Immediate Implant Placement Comparable success to alveolar ridge preservation but with Higher Complication Risk: Study
A new study published in the journal of Medicine showed that the immediate implant placement (IIP) protocol demonstrated a greater incidence of postoperative problems and marginal bone loss alterations, but within restrictions, it produced aesthetic results and implant success equivalent to the alveolar ridge preservation (ARP) program.
The alveolar ridge unavoidably experiences bone resorption and remodeling after exodontia. In terms of changes in the soft and hard tissues of the alveolar ridge, implant failure, postoperative complications, and patient-reported satisfaction after tooth extraction, this systematic review attempts to assess and compare the multifaceted performance of IIP and ARP.
To find randomized controlled trials (RCTs) comparing IIP and ARP procedures, an electronic search was carried out using the databases of MEDLINE (PubMed), Cochrane Library, Embase, Web of Science, and Scopus. Marginal bone level (MBL), pink esthetic score (PES), and implant failure were the main end factors.
Postoperative complications, facial gingival margin change, horizontal width change, and patient-reported satisfaction were the secondary outcome variables. The risk of bias in RCTs was evaluated using the Cochrane RoB2 method. The odds ratio (OR), matching 95% confidence intervals (CI), and weighted or mean differences (MD) were computed. The procedure was prospectively registered in PROSPERO and adhered to the recommended reporting elements for systematic reviews and meta-analysis statements.
Eleven RCTs were analyzed, including 353 patients in the IIP group and 348 in the ARP group. The IIP protocol significantly reduced MBL in both non-molar (MD = −0.36 mm, 95% CI = −0.64 to 0.07]) and molar regions (MD = −0.41 mm, 95% CI = −0.49 to −0.32]) regions compared to ARP.
However, no statistical differences were observed in PES (MD = −0.05, 95% CI = −0.05). Both groups had similar results in terms of horizontal width change, facial gingival margin change, and patient-reported satisfaction (P >.05), with the exception of a greater frequency of postoperative problems in the IIP group (p <.05).
Overall, it is hypothesized that, within the constraints of this investigation, marginal bone loss and postoperative problems could be more prominent in the IIP protocol than in the ARP protocol. However, at least six months following surgery, aesthetic results and patient-reported satisfaction seem to be equal.
Source:
Fan, L., Zhao, R., Zheng, X., Yuan, Z., Xu, X., & Gong, J. (2025). Comparative efficacy of immediate implant placement and alveolar ridge preservation after tooth extraction: A comprehensive systematic review and meta-analysis of randomized controlled trials. Medicine, 104(52), e46832. https://doi.org/10.1097/MD.0000000000046832
