Quality Assessment of Systematic Reviews on Oral Implants Placed Immediately into Fresh Extraction Sockets

During the last two decades, many clinical trials and systematic reviews (SRs) have evaluated the clinical outcomes of immediate implant placement and its effects on soft and hard tissue. Despite the increased popularity and knowledge of immediate implant placement, the evidence about its benefits is still not conclusive. The aim of this review was to assess the quality of published SRs with meta-analyses of immediate implant placement and provide an overview of the key findings.

Searches of MEDLINE, EMBASE, the Cochrane Library, and the Database of Abstracts of Reviews of Effects were performed to include SRs with meta-analysis of immediate implant placement. Two independent reviewers assessed the methodologic quality of SRs using A MeaSurement Tool to Assess Reviews (AMSTAR), the 2003 checklist of Glenny et al, and the Critical Appraisal Skills Program (CASP).

A total of 742 articles were found; 5 were included. All included SRs were published after 2007. Implant survival rate was the most commonly reported outcome. There was insufficient information in the primary studies, and hence in the SRs, about other outcomes and any adverse events. However, the methodologic quality of the SRs was considered to be high.

There is a general consensus among the included SRs that it is still premature to draw definite conclusions about the potential benefits of immediate implant placement because of the limited number of well-designed controlled clinical trials. Improvements in future SRs are still required and can be achieved by following established quality criteria, namely researching the unpublished literature and literature not in English and by reporting the quality assessment of primary studies and any sources of bias.