Cochrane · intervention · CD005968
Interventions for replacing missing teeth: dental implants in fresh extraction sockets (immediate, immediate‐delayed and delayed implants)
Esposito, M, Grusovin, MG, Polyzos, IP, et al. · Cochrane Database of Systematic Reviews · 2010 · Cochrane Library
Oral HealthImplants and prosthodonticsOral and maxillofacial surgery3 versionsAMSTAR 2: not assessed
Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.
Questions
36
current version
GRADE rated
0
No studies
0
Included studies
7
as reported
No studies 0 · 0%Ungraded 36 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients with compromised teeth to be extracted who required dental implants with or without bone augmentation procedures at the extraction sites | Patients requiring single implants in fresh extraction sockets, mostly maxillary anterior/premolar; adults (n=270 across 7 trials) |
| Intervention | Immediate implants (placed just after tooth extraction); Immediate-delayed implants (placed within 8 weeks after tooth extraction); Augmentation procedures at immediate/immediate-delayed implants (autogenous bone graft, bone substitutes, guided bone regeneration, resorbable/non-resorbable barriers, Bio-Oss) | Immediate implants (4 trials); Immediate-delayed implants (2 trials); Augmentation at immediate implants - autogenous bone/barriers/Bio-Oss (3 trials) |
| Comparison | Delayed implants (placed at least 2 months after extraction); No augmentation; alternative augmentation procedures | Delayed implants (3 trials); No augmentation (1 trial); alternative augmentation procedures (2 trials) |
| Outcomes | Prosthesis failure; Implant failure; Major complications at the implant/donor site; Patient satisfaction including aesthetics; Patient preference including aesthetics (only in split-mouth trials); Aesthetics evaluated by dentist; Perimplant marginal bone level changes over time; Vertical and/or horizontal bone gain (only for the augmentation procedures); Duration of the treatment time; Difference in treatment costs | Prosthesis failure (n=7); Implant failure (n=7); Major complications (n=6); Patient satisfaction including aesthetics (n=2); Aesthetics evaluated by dentist (n=5); Perimplant marginal bone level changes (n=5); Vertical/horizontal bone gain (n=3); Duration of the treatment time (n=7) |
| Study designs | Randomised controlled clinical trials (RCTs) including split-mouth studies | Randomised controlled trials, all parallel group design (n=7) |
| Timing | Follow up of at least 1 year under functional loading; Time points: 1, 3 and 5 years after loading | 1 year (n=1); 2 years (n=4); 3 years (n=1); 5 years (n=1) |
Search date: 2010-06. Databases: The Cochrane Oral Health Group's Trials Register; CENTRAL; MEDLINE via OVID; EMBASE via OVID
Questions and results
Current version onlyImmediate implants (placed in a fresh extraction socket just after tooth extraction) vs Delayed implants (placed at least 2 months after extraction, in healed bone)
Population: Patients with compromised teeth to be extracted who require single dental implants in fresh postextraction sockets
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Perimplant marginal bone level changes 1 year | No statistically significant differences for perimplant marginal bone level changes at 1 year (Lindeboom 2006). | 1 study · 50 participants | Ungraded |
Prosthesis failure 1 year | RR 4.33 [0.76, 24.56] | 2 studies · 110 participants | Ungraded |
Aesthetics assessed by dentist: position of the perimplant tissues 1 year | One year after placement, there were no statistically significant differences for the level of the perimplant marginal mucosa in relation to that of the adjacent teeth (Lindeboom 2006). | 1 study · 50 participants | Ungraded |
Implant failure 1 year | RR 4.33 [0.76, 24.56] | 2 studies · 110 participants | Ungraded |
Immediate-delayed implants (placed within 8 weeks after tooth extraction) vs Delayed implants (placed at least 2 months after extraction)
Population: Patients with compromised teeth to be extracted who require single dental implants in fresh postextraction sockets
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Major complications at the implant site 5 years | RR 4.20 [1.01, 17.43] | 1 study · 46 participants | Ungraded |
Implant failure up to 5 years | Three early implant failures (two immediate-delayed, one delayed); no statistically significant difference up to 5 years (Schropp 2003). | 1 study · 46 participants | Ungraded |
Perimplant marginal bone level changes 2 years | No statistically significant differences for marginal bone level changes (Analysis 2.9; Schropp 2003). | 1 study · 44 participants | Ungraded |
Patients' aesthetic perception (satisfaction with crown appearance) 2 years | No statistically significant difference for aesthetics assessed by the patient (Analysis 2.5; Schropp 2003). | 1 study · 44 participants | Ungraded |
Aesthetics assessed by dentist: interproximal papilla dimension 2 years | No statistically significant difference for the papilla height assessed by the dentist (Schropp 2003). | 1 study · 44 participants | Ungraded |
Aesthetics assessed by dentist: position of the perimplant tissues 2 years | RR 1.68 [1.04, 2.72] | 1 study · 44 participants | Ungraded |
Prosthesis failure up to 5 years | After 2 years (and up to 5 years) there were no statistically significant differences for prosthesis failures (Schropp 2003). | 1 study · 46 participants | Ungraded |
Patients' general satisfaction of treatment 2 years | MD 6.51 [0.39, 12.63] | 1 study · 44 participants | Ungraded |
Patients' perception of how long treatment took 2 years | MD -20.30 [-33.36, -7.24] | 1 study · 44 participants | Ungraded |
Immediate implants (placed just after tooth extraction) vs Immediate-delayed implants (placed within 8 weeks after tooth extraction)
Population: Patients with compromised teeth to be extracted who require single dental implants in fresh postextraction sockets
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Aesthetics assessed by dentist: position of the perimplant tissues 2 years | Two years after implant placement there were no implant failures, complications or drop-outs, nor statistically significant differences for the level of the perimplant marginal mucosa in relation to the implant collar… | 1 study · 16 participants | Ungraded |
Perimplant marginal bone level changes 2 years | No statistically significant differences for perimplant marginal bone level changes (Analysis 3.2; Palattella 2008). | 1 study · 16 participants | Ungraded |
Autogenous bone graft augmentation at the immediate implant site vs No augmentation
Population: Patients receiving immediate single implants in fresh extraction sockets (maxillary anterior/premolar sites)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Implant failure up to 2 years | Two implants were lost in the autogenous bone group versus none in the non-augmented group; no statistically significant difference (Chen 2005b). | 1 study · 26 participants | Ungraded |
Prosthesis failure up to 2 years | In total two implants were lost in the autogenous bone group, whereas no complications or failures occurred in the non-augmented control group; underpowered, no statistically significant difference (Chen 2005b). | 1 study · 26 participants | Ungraded |
Major complications at the implant/donor site up to 2 years | Two complications occurred in the group treated with autogenous bone (one abscess that determined the early failure of the implant and one wound dehiscence); none in the control group. | 1 study · 26 participants | Ungraded |
Bone gain (vertical - VDH) up to 2 years | Both treatments resulted in statistically significant bone gain, however no statistically significant differences were found between the two procedures for vertical height of the defect (VDH) (Chen 2005b). | 1 study · 26 participants | Ungraded |
Bone gain (horizontal - HDD) up to 2 years | No statistically significant differences between the two procedures for horizontal depth of the defect (HDD) (Chen 2005b). | 1 study · 26 participants | Ungraded |
Resorbable barrier (guided bone regeneration) vs Non-resorbable barrier (guided bone regeneration)
Population: Patients receiving immediate single implants in fresh extraction sockets (maxillary anterior/premolar sites)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Bone gain (horizontal - HDD) up to 2 years | All treatments resulted in statistically significant bone gain, however no statistically significant differences were found between the three procedures (Chen 2005a). Horizontal depth of the defect (HDD). | 1 study · 23 participants | Ungraded |
Bone gain (vertical - VDH) up to 2 years | All treatments resulted in statistically significant bone gain, however no statistically significant differences were found between the three procedures (Chen 2005a). Vertical height of the defect (VDH). | 1 study · 23 participants | Ungraded |
Major complications at the implant/donor site up to 2 years | Four complications occurred: two dehiscences in the resorbable group; one abscess and one dehiscence in the resorbable + autogenous bone group; none in the non-resorbable group. No statistically significant differences… | 1 study · 23 participants | Ungraded |
Resorbable barrier (guided bone regeneration) vs Resorbable barrier + autogenous bone
Population: Patients receiving immediate single implants in fresh extraction sockets (maxillary anterior/premolar sites)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Bone gain (vertical - VDH) up to 2 years | All treatments resulted in statistically significant bone gain, however no statistically significant differences were found between the three procedures (Chen 2005a). Vertical height of the defect (VDH). | 1 study · 24 participants | Ungraded |
Bone gain (horizontal - HDD) up to 2 years | All treatments resulted in statistically significant bone gain, however no statistically significant differences were found between the three procedures (Chen 2005a). Horizontal depth of the defect (HDD). | 1 study · 24 participants | Ungraded |
Major complications at the implant/donor site up to 2 years | Four complications occurred: two dehiscences in the resorbable group; one abscess and one dehiscence in the resorbable + autogenous bone group; none in the non-resorbable group. No statistically significant differences… | 1 study · 24 participants | Ungraded |
Non-resorbable barrier (guided bone regeneration) vs Resorbable barrier + autogenous bone
Population: Patients receiving immediate single implants in fresh extraction sockets (maxillary anterior/premolar sites)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Bone gain (horizontal - HDD) up to 2 years | All treatments resulted in statistically significant bone gain, however no statistically significant differences were found between the three procedures (Chen 2005a). Horizontal depth of the defect (HDD). | 1 study · 25 participants | Ungraded |
Major complications at the implant/donor site up to 2 years | Four complications occurred: two dehiscences in the resorbable group; one abscess and one dehiscence in the resorbable + autogenous bone group; none in the non-resorbable group. No statistically significant differences… | 1 study · 25 participants | Ungraded |
Bone gain (vertical - VDH) up to 2 years | All treatments resulted in statistically significant bone gain, however no statistically significant differences were found between the three procedures (Chen 2005a). Vertical height of the defect (VDH). | 1 study · 25 participants | Ungraded |
Bio-Oss (anorganic bovine bone) vs Bio-Oss + resorbable barrier
Population: Patients receiving immediate single implants in fresh extraction sockets (maxillary anterior/premolar sites)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Bone gain (horizontal - HDD) up to 3 years | No statistically significant differences in bone gain between the two procedures for horizontal depth of the defect (HDD) (Chen 2007). | 1 study · 20 participants | Ungraded |
Bone gain (vertical - VDH) up to 3 years | All treatments resulted in statistically significant bone gain, however no statistically significant differences in bone gain were found between the two procedures for vertical height of the defect (VDH) (Chen 2007). | 1 study · 20 participants | Ungraded |
Major complications at the augmented site up to 3 years | Two complications occurred in the Bio-Oss plus barrier group (one abscess during healing; one chronic perimplant mucositis); none in the Bio-Oss group. No statistically significant difference. | 1 study · 20 participants | Ungraded |
Poor aesthetics measured by dentist (after restoration) up to 3 years | After placement of the final restorations the operator judged aesthetics to be poor in 2/10 patients of the Bio-Oss group and in 4/10 of the Bio-Oss plus barrier group; no statistically significant difference. | 1 study · 20 participants | Ungraded |
Poor aesthetics measured by patient (after restoration) up to 3 years | After delivery of the prostheses one patient in each group was dissatisfied with aesthetics (1/10 vs 1/10); no statistically significant difference (Chen 2007). | 1 study · 20 participants | Ungraded |
Augmentation (prosthesis/implant) failure up to 3 years | There were no prosthesis or implant failures in either group (Bio-Oss vs Bio-Oss + resorbable barrier; Chen 2007); not estimable. | 1 study · 20 participants | Ungraded |
Poor aesthetics measured by dentist (3 years) 3 years | After 3 years of loading, the operator judged aesthetics to be poor in 2/7 patients of the Bio-Oss group and in 2/5 of the Bio-Oss plus barrier group; no statistically significant difference. | 1 study · 20 participants | Ungraded |
Immediate implants (placed in a fresh extraction socket just after tooth extraction) vs Delayed implants (placed at least 2 months after extraction, in healed bone)
Population: Patients with compromised teeth to be extracted who require single dental implants in fresh postextraction sockets
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Major complications at the implant site 1 year | According to the authors no complication occurred (0/25 immediate vs 0/25 delayed; Lindeboom 2006); not estimable. | 1 study · 50 participants | Ungraded |
Prosthesis failure 1 year | One study (Lindeboom 2006) compared immediate versus delayed implants in periapical infected sites (25 per group). After 1 year there was no statistically significant difference for prosthesis failures. | 1 study · 50 participants | Ungraded |
Aesthetics assessed by dentist: interproximal papilla dimension 1 year | No statistically significant difference for aesthetics assessed by a dentist (interproximal papilla dimension) after 1 year (Lindeboom 2006). | 1 study · 50 participants | Ungraded |
Implant failure 1 year | Two early implant failures occurred in the immediate group (2/25 vs 0/25 delayed); no statistically significant difference for implant failures after 1 year (Lindeboom 2006). | 1 study · 50 participants | Ungraded |
Aesthetics assessed by dentist: position of the perimplant tissues 1 year | No statistically significant difference for the level of the perimplant marginal mucosa in relation to that of the adjacent teeth after 1 year (Lindeboom 2006). | 1 study · 50 participants | Ungraded |
Immediate-delayed implants (placed within 8 weeks after tooth extraction) vs Delayed implants (placed at least 2 months after extraction)
Population: Patients with compromised teeth to be extracted who require single dental implants in fresh postextraction sockets
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Patients' aesthetic perception (satisfaction with crown appearance) 1.5 years | No statistically significant difference for aesthetics assessed by the patient (satisfaction with the appearance of the crown) (Schropp 2003). | 1 study · 44 participants | Ungraded |
Major complications at the implant site 1.5 years | Four minor complications occurred, all in the immediate-delayed group; no statistically significant difference (Schropp 2003). | 1 study · 46 participants | Ungraded |
Prosthesis failure 1.5 years | One study (Schropp 2003) compared immediate-delayed versus delayed implants (23 per group). After 1 year and a half there was no statistically significant difference for prosthesis failures. | 1 study · 46 participants | Ungraded |
Aesthetics assessed by dentist: position of the perimplant tissues 1.5 years | RR 1.68 [1.04, 2.72] | 1 study · 46 participants | Ungraded |
Patients' perception of how long treatment took 1.5 years | MD -20.30 [-33.36, -7.24] | 1 study · 44 participants | Ungraded |
Aesthetics assessed by dentist: interproximal papilla dimension 1.5 years | No statistically significant difference for the papilla height assessed by the dentist (Schropp 2003). | 1 study · 46 participants | Ungraded |
Patients' general satisfaction of treatment 1.5 years | MD -6.51 [-12.63, -0.39] | 1 study · 44 participants | Ungraded |
Implant failure 1.5 years | Three early implant failures occurred, two in the immediate-delayed group and one in the delayed group; no statistically significant difference (Schropp 2003). | 1 study · 46 participants | Ungraded |
Immediate implants (placed just after tooth extraction) vs Immediate-delayed implants (placed within 8 weeks after tooth extraction)
Population: Patients with compromised teeth to be extracted who require single dental implants in fresh postextraction sockets
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome NR | Immediate versus immediate-delayed implant placement (no trial). | 0 studies | No studies |
Immediate implants (placed in a fresh extraction socket just after tooth extraction) vs Delayed implants (placed at least 2 months after extraction, in healed bone)
Population: Patients with compromised teeth to be extracted who require single dental implants in fresh postextraction sockets
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome NR | Protocol only (published 19 April 2006). Immediate versus delayed implants named as a planned comparison; no studies included yet. | 0 studies | No studies |
Immediate-delayed implants (placed within 8 weeks after tooth extraction) vs Delayed implants (placed at least 2 months after extraction)
Population: Patients with compromised teeth to be extracted who require single dental implants in fresh postextraction sockets
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome NR | Protocol only. Immediate-delayed versus delayed implants named as a planned comparison; no studies included yet. | 0 studies | No studies |
Immediate implants (placed just after tooth extraction) vs Immediate-delayed implants (placed within 8 weeks after tooth extraction)
Population: Patients with compromised teeth to be extracted who require single dental implants in fresh postextraction sockets
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome NR | Protocol only. Immediate versus immediate-delayed implants named as a planned comparison; no studies included yet. | 0 studies | No studies |