Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2022 Oct;49(10):1012-1023.
doi: 10.1111/jcpe.13686. Epub 2022 Jul 15.

Immediate implant placement with or without immediate provisionalization: A systematic review and meta-analysis

Jeremy Pitman  1 , Lorenz Seyssens  1 , Véronique Christiaens  1 , Jan Cosyn  1
Affiliations
Meta-Analysis

Immediate implant placement with or without immediate provisionalization: A systematic review and meta-analysis

Jeremy Pitman et al. J Clin Periodontol. 2022 Oct.

Abstract

Aim: To assess the effect of immediate provisionalization (IP) on soft tissue changes, hard tissue changes, and clinical parameters following single immediate implant placement (IIP).

Materials and methods: Two independent reviewers conducted an electronic literature search in PubMed, Web of Science, Embase, and Cochrane databases as well as a manual search to identify eligible clinical studies up to September 2021. Randomized controlled trials (RCTs) comparing IIP with IP (test) and IIP without IP (control) were included for a qualitative and quantitative analysis. The primary outcome was vertical midfacial soft tissue changes. Secondary outcomes included horizontal midfacial soft tissue changes, implant survival, mesial and distal papillary changes, Pink Esthetic Score (PES) at final follow-up, marginal bone-level changes, probing depth at final follow-up, and bleeding on probing at final follow-up.

Results: Of the 8213 records, 7 RCTs reporting on 323 patients who received 323 single immediate implants (IIP + IP: 161 implants in 161 patients; IIP: 162 implants in 162 patients) were selected with a mean follow-up ranging from 12 to 60 months. Risk of bias assessment yielded some concerns for five RCTs and high risk for two RCTs. Meta-analysis on the cases with intact alveoli demonstrated 0.87 mm (95% confidence interval [CI] [0.57; 1.17], p < .001) less apical migration of the midfacial soft tissue level for IIP + IP when compared to IIP alone. Implant survival, papillary changes, marginal bone-level changes, probing depth, and bleeding on probing were not significantly affected by IP. Insufficient data were available for meta-analyses on horizontal midfacial soft tissue changes and PES.

Conclusions: IP may contribute to midfacial soft tissue stability at immediate implants. However, high-quality RCTs are needed since the strength of this conclusion is currently rated as low according to GRADE guidelines.

Keywords: dental implant; immediate; provisional; provisionalization; restoration.

PubMed Disclaimer

References

REFERENCES

    1. Altman, D. G. (1999). Practical statistics for medical research. Chapman & Hall/CRC Press.
    1. Araujo, M. G., Sukekava, F., Wennstrom, J. L., & Lindhe, J. (2005). Ridge alterations following implant placement in fresh extraction sockets: An experimental study in the dog. Journal of Clinical Periodontology, 32, 645-652. https://doi.org/10.1111/j.1600-051X.2005.00726.x
    1. Assaf, J. H., Assaf, D. D., Antoniazzi, R. P., Osorio, L. B., & Franca, F. M. (2017). Correction of buccal dehiscence during immediate implant placement using the flapless technique: A tomographic evaluation. Journal of Periodontology, 88, 173-180. https://doi.org/10.1902/jop.2016.160276
    1. Bakkali, S., Rizo-Gorrita, M., Romero-Ruiz, M. M., Gutierrez-Perez, J. L., Torres-Lagares, D., & Serrera-Figallo, M. A. (2021). Efficacy of different surgical techniques for peri-implant tissue preservation in immediate implant placement: A systematic review and meta-analysis. Clinical Oral Investigations, 25, 1655-1675. https://doi.org/10.1007/s00784-021-03794-y
    1. Belser, U. C., Grutter, L., Vailati, F., Bornstein, M. M., Weber, H. P., & Buser, D. (2009). Outcome evaluation of early placed maxillary anterior single-tooth implants using objective esthetic criteria: A cross-sectional, retrospective study in 45 patients with a 2- to 4-year follow-up using pink and white esthetic scores. Journal of Periodontology, 80, 140-151. https://doi.org/10.1902/jop.2009.080435

Substances

LinkOut - more resources