinical point of view, the region of the anterior maxilla is specific and can be difficult for immediate implant placement. Findings: Anatomical structures in the anterior maxilla, such as the nasopalatine canal and accessory canals, may limit and influence the implant therapy outcome. In addition to the aforementioned region, immediate implant placement in the posterior maxilla may be challenging for clinicians, especially in prosthetic-driven immediate implant placement procedures. Data presented within the recently published materials summarize the investigations performed in order to achieve more reliable indicators that may make more accurate decisions for clinicians. Conclusion: The possibility for immediate implant placement may be affected by the NPC shape in the anterior maxilla, while the presence of ACs may increase the incidence of immediate implant placement complications. The variations in IRS characteristics may be considered important criteria for choosing the implant properties required for successful immediate implant placement. [ABSTRACT FROM AUTHOR]

PURPOSE. This cone-beam computed tomography (CBCT) study aimed to analyze the anatomical characteristics of alveolar bone at mandibular first molar (MFM) and their implications for immediate implant placement surgery. MATERIALS AND METHODS. 100 patients with 140 MFMs were reviewed retrospectively. We first performed a 3D reconstruction of the patient's CBCT data to determine a reference plane with ideal implant placement and orientation. The following parameters of MFM region were analyzed: mesial-distal socket size (MDSS), buccal-lingual socket size (BL-SS), root furcation fornix to inferior alveolar nerve (IAN) distance (RF-I), interradicular bone thickness (IRB), mesial/distal root apex to the IAN distance (MRA-I/DRA-I), thickness of the buccal/lingual bone of the mesial root (MR-B/MR-L), thickness of the buccal/lingual bone of the distal root (DR-B/DR-L). RESULTS. The MD-SS of MFM was 8.74 ± 0.76 mm, and the BLSS was 8.26 ± 0.72 mm. The MR-B, DR-B was 1.01 ± 0.40 mm and 1.14 ± 0.50 mm, and the difference was statistically significant ( P = .001). The values of the MR-L, DR-L were 2.71 ± 0.78 mm and 3.09 ± 0.73 mm, and the difference was also statistically significant ( P < .001). The mean distance of RF-I was 15.68 ± 2.13 mm, and the MRA-I was 7.06 ± 2.22 mm, which was greater than that of DRA-I (6.48 ± 2.30 mm, P < .001). The IRB at 2 mm, 4 mm apical from the furcation fornix, and at apex level was 2.81 ± 0.50 mm, 3.30 ± 0.62 mm, and 4.44 ± 1.02 mm, respectively. CONCLUSION. There is relatively sufficient bone mass in interradicular bone in height, but an adequate width is lacking for the bone between the mesial and distal root after the extraction of the MFM for immediate implantation. The thickness of the MFM buccal bone is relative thin, especially for the mesial root. [ABSTRACT FROM AUTHOR]

Aim: To conduct a bibliometric network analysis to explore the research landscape of immediate implant placement (IIP) and provide insights into its trends and contributors. Materials and Methods: The Scopus database was utilized as the bibliographic source, and a search strategy was implemented to identify relevant research articles. Various bibliometric parameters were extracted, including publication year, journal, authors, citations, and funding. The analysis involved examining authorship patterns, international collaborations, level of evidence, Altmetric data, and funding analysis. Results: We identified a steady annual growth rate of 6.49% in IIP research. The top three countries contributing to research output were the USA, Italy, and China. Prolific authors were identified based on publication and citation metrics. International collaborations among different countries were observed. The level of evidence analysis revealed that over 30% of the articles fell into higher levels of evidence (levels 1 and 2). Altmetric data analysis indicated no significant correlations between citation counts and Altmetric Attention Score (AAS), and conversely a significant association with Mendeley readers count. Funding and open access did not significantly impact the bibliometric indices of the papers. Conclusions: The focus of research on IIP has been evolving as indicated by an exponential growth rate in this study. Only approximately 16% of the articles fit into level 1 evidence, therefore, emphasizing on higher quality level research study shortage in this field. Modern indices can be used as new bibliometric indicators as they also cover social media and online attention scores. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study is (1) to compare the accuracy of an open‐sleeved static computer‐assisted implant system (sCAIS) with a closed‐sleeve sCAIS and free‐hand approach in immediate implant placement (IIP) of maxillary molar sites and (2) to investigate the influence of socket morphology on these approaches. Materials and Methods: Ninety partially edentulous duplicated maxillary models simulating three different molar sockets (type A, B, and C based on Smith and Tarnow's classification) were investigated. Three modalities, including sCAIS with open‐sleeves, sCAIS with closed‐sleeves, and free‐hand approach, were applied separately to 30 models with 120 sockets. A customized Python script automatically measured the deviations between the virtual and actual implant positions for all 360 implants. Results: The 3D deviations of sCAIS were significantly influenced by the socket and sleeve types. Both guided groups exhibited significantly less deviation than the free‐hand approach. Type A and C sockets resulted in better implant positions than type B socket sites. In type B sockets, the open‐sleeve group achieved significantly less deviation compared to the closed‐sleeve group, with respect to apical global (1.34 ± 0.53 vs. 1.84 ± 0.59 mm), coronal horizontal (0.68 ± 0.36 vs. 0.93 ± 0.34 mm), apical horizontal (1.21 ± 0.59 vs. 1.74 ± 0.63 mm), and angular (3.30 ± 1.41 vs. 4.41 ± 1.96°) deviations. Conclusions: Guided implant surgery significantly reduces deviations during molar IIP compared to free‐hand procedures. Furthermore, the use of open‐sleeve sCAIS appears to be more effective in minimizing deviations in type B sockets when compared with the closed‐sleeve guided system. [ABSTRACT FROM AUTHOR]

Background: Dental implants are a widely accepted method for replacing missing teeth, but the timing of implant placement--whether immediate (at the time of tooth extraction) or delayed (after a healing period)--remains a debated topic. Immediate implant placement is believed to preserve alveolar bone and soft tissue contours, potentially improving aesthetic outcomes. However, concerns persist about increased postoperative pain and complications. Delayed implants, on the other hand, are considered more predictable in terms of osseointegration, but they require longer treatment times and multiple surgical interventions. This study aimed to compare patient-centered outcomes, including pain, aesthetic satisfaction, quality of life, implant stability, and bone loss, between immediate and delayed implant placement. Objectives: This randomized controlled trial sought to evaluate and compare the patient-centered outcomes of immediate versus delayed implant placement in terms of pain, aesthetics, quality of life, implant stability, and peri-implant bone loss. Materials and Methods: A total of 60 patients requiring single-tooth implants in the anterior or premolar region were randomly allocated to either the immediate implant placement group (n=30) or the delayed implant placement group (n=30). Two patients were lost to follow-up, resulting in 58 participants. Pain levels were assessed using a Visual Analog Scale (VAS), aesthetic satisfaction using the Pink Esthetic Score (PES), and quality of life using the Oral Health Impact Profile (OHIP-14). Implant stability was evaluated using resonance frequency analysis (RFA), and peri-implant bone loss was measured radiographically at six months. Data were analyzed using SPSS 25.0 version Results: Patients in the immediate implant group experienced significantly higher pain on the first postoperative day (VAS score = 5.8 ± 1.4) compared to the delayed group (VAS score = 4.1 ± 1.2, p = 0.002), but pain levels equalized by day seven. The immediate implant group had significantly higher aesthetic satisfaction at six months (PES = 10.6 ± 1.1) compared to the delayed group (PES = 9.3 ± 1.5, p = 0.01). Quality of life scores were also better in the immediate group (OHIP-14 score = 5.1 ± 2.8) compared to the delayed group (OHIP-14 score = 7.2 ± 3.0, p = 0.03). Both groups demonstrated comparable implant stability and minimal peri-implant bone loss at six months (p > 0.05), with no implant failures, resulting in a 100% survival rate. Conclusions: Immediate implant placement provided superior aesthetic outcomes and enhanced quality of life compared to delayed placement, although it was associated with higher early postoperative pain. Both approaches achieved high implant stability, minimal bone loss, and excellent implant survival. Immediate implant placement may be preferred when aesthetics and rapid restoration are priorities. [ABSTRACT FROM AUTHOR]

Purpose: To systematically analyze the outcomes of immediate implant placement (IIP) with bone grafting in the esthetic area. Materials and Methods: PubMed, Embase, and Cochrane CENTRAL were searched. Prospective studies reporting midfacial soft tissue recession (primary outcome) of single-tooth IIP with bone grafting in the esthetic area were included. Risks of bias were assessed. Meta-analysis, sensitivity analysis, and meta-regression were undertaken. Results: A total of 13 studies and 421 patients were included, with a follow-up length of 1 to 10 years in function. The weighted mean (95% CI) of midfacial soft tissue recession was 0.33 (0.21, 0.46) mm and 0.54 (0.16, 0.93) mm after 1 year and 5 years in function. Meta-regression indicated that after 1 year in function, there was 0.33 mm less midfacial soft tissue recession with soft tissue grafting (P = .021), while there was 0.58 mm more soft tissue recession (P = .007) in defect extraction sockets. Implant survival was 97.8%, and all failures were early failures. Peri-implant soft and hard tissue stability, periimplant health, esthetic outcomes, and patient satisfaction were predictable within the follow-up period. Conclusion: Midfacial soft tissue recession showed an ongoing status in IIP with bone grafting in the esthetic area within 5 years in function. For extraction sockets with a thin gingival biotype or deficient buccal bone wall, soft tissue grafting was recommended. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the implant stability, volumetric changes, and patient-reported outcome measures (PROMs) of hydroxyapatite (HA) nano-coated sandblasted/acid-etched (SLA) implants compared to uncoated SLA implants. Methods: Forty patients were recruited and randomly allocated to HA nano-coated SLA group (test, n = 20) and uncoated SLA group (control, n = 20) using single-blinded/block randomization. Implants were immediately placed in maxillary posterior region using a digital surgical guide. Insertion torque and implant stability quotient (ISQ) were measured at implant surgery and 1, 2, 3, and 4 months postoperatively. Intraoral scans, PROMs and soft tissue inflammation data were collected, and multivariable linear regression analysis of ISQ was performed. Results: In total, 48 implants (test; n = 24, control; n = 24) in 37 patients (test; n = 19, control; n = 18) were analyzed. Despite no significant between-group difference at surgery, the test group showed higher ISQ values than the control group at 2 (76.53 ± 4.17 vs. 71.32 ± 4.79, p < 0.01), 3 (77.45 ± 4.41 vs. 73.85 ± 4.69, p < 0.05), and 4 months (79.08 ± 2.96 vs. 73.43 ± 3.52, p < 0.0001) postoperatively. There were no significant differences in linear and volumetric changes, PROMs, and soft tissue inflammation analysis between two groups. The ISQ at implant surgery was influenced by age and diabetes mellitus (DM) at the implant level and DM and predicted total bone-to-implant contact area at the patient level. Conclusion: HA nano-coated SLA implants promoted favorable immediate implants stability during early osseointegration phase compared to uncoated SLA implants, but displayed similar dimensional changes, PROMs, and soft tissue inflammation outcomes. Trial registration: Clinical Research Information Service (CRIS), KCT0006364. Registered 21 July 2021, https://cris.nih.go.kr/cris/search/detailSearch.do?seq=24221&search_page=L. [ABSTRACT FROM AUTHOR]

Aim: To compare the marginal bone level of immediately placed implants, with either immediate or delayed provisionalization (IP or DP), in the maxillary aesthetic zone after 10 years of function. Materials and Methods: Participants with a failing tooth in the maxillary aesthetic zone were randomly assigned to immediate implant placement with either IP (n = 20) or DP (n = 20) after primary wound closure with a free gingival graft. The final restoration was placed 3 months after provisionalization. The primary outcome was change in marginal bone level. In addition, implant survival, restoration survival and success, peri‐implant tissue health, mucosa levels, aesthetic indices, buccal bone thickness and patient satisfaction were evaluated. Results: After 10 years, the mean mesial and distal changes in marginal bone level were −0.47 ± 0.45 mm and −0.49 ± 0.52 mm in the IP group and −0.58 ± 0.76 mm and −0.41 ± 0.72 mm in the DP group (p =.61; p =.71). The survival rate was 100% for the implants; for the restorations, it was 88.9% in the IP group and 87.5% in the DP group. Restoration success, according to modified USPHS criteria, was 77.8% in the IP group and 75.0% in the DP group. The prevalence of peri‐implant mucositis was 38.9% and 35.7% and of peri‐implantitis 0.0% and 6.3%, respectively, in the IP group and DP group (p = 1.0; p =.40). The Pink Esthetic Score and White Esthetic Score was 15.28 ± 2.32 in the IP group and 14.64 ± 2.74 in the DP group, both clinically acceptable (p =.48). The buccal bone thickness was lower in the DP group. Patient satisfaction was similar in both groups (p =.75). Conclusions: The mean marginal bone level changes after immediate implant placement with IP were similar to those after immediate placement with DP. Clinical Trial Registration: Registered in the National Trial Register (NL9340). [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Impiant-supported réhabilitation in high-risk patients poses significant challenges for the dental team. The presence of comorbidities and increased infection risk can, for example, lead to a higher risk of implant loss. For the therapy to be completed with as few compli-cations as possible, special anamnesis, detailed diag-nostics, and a risk analysis based on those findings are indispensable. The aim of all considerations is to keep the risk of infection for the patient with a disease his-tory to a minimum and to strive for an appropriate functional and esthetic therapeutic success. Particu-larly in the esthetic zone, in addition to the general health risks of the surgical procedure, esthetic aspects are increasingly taken into account in planning. The present article describes the implant-prosthetic re-placement of a single anterior tooth in a dialysis pa-tient. Several aspects (regular dialysis, missing buccal lamella, high smile line, functional risk) increased the risk of complications in this case. (Int J Esthet Dent 2024;19:152-169) [ABSTRACT FROM AUTHOR]

Purpose: The objective of the present study was to ascertain the effect of immediate occlusal loading after implant placement on osseointegration and the micro/nanostructure of the surrounding bone. Methods: After extraction of a rat maxillary right second molar, an implant was placed immediately with initial fixation (2 N<). The implants were placed to avoid occlusal loading due to mastication, and in the loaded group, a superstructure was fabricated and subjected to occlusal loading. Bone morphometry, collagen fiber anisotropy, and biological apatite (BAp) crystallite alignment were quantitatively evaluated in both groups after extraction and fixation of the jaw bone at Days 7 and 21 after surgery. Results: Osseointegration was observed in both groups. Bone morphometry showed significant differences in bone volume, trabecular number, trabecular thickness and bone mineral density (BMD) at Days 21 postoperatively (P < 0.05). A significant difference was also found in the trabecular separation at Days 7 postoperatively (P < 0.05). In the evaluation of collagen fiber anisotropy, collagen fiber bundles running differently from the existing bone were observed in both groups. In terms of BAp crystallite alignment, a specific structure was observed in the reconstructed new bone after implantation, and preferential orientation of BAp crystallite alignment was observed in the longitudinal direction of the implants in the Day 21 postoperative loaded group. Conclusion: When sufficient initial fixation is achieved at the time of dental implant placement, then the applied masticatory load may contribute to rapidly achieving not only bone volume, but also adequate bone quality after implant placement. [ABSTRACT FROM AUTHOR]

Objectives: The present study aimed to assess clinically and radiographically the usage of autogenous tooth bone graft (ATBG) combined with and without Simvastatin (SMV) around immediately placed dental implants in periodontally compromised sites. Methods: Thirty-nine patients required a single extraction of periodontally compromised tooth were divided into three groups (13 patients each). Group I received immediate implant placement (IIP) without grafting. Group II received IIP with ATBG filling the gap around IIP. Group III received SMV gel mixed with ATBG around IIP. Radiographic changes were reported at the baseline, 6-, and 12-months post-surgery. Results: All implants achieved the success criteria with no complications. At 6- and 12-months post-surgery, group III showed a statistically lower mean ridge width loss compared to Group I and Group II (P <.001). Group II revealed less reduction in the mean alveolar ridge width compared to group I (P <.001). Group III showed a statistically significantly less MBL loss than group I and group II (P <.001). All groups showed a statistically significant increase in BD gain compared to baseline (P <.001). Group III showed statistically significant high BD compared to group II (P <.001). Group II showed statistically significantly higher mean BD gain than that of group I (P <.001). Conclusion: SMV combined with ATBG boosts the hard tissue parameters around dental implants over ATBG alone. Clinical trial registration was on August 1, 2021 (NCT04992416). Clinical relevance: ATBG with SMV in periodontally compromised sites could improve implant osseointegration and promote favorable changes in peri-implant tissues. [ABSTRACT FROM AUTHOR]

Background: Immediate implant placement after tooth extraction has been found to be a workable and reliable treatment for tooth loss based on clinical and radiographic evaluation. Aim: This study was conducted for comparative evaluation of immediate implant placement in fresh extraction socket with and without the use of platelet-rich fibrin (PRF). Materials and Method: Forty sites in all were chosen, and they were split into two groups at random. Twenty of these were placed immediately with PRF (test category), while the remaining 20 were placed immediately without the use of any comparable adjunct (control group). Using cone beam computed tomography, radiographic characteristics were evaluated both at the time of implant implantation and a year later. Results: The crestal bone at the mesial surface was 2.74 ± 1.44 and 1.96 ± 1.41 mm at baseline and 12-month follow-up in the control group. The crestal bone at the mesial surface was 2.93 ± 1.44 and 2.57 ± 1.57 mm at baseline and 12-month follow-up in the test group. Conclusion: Immediate implant placement in fresh extraction socket showed better results with the use of PRF.

Abstract Background The placement of implants into the alveolar socket right after tooth extraction is called immediate implant placement (IIP). This approach has its particularities depending on which region of the jaws is involved. The anterior mandible region is peculiar due to the presence of mandibular incisors, which have the shortest roots among all permanent teeth. Purpose This study aimed to investigate the factors that could be associated with the risk of either cortical bone wall perforation or invasion of the 2 mm secure distance from the surrounding anatomical structures (defined as unsafe implant placement), with IIP in the maxillary aesthetic zone, in a cone-beam computed tomography (CBCT) virtual study. Materials and methods CBCT exams from 239 eligible subjects were investigated. Implants were virtually placed in two distinct positions: prosthetically-driven (along the long axis of the existing tooth) and bone-driven position (according to the available bone and with regard to nearby anatomical structures). Correlation between several variables was tested, and binary logistic regression analysis in order to assess of the possible associations between covariates and unsafe placement was performed. Results Safe placing implants was significantly higher for the bone-driven in comparison to the prosthetically-driven position (22.2% vs. 3.3%, respectively), and the 2-mm secure distance from anatomical structures was not possible to respect in the majority of cases (77.6% vs. 82.9%, respectively). Covariates associated with a higher risk of unsafe placement were tooth region (CI in relation to IL and CA), decrease of labial concavity angle (LCA), decrease of mandible basal bone height (MBBH), and decrease in mandibular bone thickness at the tooth apex level (MBT0). Conclusion The possibility of safely placing immediate implants in the anterior mandible is significantly higher for bone-driven than in prosthetically driven position. Presurgical virtual planning with CBCT is a great tool for minimizing the risk of implant unsafe placement with regards to the anatomical conditions in the mandible.

Abstract 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.

Background: The aim of this study was to compare and evaluate clinical and radiological outcomes of conventional osteotome technique and CAS kit uses for indirect sinus lifting and immediate implant placement in atrophic posterior maxilla. Methods: A total of 20 patients aged 3mm) posterior maxilla with a minimum width of 6mm were included in the study. They were randomly divided into two groups by computerised allocation into one group undergoing sinus lift with osteotome, and the other with CAS kit. Statistical analysis was done by using descriptive and inferential statistics. Qualitative data were analyzed using the Chi-square test. Dependent and independent variables were evaluated by the paired t-test and unpaired t-test respectively. A p Results: Mean duration for implant placement in the CAS group was 13.40±2.98 and in patients the osteotome group was 22.10±2.55. Mean primary stability in patients with CAS group was 44±6.14 and patients with osteotome group were 35.50±7.61. Mean amount of bone regeneration radiographic evaluation at three months in patients of CAS group was 4.99±0.86 and in patients of osteotome group was 5.59±1.21. The mean amount of bone regeneration radiographic evaluation at nine months in the CAS group was 5.53±0.77 and 6.34±1.11 in the osteotome group. Conclusions: CAS kit compared to osteotome was better in terms of operative time, primary stability, and marginal bone loss resulting in recommended modality.

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. [ABSTRACT FROM AUTHOR]

Immediate oral implant placement is a widely accepted technique, known for its efficacy in reducing treatment duration, surgical visits, and overall healing time. One of the primary challenges associated with immediate implant placement is the attainment of initial stability. The inevitable loss of bone and soft tissue after extraction poses a risk to implant osseointegration in both vertical and horizontal dimensions. Guided tissue regeneration/guided bone regeneration (GTR/GBR) is a well‐established method for periodontal regeneration. However, current GTR/GBR membranes lack tissue inherent regeneration properties and necessitate combination with grafts to enhance tissue recovery. In this context, biomaterials have emerged as a promising option due to their good biocompatibility, biodegradability, and bioactive properties. They present a potential alternative to standard autologous/allograft procedures. The field of biomaterials for bone regeneration has rapidly evolved, developing new guiding materials and engineering techniques. These advances have become integral in addressing tissue defects at the immediate implant site. Various materials such as bioceramics, natural polymers, and synthetic polymers have been used for tissue repair. This article undertakes an etiological examination of tissue deficiency associated with immediate implant placement. Additionally, it reviews the advantages and disadvantages of a variety of biomaterials, aiming to provide references for clinical treatment and areas for further investigation. [ABSTRACT FROM AUTHOR]

Objective: To observe the clinical efficacy of autologous platelet-rich fibrin (PRF) application alone in immediate dental implant placement in the molars with periapical periodontitis, and to discuss the mechanism, in order to widen its clinical application and to provide the guidance for its clinical practice. Methods: The clinical data of one patient who underwent immediate implant placement in the molars with periapical periodontitis using PRF as the sole material were collected. The changes in the tissues surrounding the implant were evaluated through the three-dimensional reconstruction of cone-beam CT (CBCT) and oral scan data, the therapeutic methods and outcomes of PRF treatment were analyzed combined with the relevant literatures. Results: A minimally invasive extraction of the patient’s 46 diseased molar was conducted followed by the immediate implant placement. Before surgery，30 mL of the patient’s own blood (3 tubes) was drawn, which was then placed in 10 mL glass-coated plastic tubes without anticoagulants. Three PRF were prepared with the blood by centrifuging at 3 000 r·min-1 for 10 min. These clots were used as the only filling material for the jumping gap. The postoperative CBCT and oral scan 3D reconstruction results showed that the peri-implant bone tissue was increased by 203. 19 mm3, the buccal bone height was increased by 5. 83 mm, and the buccal bone tissue was increased by more than 1 mm at 6 months postoperatively; after 12 months, the soft and hard tissues around the implant remained essentially stable. Conclusion: The application of autologous PRF alone in immediate implant placement in the molars with periapical periodontitis achieves favorable treatment outcomes, the peri-implant bone tissue regenerates, and the peri-implant hard and soft tissues remain stable, which providing the new insights into the immediate implant treatment. [ABSTRACT FROM AUTHOR]

Objectives: The present case report describes the atraumatic extraction of a primary maxiiiary right canine followed by immediate implant placement with a customized zirconia abutment and monolithic uitra-trans- iucent zirconia (5Y-PSZ) crown. Clinical considerations: A 31-year-oid patient presented to the ciinic with the primary concern of mo- biiity and gingival inflammation around the maxiiiary right canine. After ciinicai evaluation, the tooth was found to be a primary retained tooth that presented grade 3 mobility and gingival inflammation. Atraumatic tooth extraction was performed, followed by immediate implant placement of a screw-retained provisional restoration with the use of a surgical guide. The soft tissue was contoured untii ideai architecture was obtained. The final restoration included a customized zirconia and titanium abutment and a characterized impiant-supported monolithic 5Y-PSZ crown. Conclusions: Weii-pianned surgicai and restorative procedures inciuding atraumatic extraction, 3D im- piant pianning for surgicai guide fabrication, impiant piacement, and a customized zirconia abutment with a monoiithic 5Y-PSZ crown can achieve high esthetic re- suits in repiacing a primary tooth in the esthetic zone. (Int J Esthet Dent 2024;19:34-44) [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to assess soft and hard tissue changes occurring 6 and 12 months after guided implant placement into extraction sockets and immediate temporization in the esthetic zone. Methods: Eight patients requiring single immediate implant placement in the anterior mandible or maxilla were included in this study. A traumatic extractions were performed using ultrasonic instruments and implants were placed into extraction sockets following digitally guided surgery. Gap between implants and buccal bone plate was filled with allogeneic bone substitutes. Implants were immediately temporized with pre-prepared PMMA crowns. Cone Beam Computed Tomography and digital impressions were done pre-operatively, immediately following surgery and at 6 and 12 months and were used to compare hard and soft tissue retraction at these time points. Changes in buccal bone thickness at 0, 2 and 4mm from implant neck were measured using ITK-Snap software and soft tissue profile changes were measured using the Blue-Sky software. Two-way repeated measures analysis of variance and one-sample t tests were conducted to analyze data. Results: All eight implants were successfully osseointegrated. Mean buccal Bone thickness at implant neck level was 1.90mm after 12 months and at 2 and 4mm apical to the neck bone thickness was respectively 1.88 and 1.56mm. When comparing bone retraction at implant neck level at different time points, a statistically significant buccal bone thickness reduction of 0.56 ± 0.66mm was observed between 0 and 6 months (p=0.049), as well as a reduction of 0.32 ± 0.37mm between 6 and 12 months (p=0.046). However, at the 2 mm and 4 mm levels, no statistically significant reduction appeared in buccal bone thickness at 6 and 12 months (p>0.05). Soft tissue profile measured facing implant neck was significantly reduced by 0.45 ± 0.39mm (p=0.014) between 0 and 6 months, and by 0.52 ± 0.59mm between 6 and 12 months. Conclusion: Immediate implant placement and temporization using digitally guided approach is a reliable technique in the esthetic area. Following gap grafting, minimal hard and soft tissue contour remodeling was observed with an optimal residual buccal bone thickness, allowing the maintenance of a stable emergence profile at 12 months. [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 Background This study aimed to compare the efficacy of different gap filling materials in immediate implant in anterior and premolar regions of maxilla. Materials and methods Thirty-six implants were inserted in patients seeking for replacement of non-restorable maxillary anterior and premolar teeth (esthetic zone) by immediate implant. Patients were randomly distributed into three equal groups, twelve implants in each group. Group 1 received Platelet Rich Fibrin (PRF) into the jumping distance, Group 2 received Xenograft into the jumping distance and Group 3 received Alloplastic bone grafting material into the jumping distance. Implant stability by measuring the changes in Resonance Frequency Analysis (RFA), peri-implant pocket depth, marginal bone loss and changes in buccal bone thickness were evaluated during follow up periods. All the clinical and radiographic data were subjected to statistical analysis by One Way ANOVA test and the Post Hoc Tukey test. Results This study involved 19 female patients and 17 male patients who received 36 dental implants. There was no significant difference between the study groups regarding implant stability, peri-implant pocket depth and palatal bone loss, while there was a significant difference between PRF Group (Group 1) and the other Groups regarding buccal bone loss and changes in buccal bone thickness. Conclusion PRF can be used as a gap filling material in conjunction with immediate implant placement, but other bone grafting materials give superior result regarding buccal bone loss and changes in buccal bone thickness. Trial registration The study was listed on www.clinicaltrials.gov with registration number (NCT05878392) on 26/05/2023. The Institutional Review Board (IRB) of the Faculty of Dentistry, Mansoura University, Mansoura, Egypt, approved the current study in compliance with the seventh revision of the Helsinki Declaration in 2013 (A0103023OS).

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.

This case study presents the successful transformation of a 30-year-old woman's smile through immediate implant placement as an alternative to orthodontic correction. The patient, who was preparing for marriage in three months, expressed dissatisfaction with her crowded teeth and desired a rapid solution. Traditional orthodontic treatment, which typically requires around two years, was not feasible due to time constraints. Therefore, the patient opted for immediate implants with the simultaneous extraction of overcrowded front teeth. The step-by-step process of monoimplant placement and its impact on the patient's aesthetic outcome are discussed. This case highlights the efficacy and versatility of monoimplants in addressing diverse dental concerns, leading to significant smile enhancement within a short timeframe. [ABSTRACT FROM AUTHOR]

Background: The aim of this narrative review was to provide insights into the influence of the morphological characteristics of the anatomical structures of the upper jaw based on cone beam computed tomography (CBCT) analysis on the immediate implant placement in this region. Material and Methods:To conduct this research, we used many electronic databases, and the resulting papers were chosen and analyzed. From the clinical point of view, the region of the anterior maxilla is specific and can be difficult for immediate implant placement. Findings: Anatomical structures in the anterior maxilla, such as the nasopalatine canal and accessory canals, may limit and influence the implant therapy outcome. In addition to the aforementioned region, immediate implant placement in the posterior maxilla may be challenging for clinicians, especially in prosthetic-driven immediate implant placement procedures. Data presented within the recently published materials summarize the investigations performed in order to achieve more reliable indicators that may make more accurate decisions for clinicians. Conclusion: The possibility for immediate implant placement may be affected by the NPC shape in the anterior maxilla, while the presence of ACs may increase the incidence of immediate implant placement complications. The variations in IRS characteristics may be considered important criteria for choosing the implant properties required for successful immediate implant placement.

Purpose: To introduce a new method for labiopalatal positioning and angulation of immediately placed dental implants in the anterior maxilla with relation to the type of abutment used (straight/angled abutment). Materials and Methods: CBCT scans from the database of a private practice were searched for patients who received immediate implants in the anterior maxilla. After superimposition of the initial and postoperative scans, the incisor root angle (IRA), incisor implant angle (IIA), and the difference between these angles were measured. An assessment was then made about whether the implant position would be within the safe angle or not. Age, sex, tooth/implant site, and type of prosthetic abutment (straight/angled) were retrieved from the patients' records. Results: A total of 74 patients with 95 immediate implants altogether were selected for analysis. In regard to the type of abutment, 76 (80%) were straight, and 19 abutments (20%) were angled. Regardless of abutment type, 72 implants (75.8%) were placed within the safe angle, while 23 implants (24.2%) were placed outside it. All 19 implants with angled abutments were placed outside the safe angle. There were statistically significant associations between placement within the safe angle and type of abutment (P < .001; OR = 19), IRA (P < .001; effect size = 0.904), difference between IIA and IRA (P < .001; effect size = 1.209), and sex (P < .001; OR = 2.995). There was no statistically significant association between placement within the safe angle and IIA (P = .757, effect size = 0.063), site (P = .200; effect size = 0.184), or age (P = .387; effect size = 0.208). There was a statistically significant association between the type of abutment and the IRA (P = .001; effect size = 0.762) as well as the difference between IIA and IRA (P < .001; effect size = 1.056). Conclusions: The safe angle concept can be used as a reliable planning tool to determine the correct implant positioning for immediate implant placement in the anterior maxilla. Applying the safe angle concept will reduce the need for angled abutments for prosthetic correction. [ABSTRACT FROM AUTHOR]

The aim of this retrospective study was to evaluate the treatment outcome of All-on-6 and All-on-4 Fast @Fixed from Bredent implants (Brdent GmbH, Senden,Germany) immediately loaded with fixed full-arch prosthesis. Delivering a full arch implant restoration, which transits a patient from the frustartions of edentulism to the stability and function of a fixed prosthesis, is one of the most rewarding experience in dentistry. With the advancement in digital technology and with modified implant design and advance prosthetic options, what started as a two stage delayed loading procedure in the seventies, evolved to immediate implant palcement in extraction sockets and even immediate loading of these implants in a browing number of indications. Within the limits of this small group (n=11 patients/114 implants), the failure rate of the analyzed implant system (n=3 respectiv 2,63% implant loss) seems to be comparable with other immediate-loading protocols. Following this study, we can conclude that the body of the bridge in point contact with the alveolar ridge allows a better sanitation of the prostehtic bridge and thus avoids the occurrence of peri-implantitis. In the case of the bridge bodies that completely cover the vestibular and oral alveolar ridge, we observed an accentuated resorption of the alveolar ridge over time.

Abstract Immediate oral implant placement is a widely accepted technique, known for its efficacy in reducing treatment duration, surgical visits, and overall healing time. One of the primary challenges associated with immediate implant placement is the attainment of initial stability. The inevitable loss of bone and soft tissue after extraction poses a risk to implant osseointegration in both vertical and horizontal dimensions. Guided tissue regeneration/guided bone regeneration (GTR/GBR) is a well‐established method for periodontal regeneration. However, current GTR/GBR membranes lack tissue inherent regeneration properties and necessitate combination with grafts to enhance tissue recovery. In this context, biomaterials have emerged as a promising option due to their good biocompatibility, biodegradability, and bioactive properties. They present a potential alternative to standard autologous/allograft procedures. The field of biomaterials for bone regeneration has rapidly evolved, developing new guiding materials and engineering techniques. These advances have become integral in addressing tissue defects at the immediate implant site. Various materials such as bioceramics, natural polymers, and synthetic polymers have been used for tissue repair. This article undertakes an etiological examination of tissue deficiency associated with immediate implant placement. Additionally, it reviews the advantages and disadvantages of a variety of biomaterials, aiming to provide references for clinical treatment and areas for further investigation.

Background: Many techniques have been proposed to address post‐extraction ridge resorption, which often represents a concern, especially in the esthetic region. Purpose: The purpose of the present, prospective, multicenter, single cohort study was to investigate, up to 1 year of function, the effectiveness of a protocol for alveolar ridge preservation involving implants with laser‐microgrooved surface immediately placed in fresh extraction sockets. Materials and Methods: Twenty eight patients candidate to tooth extraction in the esthetic zone (site 15–25 and 35–45) were treated by immediate placement of a single laser‐microgrooved implants with the adjunct of a highly porous anorganic porcine bone mineral matrix and a collagen wound dressing. Peri‐implant marginal bone level (MBL) was evaluated at time of loading, 3 and 12 months after loading. Gingival index, plaque index, probing depth, and bleeding on probing were measured at 3, 6, and 12 months after loading. Dimensional changes at implant sites were digitally evaluated using the best‐fit superimposition of pre‐and post‐socket preservation models. Implant aesthetic score (IAS) as well as patients' post‐operative quality of life were also evaluated at 12 months. Comparisons between data relative to thick and thin gingival phenotypes were made using Student's t‐test or Mann–Whitney test, as appropriate. The significance level was set at p = 0.05. Results: No patient dropped out, and 28 implants were evaluated at 12 months post‐loading. The overall MBL was found to be 0.92 ± 1.11 mm. Volumetric analysis of superimposed models showed an alveolar bone tissue displacement at the buccal aspect of −0.57 ± 0.52 mm in thin phenotypes and −0.46 ± 0.31 mm in thick phenotypes (p = 0.58, unpaired Student's t‐test). No signs of soft tissue recession or esthetically unpleasant buccal gingiva were reported. Conclusions: The clinical protocol herein employed showed benefits in maintaining marginal bone levels and soft tissue contour around post‐extraction implants in the esthetic zone. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The clinical requirement for a good esthetic result for immediate implant placement is the absence of dehiscence in the anterior facial alveolar bone. In the presence of dehiscence, it is recommended to use a connective tissue graft in addition to immediate implant placement or to change to early implant placement. However, the literature focusing on dehiscence is scarce, and the influence of different placement times and combined use of connective tissue graft on postoperative esthetics in cases with dehiscence is unclear. Therefore, we quantitatively evaluated the pre-extraction dehiscence morphology and postoperative changes in the facial tissue of implants in three groups: immediate implant placement (Group I), immediate implant placement with connective tissue graft (Group IC), and early implant placement (Group E). To this end, 52 implants were obtained (20 in Group I, 16 in Group IC, and 16 in Group E). A wider dehiscence increases the risk of soft tissue regression, which was one reason for choosing early implant placement. A combination of immediate implant placement and connective tissue graft, or early implant placement, tended to result in less soft tissue regression due to the thicker postoperative facial soft tissue volume. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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.

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.