Soft Tissue Changes Around Immediately Placed Implants: A Systematic Review and Meta-Analyses With at Least 12 Months...

Area of Science:

• Dental Implantology
• Periodontology
• Esthetic Dentistry

Background:

• Immediate implant placement (IIP) offers predictability but poses esthetic challenges, specifically midfacial recession (MFR) and loss of papillary height (PH).
• Assessing the long-term esthetic impact of IIP is crucial for clinical decision-making and patient satisfaction.

Purpose of the Study:

• To systematically review the effects of immediate implant placement (IIP) on midfacial recession (MFR) and papillary height (PH).
• To evaluate these esthetic outcomes at least 12 months after functional loading of dental implants.

Main Methods:

• A comprehensive literature review of the Cochrane and MEDLINE databases was conducted, supplemented by a hand search.
• Four independent reviewers assessed study quality and methodology.
• Meta-analyses were performed on eligible studies to quantify the effects of different IIP protocols.

Main Results:

• Conventional implant placement (CIP) showed a trend towards less MFR and better PH than IIP, though not always statistically significant.
• Immediate implant placement (IIP) in patients with thick biotypes demonstrated statistically significant reductions in MFR and improved PH.
• Immediate provisionalization with IIP resulted in significantly better PH maintenance compared to delayed restoration.

Conclusions:

• Immediate implant placement (IIP) in thick biotypes combined with immediate provisionalization yields superior esthetic outcomes (less MFR, better PH) compared to IIP in thin biotypes or with delayed restoration.
• Findings should be interpreted cautiously due to high heterogeneity and a limited number of qualified studies.
• Further research is warranted to confirm these esthetic benefits of specific IIP protocols.