Dental implants inserted in fresh extraction sockets versus healed sites : a systematic review and meta-analysis

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Dental implants inserted in fresh extraction sockets versus healed sites : a systematic review and meta-analysis

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Publication Article, review peer-reviewed scientific
Title Dental implants inserted in fresh extraction sockets versus healed sites : a systematic review and meta-analysis
Author(s) Chrcanovic, Bruno ; Albrektsson, Tomas ; Wennerberg, Ann
Date 2015
English abstract
OBJECTIVES: The purpose of the present review was to test the null hypothesis of no difference in the implant failure rates, postoperative infection and marginal bone loss for the insertion of dental implants in fresh extraction sockets compared to the insertion in healed sites, against the alternative hypothesis of a difference. METHODS: An electronic search was undertaken in July 2014. Eligibility criteria included clinical human studies, either randomized or not. RESULTS: The search strategy resulted in 73 publications, with 8241 implants inserted in sockets (330 failures, 4.00%), and 19,410 in healed sites (599 failures, 3.09%). The difference between the procedures significantly affected the failure rates (RR 1.58, 95% CI 1.27-1.95, P<0.0001). The difference was not statistically significant when studies evaluating implants inserted in maxillae or in mandibles were pooled, or when the studies using implants to rehabilitate patients with full-arch prostheses were pooled; however, it was significant for the studies that rehabilitated patients with implant-supported single crowns and for the controlled studies. There was no apparent significant effect of implants inserted in fresh extraction sockets on the occurrence of postoperative infection or on the magnitude of marginal bone loss. CONCLUSION: It is suggested that the insertion of implants in fresh extraction sockets affects the failure rates. However, it does not affect the marginal bone loss or the occurrence of postoperative infection. The results should be interpreted with caution due to the potential for biases and to the presence of uncontrolled confounding factors in the included studies, most of them not randomized. CLINICAL SIGNIFICANCE: The question whether immediate implants are more at risk for failure than implants placed in mature bone has received increasing attention in the last years. As the philosophies of treatment alter over time, a periodic review of the different concepts is necessary to refine techniques and eliminate unnecessary procedures. This would form a basis for optimum treatment.
DOI http://dx.doi.org/10.1016/j.jdent.2014.11.007 (link to publisher's fulltext)
Publisher Elsevier
Host/Issue Journal of Dentistry;1
Volume 43
ISSN 0300-5712
Pages 16-41
Language eng (iso)
Subject(s) Dental implants
Fresh extraction socket
Healed site
Immediate insertion
Implant failure rate
Meta-analysis
Medicine
Research Subject Categories::ODONTOLOGY
Handle http://hdl.handle.net/2043/18137 (link to this page)

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