Non-Cochrane · intervention · PM41406906
Pre-extractive Versus Postextractive Implant Site Preparation for Immediate Implant Placement in Mandibular Molar Sites: A Systematic Review and Meta-Analysis.
Atieh Momen A, Shah Maanas, Hakam Abeer, et al. · International dental journal · 2026 · PubMed · doi:10.1016/j.identj.2025.109316
Findings
Population Adults with a hopeless mandibular molar indicated for extraction and immediate implant placement
8 findings
| Pre-extractive implant site preparation (osteotomy through retained roots before extraction) | Postextractive implant site preparation | Changes in marginal bone level (bucco-lingual, mm) At 6 months · University settings (Egypt, Italy) | MD -0.05 [-0.32, 0.21] Very low Downgraded: risk of bias, inconsistency 3 studies · 60 participants |
| Pre-extractive implant site preparation (osteotomy through retained roots before extraction) | Postextractive implant site preparation | Implant stability (ISQ) At 6 months · University settings (Egypt, Italy) | MD -2.72 [-7.72, 2.29] Very low Downgraded: risk of bias, inconsistency 3 studies · 60 participants |
| Pre-extractive implant site preparation (osteotomy through retained roots before extraction) | Postextractive implant site preparation | Implant stability (ISQ) At implant placement · University settings (Egypt, Italy) · Leave-one-out sensitivity: Alzaibak 2024 removed | MD -3.48 [-4.31, -2.65] GRADE not reported 3 studies · 68 participants |
| Pre-extractive implant site preparation (osteotomy through retained roots before extraction) | Postextractive implant site preparation | Implant stability (ISQ) At implant placement · University settings (Egypt, Italy) | MD -3.39 [-4.20, -2.59] Low Downgraded: risk of bias 4 studies · 82 participants |
| Pre-extractive implant site preparation (osteotomy through retained roots before extraction) | Postextractive implant site preparation | Implant stability (ISQ) At implant placement · University settings (Egypt, Italy) · Leave-one-out sensitivity: Scarano 2017 removed | MD -3.33 [-4.14, -2.52] GRADE not reported 3 studies · 60 participants |
| Pre-extractive implant site preparation (osteotomy through retained roots before extraction) | Postextractive implant site preparation | Implant stability (ISQ) At implant placement · University settings (Egypt, Italy) · Leave-one-out sensitivity: Elshoaby 2020 removed | MD -3.55 [-6.52, -0.57] GRADE not reported 3 studies · 62 participants |
| Pre-extractive implant site preparation (osteotomy through retained roots before extraction) | Postextractive implant site preparation | Implant position (deviation from central position) Implant placement (6 to 12 months follow-up) · University settings (Egypt, Italy) | RR 0.05 [0.01, 0.33] 50 [10, 330] per 1000 (greater) Low Downgraded: risk of bias 2 studies · 48 participants |
| Pre-extractive implant site preparation (osteotomy through retained roots before extraction) | Postextractive implant site preparation | Implant stability (ISQ) At implant placement · University settings (Egypt, Italy) · Leave-one-out sensitivity: Shokry and Taalab 2020 removed | MD -3.37 [-4.63, -2.11] GRADE not reported 3 studies · 56 participants |
Included primary studies 6
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Alzaibak 2024 Immediate Implant Placement with Different Interradicular Osteotomies in the Mandible: A Randomized Clinical Study DOI:10.5005/jp-journals-10024-3674 | 2024 | this review only | not stated | not extracted yet |
| Alzaibak 2024 Immediate Implant Placement with Different Interradicular Osteotomies in the Mandible: A Randomized Clinical Study. PMID:38956843 | 2024 | this review only | not stated | not extracted yet |
| Elshoaby 2020 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Scarano 2017 Traditional Postextractive Implant Site Preparation Compared with Pre-extractive Interradicular Implant Bed Preparation in the Mandibular… DOI:10.11607/jomi.5342 | 2017 | this review only | not stated | not extracted yet |
| Scarano 2017 Traditional Postextractive Implant Site Preparation Compared with Pre-extractive Interradicular Implant Bed Preparation in the Mandibular… PMID:28494046 | 2017 | this review only | not stated | not extracted yet |
| Shokry and Taalab 2020 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adults aged 18 years or older with a hopeless mandibular molar indicated for extraction and immediate implant placement | Adults with a single nonrestorable mandibular molar (n=82) |
| Intervention | Pre-extractive implant site preparation (osteotomy prepared before root extraction) | Pre-extractive implant site preparation (n=41) |
| Comparison | Postextractive implant site preparation (osteotomy prepared after extraction) | Postextractive implant site preparation (n=41) |
| Outcomes | Primary: implant stability at placement; secondary: implant stability at 3 and 6 months, marginal bone level change, implant positional deviation, implant failure rate | ISQ at placement, 3 and 6 months; bucco-lingual and mesio-distal marginal bone level at 6 and 12 months; implant position; implant failure (no failures, not pooled) |
| Study designs | Randomised controlled trials | RCTs, parallel group (n=4) |
| Timing | Not specified | Follow-up 6 to 12 months |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | Yes | Yes | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | Yes | Yes | yes |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | Yes | Yes | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Low | Low | yes |