Immediately loaded non-submerged versus delayed loaded submerged dental implants: a meta-analysis

Area of Science:

• Dental Implantology
• Oral Surgery
• Biomaterials Science

Background:

• Dental implant rehabilitation is a common procedure for tooth loss.
• Immediate loading protocols and submerged vs. non-submerged implant designs are debated.
• Evidence comparing these techniques requires synthesis.

Purpose of the Study:

• To compare implant failure rates, postoperative infection, and marginal bone loss.
• To evaluate immediately loaded non-submerged implants versus delayed loaded submerged implants.
• To test the null hypothesis of no difference between the two implant rehabilitation methods.

Main Methods:

• A meta-analysis of 28 publications was conducted.
• Electronic search without time or language restrictions (March 2014).
• Included randomized and non-randomized clinical human studies; analyzed using inverse variance method (random- or fixed-effects model).

Main Results:

• A significantly higher implant failure rate was observed for non-submerged implants (Risk Ratio [RR] = 1.78, P = 0.02).
• No significant difference in postoperative infection (RR = 2.13, P = 0.29) or marginal bone loss (Mean Difference [MD] = -0.03 mm, P = 0.77) was found.
• Twenty-three studies had a high risk of bias.

Conclusions:

• Non-submerged dental implants are associated with an increased risk of implant failure.
• The choice between submerged and non-submerged implants did not significantly impact infection or bone loss.
• Further high-quality research is needed due to the high risk of bias in included studies.