Campi Marco, Leitão-Almeida Bruno, Pereira Miguel, Shibli Jamil Awad, Levin Liran, Fernandes Juliana Campos Hasse, Fernandes Gustavo Vicentis Oliveira, Borges Tiago
Quintessence Int. 2025 Jan 30;56(1):34-45. doi: 10.3290/j.qi.b5768294.
The aim of the study was to observe whether immediate implant placement into damaged extraction sockets is a successful modality for treating hopeless teeth that require extraction.
An electronic search was carried out through four databases (PubMed/MEDLINE, Web of Science, Scopus, and ScienceDirect) to identify randomized controlled trials (2013 to 2023) to understand whether immediate implant placement in damaged sockets is a successful treatment. The focus question was, 'In a patient with a hopeless tooth that needs extraction with the indication for dental implant treatment, is immediate implant placement in damaged extraction sockets, compared to undamaged sockets or healed sites, an effective method for the replacement of hopeless teeth and achieving a favorable clinical result?' The risk of bias was appraised and a meta-analysis using random effect was applied.
Five studies with 135 patients and 138 implants were included. The implant survival rate was 100% for all studies and period evaluated; the pink esthetic score (PES) scores had no statistically significant result for all articles that evaluated this parameter; the soft tissue changes was reported by two studies: one found no significant differences and the other showed that the test group experienced reduced soft tissue loss at the 1-year evaluation (measured with digital intraoral scanners); another two studies assessed the marginal bone loss, presenting no differences between groups. The meta-analysis showed homogeneity between the studies. There was an equilibrium among the groups in the various studies included, and age tended to be lower in the test group. The buccal bone tissue and pink esthetic score showed favoritism for the test group but without statistical significance.
This study suggests that immediate implant placement in the presence of buccal bone defects can achieve comparable clinical and radiologic outcomes to traditional methods in the short term of the limited studies available. It was not possible to evaluate the buccal aspect through radiographs. Bone regeneration was essential to reach optimal results. It is important to emphasize that immediate implant placement requires adherence to rigorous criteria to ensure functionally acceptable results.
本研究旨在观察即刻种植于受损拔牙窝内是否是治疗需要拔除的患牙的一种成功方式。
通过四个数据库（PubMed/MEDLINE、Web of Science、Scopus和ScienceDirect）进行电子检索，以识别随机对照试验（2013年至2023年），了解即刻种植于受损拔牙窝内是否是一种成功的治疗方法。核心问题是，“在有种植牙治疗指征且需要拔除的患牙患者中，与未受损拔牙窝或愈合部位相比，即刻种植于受损拔牙窝内是否是替换患牙并取得良好临床效果的有效方法？”评估了偏倚风险并应用随机效应进行荟萃分析。
纳入了五项研究，共135例患者和138颗种植体。在所有研究和评估期间，种植体存活率均为100%；所有评估该参数的文章中，粉色美学评分（PES）得分均无统计学显著结果；两项研究报告了软组织变化：一项研究发现无显著差异，另一项研究表明，在1年评估时（使用数字化口腔内扫描仪测量），试验组软组织损失减少；另外两项研究评估了边缘骨吸收，两组之间无差异。荟萃分析显示各研究之间具有同质性。纳入的各项研究中，组间存在平衡，试验组年龄往往较低。颊侧骨组织和粉色美学评分对试验组有利，但无统计学意义。
本研究表明，在有限的现有研究的短期内，在存在颊侧骨缺损的情况下即刻种植可取得与传统方法相当的临床和影像学结果。无法通过X线片评估颊侧情况。骨再生对于达到最佳效果至关重要。需要强调的是，即刻种植需要严格遵循标准以确保获得功能上可接受的结果。
