Implant survival and aesthetic outcomes between immediate <i>versus</i> delayed implant treatment in the anterior maxilla regions: a meta-analysis _Chinese Journal of Evidence-Based Medicine

Authors：

ZHANG Jian ¹ ,  SUN Xiaofeng ¹ , ZHANG Ping ²

1. Department of Stomatology, Wuxi No.2 Hospital, Nanjing Medical University, Wuxi, 214102, P.R.China;
2. School of Biotechnoleogy, JiangNan University, Wuxi, 214122, P.R.China;

Corresponding author：

SUN Xiaofeng, Email: zorain@126.com

Keywords：

Immediate implant; Delayed implant; Anterior teeth area; Retention rate; Pink esthetic score; Meta-analysis; Randomized controlled trial; Cohort study

DOI：

10.7507/1672-2531.201706003

Video：

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ObjectiveTo systematically review the implant survival and postoperative aesthetics of immediate versus delayed implant treatment in the anterior maxilla regions.MethodsWe searched databases including PubMed, The Cochrane Library, EMbase, CBM, CNKI and WanFang Data from inception to April 2017, to collect randomized controlled trials (RCTs) and cohort studies on immediate implant and delayed implant in the anterior teeth areas. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, RevMan 5.3 software was used to perform meta-analysis.ResultsA total of 4 RCTs and 12 retrospective cohort studies involving 1 316 implants were finally included. The results of meta-analysis showed that: there was no significant difference between two groups in retention rate (RCT: RR=0.99, 95%CI 0.97 to 1.02, P=0.70; retrospective cohort study: RR=0.99, 95%CI 0.96 to 1.02, P=0.54), the implant stability of permanent restoration for 4 months (MD=0.82, 95%CI –0.11 to 1.76, P=0.08), alveolar bone resorption of long-term permanent crown restoration (12 months: RCT: MD=0.06, 95%CI –0.35 to 0.47, P=0.79; retrospective cohort study: MD=–0.27, 95%CI –0.57 to 0.03, P=0.07; 24 months: retrospective cohort study MD=–0.09, 95%CI –0.18 to 0.00, P=0.05), respectively. The immediate implant group was superior to the control group in alveolar bone resorption of short-term permanent crown restoration (3 months: MD=–0.08, 95%CI –0.13 to –0.04, P=0.000 1; 6 months: MD=–0.23, 95%CI –0.38 to –0.07, P=0.004). The PES score in the immediate implant group was higher than that in the delayed implant group(MD=1.12, 95%CI 0.11 to 2.13, P=0.03).ConclusionsCurrent evidence shows that both immediate and delayed implant procedures have similar outcomes in terms of implant retention, long-term stability and long-term alveolar bone resorption of the implants in the anterior maxilla regions, but the former procedure possesses better short-term reduction of alveolar bone absorption and postoperative gingival aesthetics. Furthermore, due to the limited quality and quantity of the included studies, more large-scale and high-quality studies are needed to verify the above conclusions.

Citation： ZHANG Jian, SUN Xiaofeng, ZHANG Ping. Implant survival and aesthetic outcomes between immediate versus delayed implant treatment in the anterior maxilla regions: a meta-analysis . Chinese Journal of Evidence-Based Medicine, 2018, 18(3): 342-350. doi: 10.7507/1672-2531.201706003 Copy

1.	林野. 即刻种植的是与非. 中华口腔医学杂志, 2013, 48(4): 193-198.
2.	Rosenquist B, Grenthe B. Immediate placement of implants into extraction sockets: implant survival. Int J Oral Maxillofac Implants, 1996, 11(2): 205-209.
3.	Cornelini R, Scarano A, Covani U, et al. Immediate one-stage postextration implant: a human clinical and hisologic case report. Int J Oral Maxillofac Implants, 2000, 15(3):432-437.
4.	Bartee BK. Extration site reconstrucation for alveolar ridge preservation. J Oral Implantology, 2001, 27(4): 187-191.
5.	Mayer TM, Hawley CE, Gunsolley JC, et al. The single- tooth implant: a viable alternative for single-tooth replacement. J Periodontol, 2002, 73(7):687-693.
6.	Available at: http//ohri.ca/programs/clinical_epidemilolgy/ oxford.asp.
7.	Schropp L, Kostopoulos L, Wenzel A, et al. Clinical and radiographic performance of delayed-immediate single-tooth implant placement associated with peri-implant bone defects. a 2-year prospective, controlled, randomized follow-up report. J Clin Periodontol, 2005, 32(4): 480-487.
8.	Crespi R, Cappare P, Gherlone E, et al. Immediate versus delayed loading of dental implants placed in fresh extraction sockets in the maxillary esthetic zone: a clinical comparative study. Int J Oral Maxillofac Implants, 2008, 23(4): 753-758.
9.	Esposito M, Barausse C, Pistilli R, et al. Immediate loading of post-extractive versus delayed placed single implants in the anterior maxilla: outcome of a pragmatic multicenter randomised controlled trial 1-year after loading. Eur J Oral Implantol, 2015, 8(4): 347-358.
10.	Felice P, Zucchelli G, Cannizzaro G, et al. Immediate-delayed (6 weeks) and delayed (4 months) post-extractive single implants: 4-month post-loading data from a randomised controlled trial. Eur J Oral Implantol, 2016, 9(3): 233-247.
11.	Malchiodi L, Balzani L, Cucchi A. Primary and secondary stability of implants in postextraction and healed sites: a randomized controlled clinical trial. Int J Oral Maxillofac Implants, 2016, 31(6): 1435-1443.
12.	郭观生, 李一新, 李志鹏, 等. 前牙区微创即刻种植即刻修复与常规种植修复美学效果临床研究. 中国医学创新, 2016, 13(20): 129-141.
13.	浦益萍. 前牙即刻种植修复临床疗效的研究. 上海: 上海交通大学, 2008.
14.	吴敏节, 张相皞, 邹立东, 等. 前牙即刻种植和常规种植修复2年后软、硬组织稳定性比较,北京大学学报(医学版), 2015, 47(1): 67-71.
15.	徐景明, 陈冬雷, 王培, 等. 前牙微创拔牙后即刻种植和位点保存常规种植疗效的临床回顾性研究. 口腔医学, 2017, 37(4): 325-330.
16.	谢霓, 朱友家. 即刻种植与延期种植在单颗前牙修复的临床效果比较. 临床口腔医学杂志, 2015, 31(12): 758-759.
17.	田瑞雪, 唐旭炎, 徐锦程. 即刻种植和延期种植修复前牙的临床效果研究. 中国现代医学杂志, 2017, 27(4): 121-125.
18.	胡卫子, 何家才, 汪向东. 上前牙区即刻种植修复临床牙龈美学观察. 安徽医学, 2011, 32(9): 1248-1250.
19.	李伟, 张志宏, 边华琴, 等. 即刻与延期前牙种植义齿修复的临床效果及主观满意度调查. 重庆医学, 2015, 44(8): 1103-1105.
20.	姚希, 张宁, 李昀生, 等. 前牙的即刻与延期种植: 牙周组织健康程度及成功率比较. 中国组织工程研究, 2015, 19(12): 1958-1963.
21.	陈勇, 杨保全. 78例即刻种植术和延期种植术远期疗效追踪报告. 临床口腔医学杂志, 2007, 23(4): 220-221.
22.	周宏志, 贺平, 赵军, 等. 不同骨缺损条件下的即刻与延期种植修复的临床应用评价. 口腔医学研究, 2008, 24(6): 685-687.
23.	Sun Z, Herring SW, Tee BC, et al. Alveolar ridge reduction after tooth extraction in adolescents: an animal study. Arch Oral Biol, 2013, 58(7): 813-825.
24.	Park MS, Park YB, Choi H, et al. Morphometric analysis of maxillary alveolar regions for immediate implantation. J Adv Prosthodont, 2013, 5(4): 494-501.
25.	Li B, Wang Y. Contour changes in human alveolar bone following tooth extraction of the maxillary central incisor. J Zhejiang Univ Sci B, 2014, 15(12): 1064-1071.
26.	Schulte W, Kleineikenscheidt H, Schareyka R, et al. Concept and testing of the Tübingen immediate implant. Dtsch Zahnarztl Z, 1978, 33(5): 319-325.
27.	Hürzeler MB, Fickl S, Zuhr O, et al. Clinical failures and shortfalls of immediate implant procedures. Eur J Esthet Dent, 2006, 1(2): 128-140.
28.	Chen ST, Darby IB, Reynolds EC. A prospective clinical study of non-submerged immediate implants: clinical outcomes and esthetic results. Clin Oral Implants Res, 2007, 18(5): 552-562.
29.	Evans CD, Chen ST. Esthetic outcomes of immediate implant placements. Clin Oral Implants Res, 2008, 19(1): 73-80.
30.	Hämmerle CH, Araujo MG, Simion M. Evidence-based knowledge on the biology and treatment of extraction sockets. Osteology Consensus Gmup 2011. Clin Oral Implants Res, 2012, 23 Suppl 5: 80-82.
31.	Kan JY, Rungcharassaeng K, Morimoto T, et al. Facial gingival tissue stability after connective tissue graft with single immediate tooth replacement in the esthetic zone: consecutive case report. J Oral Maxillofac, 2009, 67(11 Suppl): 40-48.
32.	Block MS, Mercante DE, Lirette D, et al. Prospective evaluation of immediate and delayed pmvisional single tooth restoralions. J Oral Maxillofac Surg, 2009, 67(11 Suppl): 89-107.
33.	Raes F, Cosyn J, Crommelinck E, et al. Immediate and conventional single implant treatment in the anterior maxilla: 1-year results of a case series on hard and soft tissue response and aesthetics. J Clin Periodontol, 2011, 38(4): 385-394.
34.	Sammartino G, Marenzi G, di Lauro AE, et al. Aesthetics in oral implantology: biological, clinical, surgical, and prosthetic aspects. Implant Dentistry, 2007, 16(1): 54-65.

1. 林野. 即刻种植的是与非. 中华口腔医学杂志, 2013, 48(4): 193-198.
2. Rosenquist B, Grenthe B. Immediate placement of implants into extraction sockets: implant survival. Int J Oral Maxillofac Implants, 1996, 11(2): 205-209.
3. Cornelini R, Scarano A, Covani U, et al. Immediate one-stage postextration implant: a human clinical and hisologic case report. Int J Oral Maxillofac Implants, 2000, 15(3):432-437.
4. Bartee BK. Extration site reconstrucation for alveolar ridge preservation. J Oral Implantology, 2001, 27(4): 187-191.
5. Mayer TM, Hawley CE, Gunsolley JC, et al. The single- tooth implant: a viable alternative for single-tooth replacement. J Periodontol, 2002, 73(7):687-693.
6. Available at: http//ohri.ca/programs/clinical_epidemilolgy/ oxford.asp.
7. Schropp L, Kostopoulos L, Wenzel A, et al. Clinical and radiographic performance of delayed-immediate single-tooth implant placement associated with peri-implant bone defects. a 2-year prospective, controlled, randomized follow-up report. J Clin Periodontol, 2005, 32(4): 480-487.
8. Crespi R, Cappare P, Gherlone E, et al. Immediate versus delayed loading of dental implants placed in fresh extraction sockets in the maxillary esthetic zone: a clinical comparative study. Int J Oral Maxillofac Implants, 2008, 23(4): 753-758.
9. Esposito M, Barausse C, Pistilli R, et al. Immediate loading of post-extractive versus delayed placed single implants in the anterior maxilla: outcome of a pragmatic multicenter randomised controlled trial 1-year after loading. Eur J Oral Implantol, 2015, 8(4): 347-358.
10. Felice P, Zucchelli G, Cannizzaro G, et al. Immediate-delayed (6 weeks) and delayed (4 months) post-extractive single implants: 4-month post-loading data from a randomised controlled trial. Eur J Oral Implantol, 2016, 9(3): 233-247.
11. Malchiodi L, Balzani L, Cucchi A. Primary and secondary stability of implants in postextraction and healed sites: a randomized controlled clinical trial. Int J Oral Maxillofac Implants, 2016, 31(6): 1435-1443.
12. 郭观生, 李一新, 李志鹏, 等. 前牙区微创即刻种植即刻修复与常规种植修复美学效果临床研究. 中国医学创新, 2016, 13(20): 129-141.
13. 浦益萍. 前牙即刻种植修复临床疗效的研究. 上海: 上海交通大学, 2008.
14. 吴敏节, 张相皞, 邹立东, 等. 前牙即刻种植和常规种植修复2年后软、硬组织稳定性比较,北京大学学报(医学版), 2015, 47(1): 67-71.
15. 徐景明, 陈冬雷, 王培, 等. 前牙微创拔牙后即刻种植和位点保存常规种植疗效的临床回顾性研究. 口腔医学, 2017, 37(4): 325-330.
16. 谢霓, 朱友家. 即刻种植与延期种植在单颗前牙修复的临床效果比较. 临床口腔医学杂志, 2015, 31(12): 758-759.
17. 田瑞雪, 唐旭炎, 徐锦程. 即刻种植和延期种植修复前牙的临床效果研究. 中国现代医学杂志, 2017, 27(4): 121-125.
18. 胡卫子, 何家才, 汪向东. 上前牙区即刻种植修复临床牙龈美学观察. 安徽医学, 2011, 32(9): 1248-1250.
19. 李伟, 张志宏, 边华琴, 等. 即刻与延期前牙种植义齿修复的临床效果及主观满意度调查. 重庆医学, 2015, 44(8): 1103-1105.
20. 姚希, 张宁, 李昀生, 等. 前牙的即刻与延期种植: 牙周组织健康程度及成功率比较. 中国组织工程研究, 2015, 19(12): 1958-1963.
21. 陈勇, 杨保全. 78例即刻种植术和延期种植术远期疗效追踪报告. 临床口腔医学杂志, 2007, 23(4): 220-221.
22. 周宏志, 贺平, 赵军, 等. 不同骨缺损条件下的即刻与延期种植修复的临床应用评价. 口腔医学研究, 2008, 24(6): 685-687.
23. Sun Z, Herring SW, Tee BC, et al. Alveolar ridge reduction after tooth extraction in adolescents: an animal study. Arch Oral Biol, 2013, 58(7): 813-825.
24. Park MS, Park YB, Choi H, et al. Morphometric analysis of maxillary alveolar regions for immediate implantation. J Adv Prosthodont, 2013, 5(4): 494-501.
25. Li B, Wang Y. Contour changes in human alveolar bone following tooth extraction of the maxillary central incisor. J Zhejiang Univ Sci B, 2014, 15(12): 1064-1071.
26. Schulte W, Kleineikenscheidt H, Schareyka R, et al. Concept and testing of the Tübingen immediate implant. Dtsch Zahnarztl Z, 1978, 33(5): 319-325.
27. Hürzeler MB, Fickl S, Zuhr O, et al. Clinical failures and shortfalls of immediate implant procedures. Eur J Esthet Dent, 2006, 1(2): 128-140.
28. Chen ST, Darby IB, Reynolds EC. A prospective clinical study of non-submerged immediate implants: clinical outcomes and esthetic results. Clin Oral Implants Res, 2007, 18(5): 552-562.
29. Evans CD, Chen ST. Esthetic outcomes of immediate implant placements. Clin Oral Implants Res, 2008, 19(1): 73-80.
30. Hämmerle CH, Araujo MG, Simion M. Evidence-based knowledge on the biology and treatment of extraction sockets. Osteology Consensus Gmup 2011. Clin Oral Implants Res, 2012, 23 Suppl 5: 80-82.
31. Kan JY, Rungcharassaeng K, Morimoto T, et al. Facial gingival tissue stability after connective tissue graft with single immediate tooth replacement in the esthetic zone: consecutive case report. J Oral Maxillofac, 2009, 67(11 Suppl): 40-48.
32. Block MS, Mercante DE, Lirette D, et al. Prospective evaluation of immediate and delayed pmvisional single tooth restoralions. J Oral Maxillofac Surg, 2009, 67(11 Suppl): 89-107.
33. Raes F, Cosyn J, Crommelinck E, et al. Immediate and conventional single implant treatment in the anterior maxilla: 1-year results of a case series on hard and soft tissue response and aesthetics. J Clin Periodontol, 2011, 38(4): 385-394.
34. Sammartino G, Marenzi G, di Lauro AE, et al. Aesthetics in oral implantology: biological, clinical, surgical, and prosthetic aspects. Implant Dentistry, 2007, 16(1): 54-65.

Chinese Journal of Evidence-Based Medicine

Implant survival and aesthetic outcomes between immediate versus delayed implant treatment in the anterior maxilla regions: a meta-analysis

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