Non-Cochrane · intervention · PM41862887
Impact of an open healing approach on peri-implant mucosa following immediate implant placement with transmucosal provisionalization: a systematic review and meta-analysis.
Zadikian Charles C, Clerc Melodie M, Zadikian Jean-Louis, et al. · BMC oral health · 2026 · PubMed · doi:10.1186/s12903-026-08105-z
Findings
Population Adults undergoing single immediate implant placement after tooth extraction
4 findings
| Open healing: immediate transmucosal (non-occlusal) provisionalization with bone grafting, no primary flap closure | Bone grafting with primary flap closure | Marginal bone loss 6 to 12 months follow-up · Mostly anterior sites, university and private clinics | SMD 0.14 [-0.32, 0.59] GRADE not reported 3 studies · 86 participants |
| Open healing: immediate transmucosal (non-occlusal) provisionalization with bone grafting, no primary flap closure | Bone grafting with primary flap closure | Distal papilla height 6 to 12 months follow-up · Mostly anterior sites, university and private clinics | SMD 0.55 [-0.02, 1.11] GRADE not reported 2 studies · 50 participants |
| Open healing: immediate transmucosal (non-occlusal) provisionalization with bone grafting, no primary flap closure | Bone grafting with primary flap closure | Mesial papilla height 6 to 12 months follow-up · Mostly anterior sites, university and private clinics | SMD 0.76 [0.18, 1.34] GRADE not reported 2 studies · 50 participants |
| Open healing: immediate transmucosal (non-occlusal) provisionalization with bone grafting, no primary flap closure | Bone grafting with primary flap closure | Midfacial mucosal level (primary outcome) 6 to 12 months follow-up · Mostly anterior sites, university and private clinics | SMD -0.26 [-0.71, 0.18] GRADE not reported 3 studies · 86 participants |
Included primary studies 12
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Chan 2019 A randomized controlled trial to compare aesthetic outcomes of immediately placed implants with and without immediate provisionalization. PMID:31292983 | 2019 | this review only | Midfacial mucosal level (primary outcome); Mesial papilla height; Distal papilla height; Marginal bone loss | not extracted yet |
| Chokaree 2024 Effect of Customized and Prefabricated Healing Abutments on Peri-Implant Soft Tissue and Bone in Immediate Implant Sites: A Randomized… PMID:38337580 | 2024 | this review only | Midfacial mucosal level (primary outcome); Mesial papilla height; Distal papilla height; Marginal bone loss | not extracted yet |
| Chu 2015 Flapless Postextraction Socket Implant Placement, Part 2: The Effects of Bone Grafting and Provisional Restoration on Peri-implant Soft… PMID:26509983 | 2015 | this review only | not stated | not extracted yet |
| Chu 2018 Flapless Postextraction Socket Implant Placement, Part 3: The Effects of Bone Grafting and Provisional Restoration on Soft Tissue Color… PMID:29889914 | 2018 | this review only | not stated | not extracted yet |
| Cosyn 2011 Immediate single-tooth implants in the anterior maxilla: 3-year results of a case series on hard and soft tissue response and aesthetics. PMID:21752044 | 2011 | this review only | not stated | not extracted yet |
| Felice 2011 Immediate non-occlusal loading of immediate post-extractive versus delayed placement of single implants in preserved sockets of the… PMID:22282730 | 2011 | this review only | not stated | not extracted yet |
| Grandi 2013 Immediate provisionalisation of single post-extractive implants versus implants placed in healed sites in the anterior maxilla: 1-year… PMID:24179982 | 2013 | this review only | not stated | not extracted yet |
| Lertwongpaisan 2023 Soft tissue dimensional change using customized titanium healing abutment in immediate implant placement in posterior teeth. PMID:37308877 | 2023 | this review only | not stated | not extracted yet |
| Noelken 2011 Immediate implant placement and provisionalization after long-axis root fracture and complete loss of the facial bony lamella. PMID:21491017 | 2011 | this review only | not stated | not extracted yet |
| Perez 2020 Standard vs customized healing abutments with simultaneous bone grafting for tissue changes around immediate implants. 1-year outcomes… PMID:31797548 | 2020 | this review only | Midfacial mucosal level (primary outcome); Marginal bone loss | not extracted yet |
| Redemagni 2009 Soft tissue stability with immediate implants and concave abutments. PMID:20111758 | 2009 | this review only | not stated | not extracted yet |
| Spinato 2012 Comparison between graft and no-graft in an immediate placed and immediate nonfunctional loaded implant. PMID:22382749 | 2012 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Systemically healthy adults (18 years or older) with an indication for tooth extraction; single tooth | Patients with immediate implants in mostly anterior sites (n=431 patients, 438 implants) |
| Intervention | Open-healing: immediate implant with immediate transmucosal provisionalization (non-occlusal; customized healing abutment or provisional restoration) with bone grafting | Immediate implant with immediate provisionalization and bone grafting (n=277 implants) |
| Comparison | Bone grafting with primary flap closure | Standard healing abutment (RCTs); socket preservation with delayed implant; no-graft sites; no control in case series |
| Outcomes | Primary: midfacial mucosal level (MML). Secondary: papilla evaluation, peri-implant mucosa thickness, buccal horizontal alteration, Pink Esthetic Score, keratinized mucosa width, marginal bone loss, buccal bone thickness, implant survival rate | MML (3 RCTs), mesial and distal papilla height (2 RCTs), marginal bone loss (3 RCTs), PES (5 studies), keratinized mucosa width (1), buccal bone thickness (1), implant survival (12) |
| Study designs | Parallel RCTs and prospective case series with at least 5 patients (only RCTs meta-analyzed) | 12 studies: 4 RCTs, 1 cohort, 1 case-control, 6 case series |
| Timing | Follow-up including placement of final restorations | Follow-up 4 to 58 months (mean per implant 10.6 months); meta-analyses at 6 to 12 months |