CLINICAL AND RADIOGRAPHIC OUTCOMES OF IMMEDIATE VERSUS DELAYED IMPLANT PLACEMENT IN PREVIOUSLY GRAFTED SITES COMPARED TO NATIVE BONE
Main Article Content
Keywords
Dental implants; Immediate implant placement; Delayed implant placement; Bone grafting; Augmented ridge; Native bone; Marginal bone loss; Radiographic outcome; Implant survival; Primary stability.
Abstract
Early implantation reduces treatment periods and maintains the shape of tissues, but the results can vary compared to native bone and grafted locations because of the differences in bone remodelling and stability. There is still limited evidence on timing strategies in grafted bone and native bone in comparison.
Objective: To compare clinical and radiographic outcomes of immediate versus delayed implant placement in previously grafted sites and native bone.
Methods: This is a comparative clinical study done at Dow University of health Sciences (DUHS ) Karachi and Liaquat University of Medical and health Sciences( LUMHS ) Jamshoro /Hyderabad from January 2024 to June 2025. The number of 72 evaluated and grouped into four equal groups (n=18 each) was as follows: immediate placement in grafted sites (IG), delayed placement in grafted sites (DG), immediate placement in native bone (IN), and delayed placement in native bone (DN). Primary stability was measured by insertion torque and /or ISQ. The marginal bone loss (MBL) at 12 months was assessed using standardized periapical radiographs. Clinical outcomes were based on implant survival and parameters of peri-implant soft tissue.
Results: Implant survival was 94.4% in IG and DG and 100% in IN and DN (p>0.05). Mean MBL at 12 months differed significantly among groups (p<0.001): IG 1.32±0.38 mm, DG 0.96±0.30 mm, IN 1.08±0.34 mm, and DN 0.82±0.28 mm. MBL >1.5 mm was more frequent in IG (27.8%) than DN (5.6%) (p=0.04). Soft tissue parameters were comparable across groups (p>0.05).
Conclusions: Delayed placement particularly in native bone showed superior crestal bone stability at 12 months. Immediate placement in grafted sites demonstrated greater marginal bone loss despite high survival.
References
2. Chatzopoulos, G.S. and L.F.J.J.o.C.M. Wolff, Survival rates and factors affecting the outcome following immediate and delayed implant placement: A retrospective study. 2022. 11(15): p. 4598.
3. Garcia‐Sanchez, R., et al., Comparison of clinical outcomes of immediate versus delayed placement of dental implants: a systematic review and meta‐analysis. 2022. 33(3): p. 231-277.
4. Kabi, S., et al., Immediate dental implant placement with or without autogenous bone graft: A comparative study. 2020. 11(1): p. 46-52.
5. Clauser, T., et al., Risk of early implant failure in grafted and non-grafted sites: A systematic review and meta-analysis. 2022. 15(1).
6. Zhou, Y., et al., The comparative evaluation of transcrestal and lateral sinus floor elevation in sites with residual bone height≤ 6 mm: A two‐year prospective randomized study. 2021. 32(2): p. 180-191.
7. Donos, N., et al., Bone regeneration in implant dentistry: Which are the factors affecting the clinical outcome? 2023. 93(1): p. 26-55.
8. Said, H.J.E.J.o.O. and M. Surgery, Post extraction immediate implant placement in infected extraction sockets of maxillary posterior teeth combined with guided bone regeneration. Two-years prospective clinical and radiographic outcomes. 2021. 12(2): p. 128-136.
9. Roberto, C., et al., Bone remodeling around implants placed after socket preservation: a 10-year retrospective radiological study. 2021. 7(1): p. 74.
10. Emarah, A., et al., Four implants placed in extraction sockets or healed residual ridges and immediately loaded with maxillary All on 4 fixed restorations. One year prospective clinical and radiographic outcomes. 2022. 68(2): p. 1577-1590.
11. Comuzzi, L., et al., Clinical and radiological evaluation of a self-condensing bone implant in one-stage sinus augmentation: a 3-year follow-up retrospective study. 2023. 20(3): p. 2583.
12. Mangano, C., et al., Custom-made computer-aided-design/computer-assisted-manufacturing (CAD/CAM) synthetic bone grafts for alveolar ridge augmentation: A retrospective clinical study with 3 years of follow-up. 2022. 127: p. 104323.
13. de Carvalho Formiga, M., et al., Effects of osseodensification on immediate implant placement: retrospective analysis of 211 implants. 2022. 15(10): p. 3539.
14. Ma, G., C. Wu, and M.J.I.J.o.I.D. Shao, Simultaneous implant placement with autogenous onlay bone grafts: a systematic review and meta-analysis. 2021. 7(1): p. 61.
15. Duarte, G.M., et al., Reconstruction of acetabular defects with impaction grafting in primary cemented total hip arthroplasty produces favorable results: clinical and radiographic outcomes over 6.4 years on average. 2021. 36(1): p. 200-209.
16. Tabrizi, R., et al., Comparison of Marginal Bone Loss in Simultaneous Versus Delayed Implant Placement Following Horizontal Ridge Augmentation with Autogenous Lateral Ramus Bone Block. J Dent (Shiraz), 2023. 24(2): p. 200-205 DOI: 10.30476/dentjods.2022.92419.1641.
17. Shadid, R.M., Socket shield technique and delayed implant placement in maxilla: a series of five case reports. BMC Oral Health, 2022. 22(1): p. 110 DOI: 10.1186/s12903-022-02149-7.
18. Ho, J.C., et al., Early radiographic failure of reverse total shoulder arthroplasty with structural bone graft for glenoid bone loss. 2020. 29(3): p. 550-560.
19. Franceschetti, G., et al., The impact of graft remodeling on peri‐implant bone support at implants placed concomitantly with transcrestal sinus floor elevation: A multicenter, retrospective case series. 2020. 31(2): p. 105-120.
20. Cochran, D.L., et al., Immediate Dental Implant Stabilization in a Canine Model Using a Novel Mineral-Organic Adhesive: 4-Month Results. 2020. 35(1).
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Sohail Mustafa Shaikh
BDS, FCPS, Postgraduate Resident, Institute of Dentistry, LUMHS, Jamshoro, Pakistan
Laksh Gul
BDS, Bibi Aseefa Dental College, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, Pakistan
Muhammad Shahzad
FDS RCS, FFD RCS, FCPS, Chairman, Department of Oral and Maxillofacial Surgery, LUMHS, Jamshoro, Pakistan
Sidra Ahsan
BDS, Postgraduate Resident, Sandeman Provincial Hospital (SPH), Quetta, Pakistan
Mahzaib Bahar
BDS, Dental Surgeon, District Women and Children Hospital, Mastung, Pakistan
Adil Aman
BDS, House Officer, Bibi Aseefa Dental College, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, Pakistan
