歯周病患者における即時埋入と遅延埋入のインプラント治療成績の比較メタアナリシス

This study aimed to compare the outcomes of immediate versus delayed implant placement in patients with periodontitis through a meta-analysis, evaluating differences in restorative outcomes, implant success rate and aesthetics.

A systematic search was conducted across multiple databases (PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure) for relevant randomised controlled trials (RCTs). The inclusion criteria identified patients with severe periodontitis with residual alveolar bone height ≥4 mm post-extraction. Nine RCTs were included, analysing the postoperative probing depth (PD), modified sulcus bleeding index (mSBI), modified plaque index (mPLI), aesthetic outcomes and implant success rate.

Postoperative PD: Immediate implantation had significantly higher PD scores than delayed implantation (mean difference [MD] = 0.32, 95% confidence interval [CI] = 0.21-0.43, p < 0.0001). Postoperative mSBI: Immediate implantation showed superior mSBI scores (MD = 0.29, 95% CI = 0.12-0.46, p = 0.001). Postoperative mPLI: Immediate implantation outperformed delayed implantation (MD = 0.61, 95% CI = 0.53-0.69, p < 0.0001). Aesthetic outcomes: Immediate implantation resulted in better aesthetic scores at 3, 6 and 12 months (3 months: MD = 1.80, p < 0.0001; 6 months: MD = 2.42, p = 0.03; 12 months: MD = 1.65, p = 0.04). Implant Success Rate: A significant difference was found in implant success rates between the groups (risk ratio = 1.74, 95% CI = 1.30-2.34, p = 0.0002).

Immediate implantation shows significant short-term benefits in patients with periodontitis, particularly in restorative outcomes and aesthetics. Although there is no significant difference in implant success rates, delayed implantation may aid in periodontal tissue recovery. The choice between the two strategies should be tailored to the patient's condition and clinical needs.