Non-Cochrane · intervention · PM41465916
Comparative efficacy of immediate implant placement and alveolar ridge preservation after tooth extraction: A comprehensive systematic review and meta-analysis of randomized controlled trials.
Fan Liqin, Zhao Ruimin, Zheng Xixi, et al. · Medicine · 2025 · PubMed · doi:10.1097/md.0000000000046832
Findings
25 findings
| Population | ||||
|---|---|---|---|---|
| Patients requiring implant-supported restoration after tooth extraction | Immediate implant placement (IIP) into the fresh extraction socket | Alveolar ridge preservation (ARP) followed by delayed implant placement | Marginal bone level (MBL), overall 6 months to 5 years | MD -0.3 [-0.48, -0.13] GRADE not reported 7 studies · 534 participants |
| Patients requiring implant-supported restoration after tooth extraction | Immediate implant placement (IIP) into the fresh extraction socket | Alveolar ridge preservation (ARP) followed by delayed implant placement | Mesial marginal bone level 12 months and 5 years | MD -0.79 [-2.42, 0.84] GRADE not reported 2 studies · 83 participants |
| Patients requiring implant-supported restoration after tooth extraction | Immediate implant placement (IIP) into the fresh extraction socket | Alveolar ridge preservation (ARP) followed by delayed implant placement | Mesial facial gingival margin change 12 months and 5 years | MD -0.08 [-0.23, 0.06] GRADE not reported 2 studies · 83 participants |
| Patients requiring implant-supported restoration after tooth extraction | Immediate implant placement (IIP) into the fresh extraction socket | Alveolar ridge preservation (ARP) followed by delayed implant placement | Facial gingival margin change, overall 12 months · Follow-up 12 months | MD -0.1 [-0.42, 0.23] GRADE not reported 2 studies · 124 participants |
| Patients requiring implant-supported restoration after tooth extraction | Immediate implant placement (IIP) into the fresh extraction socket | Alveolar ridge preservation (ARP) followed by delayed implant placement | Postoperative complications 6 months to 5 years | OR 3.47 [1.92, 6.28] GRADE not reported 8 studies · 625 participants |
| Patients requiring implant-supported restoration after tooth extraction | Immediate implant placement (IIP) into the fresh extraction socket | Alveolar ridge preservation (ARP) followed by delayed implant placement | Pink esthetic score (PES), overall 6 months to 5 years | MD -0.05 [-0.52, 0.43] GRADE not reported 7 studies · 534 participants |
| Patients requiring implant-supported restoration after tooth extraction | Immediate implant placement (IIP) into the fresh extraction socket | Alveolar ridge preservation (ARP) followed by delayed implant placement | Distal marginal bone level 12 months and 5 years | MD -0.84 [-2.11, 0.43] GRADE not reported 2 studies · 83 participants |
| Patients requiring implant-supported restoration after tooth extraction | Immediate implant placement (IIP) into the fresh extraction socket | Alveolar ridge preservation (ARP) followed by delayed implant placement | Facial gingival margin change, overall 12 months and 5 years | MD 0.02 [-0.23, 0.27] GRADE not reported 3 studies · 159 participants |
| Patients requiring implant-supported restoration after tooth extraction | Immediate implant placement (IIP) into the fresh extraction socket | Alveolar ridge preservation (ARP) followed by delayed implant placement | Distal facial gingival margin change 12 months and 5 years | MD -0.04 [-0.22, 0.15] GRADE not reported 2 studies · 83 participants |
| Patients requiring implant-supported restoration after tooth extraction | Immediate implant placement (IIP) into the fresh extraction socket | Alveolar ridge preservation (ARP) followed by delayed implant placement | Horizontal ridge width change at 1 mm 6 and 12 months | MD -0.61 [-1.91, 0.69] GRADE not reported 2 studies · 72 participants |
| Patients requiring implant-supported restoration after tooth extraction | Immediate implant placement (IIP) into the fresh extraction socket | Alveolar ridge preservation (ARP) followed by delayed implant placement | Pink esthetic score (PES), overall 12 months · Follow-up 12 months | MD 0.07 [-0.45, 0.58] GRADE not reported 6 studies · 475 participants |
| Patients requiring implant-supported restoration after tooth extraction | Immediate implant placement (IIP) into the fresh extraction socket | Alveolar ridge preservation (ARP) followed by delayed implant placement | Horizontal ridge width change at 3 mm 6 and 12 months | MD -0.24 [-0.69, 0.21] GRADE not reported 2 studies · 72 participants |
| Patients requiring implant-supported restoration after tooth extraction | Immediate implant placement (IIP) into the fresh extraction socket | Alveolar ridge preservation (ARP) followed by delayed implant placement | Implant failure 6 months to 5 years | OR 2.09 [0.98, 4.44] GRADE not reported 9 studies · 701 participants |
| Patients requiring implant-supported restoration after tooth extraction | Immediate implant placement (IIP) into the fresh extraction socket | Alveolar ridge preservation (ARP) followed by delayed implant placement | Implant failure 6 months to 5 years | RD 0.02 [-0.01, 0.05] GRADE not reported 9 studies · 701 participants |
| Patients requiring implant-supported restoration after tooth extraction | Immediate implant placement (IIP) | Delayed implant placement after alveolar ridge preservation (ARP) | Postoperative complications 12 months · Dental implant therapy after tooth extraction · Molar site | OR 2.78 [0.81, 9.51] GRADE not reported 2 studies · 131 participants |
| Patients requiring implant-supported restoration after tooth extraction | Immediate implant placement (IIP) into the fresh extraction socket | Alveolar ridge preservation (ARP) followed by delayed implant placement | Marginal bone level (MBL), overall 12 months · Follow-up 12 months | MD -0.32 [-0.52, -0.12] GRADE not reported 6 studies · 475 participants |
| Patients requiring implant-supported restoration after tooth extraction (non-molar implant sites) | Immediate implant placement (IIP) into the fresh extraction socket | Alveolar ridge preservation (ARP) followed by delayed implant placement | Pink esthetic score (PES), non-molar region 12 months and 5 years · Non-molar region | MD 0.26 [-0.07, 0.59] GRADE not reported 4 studies · 239 participants |
| Patients requiring implant-supported restoration after tooth extraction (non-molar implant sites) | Immediate implant placement (IIP) into the fresh extraction socket | Alveolar ridge preservation (ARP) followed by delayed implant placement | Postoperative complications, non-molar region 6 months to 5 years · Non-molar site | OR 4.98 [2.2, 11.3] GRADE not reported 5 studies · 354 participants |
| Patients requiring implant-supported restoration after tooth extraction (non-molar implant sites) | Immediate implant placement (IIP) into the fresh extraction socket | Alveolar ridge preservation (ARP) followed by delayed implant placement | Marginal bone level (MBL), non-molar region 6 months to 5 years · Non-molar region | MD -0.36 [-0.64, -0.07] GRADE not reported 4 studies · 239 participants |
| Patients requiring implant-supported restoration after tooth extraction (non-molar implant sites) | Immediate implant placement (IIP) into the fresh extraction socket | Alveolar ridge preservation (ARP) followed by delayed implant placement | Marginal bone level (MBL), non-molar region 12 months · Non-molar region, follow-up 12 months | MD -0.41 [-0.74, -0.09] GRADE not reported 3 studies · 204 participants |
| Patients requiring implant-supported restoration after tooth extraction (non-molar implant sites) | Immediate implant placement (IIP) into the fresh extraction socket | Alveolar ridge preservation (ARP) followed by delayed implant placement | Pink esthetic score (PES), non-molar region 12 months · Non-molar region, follow-up 12 months | MD 0.3 [-0.05, 0.65] GRADE not reported 3 studies · 204 participants |
| Patients requiring implant-supported restoration after tooth extraction (molar implant sites) | Immediate implant placement (IIP) into the fresh extraction socket | Alveolar ridge preservation (ARP) followed by delayed implant placement | Marginal bone level (MBL), molar region 12 months · Molar region, follow-up 12 months | MD -0.42 [-0.52, -0.33] GRADE not reported 2 studies · 131 participants |
| Patients requiring implant-supported restoration after tooth extraction (molar implant sites) | Immediate implant placement (IIP) into the fresh extraction socket | Alveolar ridge preservation (ARP) followed by delayed implant placement | Marginal bone level (MBL), molar region 6 months and 12 months · Molar region | MD -0.41 [-0.49, -0.32] GRADE not reported 2 studies · 155 participants |
| Patients requiring implant-supported restoration after tooth extraction (molar implant sites) | Immediate implant placement (IIP) into the fresh extraction socket | Alveolar ridge preservation (ARP) followed by delayed implant placement | Pink esthetic score (PES), molar region 12 months · Molar region, follow-up 12 months | MD -0.61 [-1.1, -0.12] GRADE not reported 2 studies · 131 participants |
| Patients requiring implant-supported restoration after tooth extraction (molar implant sites) | Immediate implant placement (IIP) into the fresh extraction socket | Alveolar ridge preservation (ARP) followed by delayed implant placement | Pink esthetic score (PES), molar region 6 months and 12 months · Molar region | MD -0.68 [-1.13, -0.23] GRADE not reported 2 studies · 155 participants |
Included primary studies 11
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Block 2009 Prospective evaluation of immediate and delayed provisional single tooth restorations. PMID:19835754 | 2009 | this review only | not stated | not extracted yet |
| Cardaropoli 2022a Bone and Soft Tissue Modifications in Immediate Implants Versus Delayed Implants Inserted Following Alveolar Ridge Preservation: A… PMID:35353088 | 2022 | this review only | not stated | not extracted yet |
| Cardaropoli 2022b Bone and Soft Tissue Modifications in Immediate Implants Versus Delayed Implants Inserted Following Alveolar Ridge Preservation: A… PMID:35830312 | 2022 | this review only | not stated | not extracted yet |
| Checchi 2017 Wide diameter immediate post-extractive implants vs delayed placement of normal-diameter implants in preserved sockets in the molar… PMID:28944355 | 2017 | this review only | not stated | not extracted yet |
| Esposito 2015 Immediate loading of post-extractive versus delayed placed single implants in the anterior maxilla: outcome of a pragmatic multicenter… PMID:26669545 | 2015 | this review only | not stated | not extracted yet |
| Esposito 2017 Immediate, immediate-delayed (6 weeks) and delayed (4 months) post-extractive single implants: 1-year post-loading data from a randomised… PMID:28327692 | 2017 | this review only | not stated | not extracted yet |
| Felice 2015 Immediate non-occlusal loading of immediate post-extractive versus delayed placement of single implants in preserved sockets of the… PMID:26669546 | 2015 | this review only | not stated | not extracted yet |
| Slagter 2021 Immediate single-tooth implant placement with simultaneous bone augmentation versus delayed implant placement after alveolar ridge… PMID:33724473 | 2021 | this review only | not stated | not extracted yet |
| Tallarico 2016 Single post-extractive ultra-wide 7 mm-diameter implants versus implants placed in molar healed sites after socket preservation for molar… PMID:27722224 | 2016 | this review only | not stated | not extracted yet |
| Tallarico 2017 Molar replacement with 7 mm-wide diameter implants: to place the implant immediately or to wait 4 months after socket preservation?
1… PMID:28555207 | 2017 | this review only | not stated | not extracted yet |
| Tonetti 2016 Immediate versus delayed implant placement after anterior single tooth extraction: the timing randomized controlled clinical trial. PMID:27978602 | 2017 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients (18+ years, systemically healthy) requiring implant-supported restoration after tooth extraction | 701 patients (353 IIP, 348 ARP) in 9 integrated trials (11 reports); molar, non-molar and unspecified sites |
| Intervention | Immediate implant placement (IIP) | IIP with or without grafting, flap or flapless (n=353) |
| Comparison | Alveolar ridge preservation (ARP) before delayed implant placement | ARP with bone substitutes, then delayed implant (n=348) |
| Outcomes | MBL, PES, implant failure (primary); postoperative complications, horizontal width change, facial gingival margin change, patient-reported satisfaction (secondary) | MBL, PES, implant failure, postoperative complications, horizontal width change, facial gingival margin change, patient-reported satisfaction (narrative) |
| Study designs | RCTs with at least 10 patients per group | RCTs (n=11 reports, 9 studies) |
| Timing | At least 6 months follow-up | 6 months to 5 years |
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 | No | no |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | NRSI: N/A · RCT: Yes | RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | NRSI: N/A · RCT: Partial Yes | RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | No | No | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |