Implant site development by orthodontic extrusion. A systematic review

To determine the effectiveness of orthodontic extrusion of nonrestorable teeth prior to implant placement for improving the alveolar bone and gingival characteristics of implant recipient sites.

Electronic database searches of the following databases were conducted with the help of a senior health sciences librarian: Medline, PubMed, EMBASE, Scopus, Web of Science, and CINAHL Plus. Hand searches of the reference lists of selected articles were also conducted. Abstracts that appeared to fulfill the initial selection criteria were selected for full article retrieval. Retrieved articles were then carefully evaluated, and more specific selection criteria were applied. The authors conducted the selection processes independently, and any differences were resolved through discussion. An analysis of timing, type, and magnitude of forces applied was sought.

Eighteen articles were considered for review. Most of the selected articles were case reports or case series describing orthodontic extrusion of periodontally hopeless maxillary anterior teeth. The results of the reported cases were evaluated individually and collectively with regard to various hard and soft tissue implant site characteristics. Clinically significant gains in alveolar bone and gingival tissue were reported in all cases, resulting in significant quantitative and qualitative improvements in the implant sites.

Based on the available literature, orthodontic extrusion of nonrestorable teeth prior to implant placement appears to be a viable alternative to conventional surgical augmentative procedures in implant site development. No direct comparison to any other method was found, and therefore no conclusion could be made about its relative efficacy.