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A Systematic Review of Outcomes Following Immediate Molar Implant Placement Based on Recently Published Studies
Mohammad Ketabi1, Douglas Deporter2, Eshetu G Atenafu3
1Professor, Department of Periodontology, Faculty of Dentistry, Islamic Azad University, Isfahan Branch, Isfahan, Iran.
Background:
Immediate implant placement in molar extraction sites has become a treatment option for experienced clinicians.
Purpose:
The aim of this study was to provide a systematic review and meta-analysis of outcomes from recent clinical studies with immediate molar implants.
Materials And Methods:
A systematic review was undertaken of relevant literature published from November 2008 to May 2015. Data collected included implant survival rates after at least 1 year in function, cumulative crestal bone loss, and implant location (maxilla vs mandible) and diameter. Implant diameters were grouped as "wide" (4-6 mm) or "ultra-wide" (>6-9 mm). Survival and bone loss with 95% CIs were calculated using a random effects model. Meta-analysis techniques were used to compare survival rates and cumulative mean bone loss between immediate and delayed placement implants. Survival rates also were computed and compared between wide and ultra-wide implants using chi-square testing. The quality of each study was assessed using established criteria.
Results:
The literature search provided 15 papers published between November 2008 and May 2015 that satisfied the inclusion criteria. Data on survival were found for a total of 768 immediate molar implants inserted in 757 patients. Meta-analysis of these data showed an implant survival rate of 98% with no difference between maxilla and mandible. Five studies included delayed molar implants as controls, and no significant differences were detected. A significant difference (p = .048) was found in relation to implant diameter with implant failures being higher (3.67 vs 1.45%) for ultra-wide (>6-9 mm) versus wide (4-6 mm) implants. The majority of the 15 studies were determined to be either "average" (prospective case series) or "fair" (retrospective) in quality.
Conclusion:
While there are still no published reports from double-blind, randomized, controlled (best quality) clinical trials of immediate molar implant placement, high survival rates have been reported. The present data, however, suggests that there may be an optimal diameter for this implant application. Meta-analysis of the limited bone loss data reported estimated the overall mean cumulative bone loss after at least 1 year to be 0.57 mm.
