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Purpose: This retrospective clinical study aimed to evaluate the implants placed in fresh sockets and investigate the effect of varied oral health conditions and treatment plan details on the clinical and radiographic outcomes. Materials and methods: Fifty-nine participants (102 implants) were included in this study. Four variables, including mean probing depth (PD), mean marginal bone loss (MBL), pink esthetic score (PES), and patient satisfaction, were significant dependent variables, and the effects of independent variables on these four items were studied. The data were analyzed by the analysis of covariance (ANCOVA) using a statistical software. Results: The mean follow-up period was 4.75 ± 1.74 years, and the mean MBL was 1.21 ± 0.81 mm. The survival rate was 97 %. There were significant effects of the finish line site, keratinized gingival width, and attached gingival width on PD after adjusting the factors. Also, the implant brand, plaque index, and uncemented prosthesis affected MBL significantly. In addition, significant effects of the surgeon, implant brand, and proximal contact on PES were found. Conclusion: More PD was found around restorations with a finish line site > 1.5 mm subgingival. Sufficient attached gingiva was a more effective factor on PD than keratinized gingiva. Implants with more plaque scores showed more MBL.

This retrospective clinical study aimed to evaluate the implants placed in fresh sockets and investigate the effect of varied oral health conditions and treatment plan details on the clinical and radiographic outcomes. Fifty-nine participants (102 implants) were included in this study. Four variables, including mean probing depth (PD), mean marginal bone loss (MBL), pink esthetic score (PES), and patient satisfaction, were significant dependent variables, and the effects of independent variables on these four items were studied. The data were analyzed by the analysis of covariance (ANCOVA) using a statistical software. The mean follow-up period was 4.75 ± 1.74 years, and the mean MBL was 1.21 ± 0.81 mm. The survival rate was 97 %. There were significant effects of the finish line site, keratinized gingival width, and attached gingival width on PD after adjusting the factors. Also, the implant brand, plaque index, and uncemented prosthesis affected MBL significantly. In addition, significant effects of the surgeon, implant brand, and proximal contact on PES were found. More PD was found around restorations with a finish line site > 1.5 mm subgingival. Sufficient attached gingiva was a more effective factor on PD than keratinized gingiva. Implants with more plaque scores showed more MBL. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The objective of the present case series with 24 months of follow-up was to document the clinicoradiographic status of IDI placed in fresh extraction sockets (FES) in the maxillary esthetic zone (MEZ). PATIENTS AND METHODS: Immediate implants were placed in the FES of three adult patients. Medical history and demographics of these patients were retrieved from their respective healthcare records. All extractions were done using atraumatic techniques and performed in the MEZ. Diameter and lengths of IDI ranged between 4-4.1 mm and 14-16 mm, respectively. Osseous drilling was done at 2000 rpm and implants were inserted using an insertion torque of 45 Ncm. All implants were restored with screw-retained ceramic restorations. Follow-up clinicoradiographic investigations were done after 2-years. At follow-up, peri-implant plaque and gingival indices were measured and peri-implant probing depth was measured. Marginal bone loss was also measured. RESULTS: The two-year follow-up clinical and radiographic results from all cases showed that the implant success and survival rates were 100% and 100%, respectively. There was no clinical evidence of peri-implant soft tissue inflammation in all cases. Scores of peri-implant plaque index, bleeding on probing, probing depth and crestal bone loss showed no evidence of peri-implant inflammation at 2-years' follow-up. All implants and their prostheses were clinically stable. CONCLUSIONS: It is concluded that IDI can osseointegrate and remain functionally and esthetically stable when placed in FES located in the MEZ. [ABSTRACT FROM AUTHOR]

Purpose: This study assessed a novel treatment protocol for immediate implant placement in defective fresh extraction sockets. Materials and Methods: A single-arm clinical study was conducted including 12 fresh extraction sockets divided into two groups: those with intact and those with a deficient facial plate of bone. Hopeless teeth were atraumatically extracted, a vestibular access horizontal incision was made 3 to 4 mm apical to the mucogingival junction, a mucoperiosteal tunnel was created from the labial orifice of the socket, a slowly resorbing membrane shield was stabilized under the tunnel, implants were placed using a surgical guide, and a subepithelial connective tissue graft was harvested and secured over the membrane shield. Definitive restorations were delivered at 3 months postoperatively. Cone beam computed tomography (CBCT) scans were taken at baseline and after 6 and 13 months to measure facial bone thickness and height. Pink esthetic score (PES) was recorded at 6 and 13 months. Results: At 6 months, the mean ± SD facial bone thickness was 1.88 ± 0.73 mm for sockets with intact facial bone compared to 0.76 ± 0.42 at baseline and 2.34 ± 0.78 mm for sockets with deficient facial bone compared with 0 ± 0 at baseline, whereas at 13 months, the thickness was 1.84 ± 0.74 and 2.18 ± 0.73 mm, respectively. The facial bone crest coincided with the implant platform in sockets with an intact facial bone plate and those with a deficient facial bone plate at 6 months, whereas at 13 months, the distance for sockets with a deficient facial bone plate increased to 0.20 ± 0.13 mm. The mean PES at 6 and 13 months was 11.33 for both groups out of a maximum score of 14. Conclusion: The proposed technique provided a minimally invasive treatment with predictable esthetic outcome allowing immediate implant placement in sockets with intact and with deficient facial plates. [ABSTRACT FROM AUTHOR]

The aim of this model-base study was to compare the accuracy of implant placement between static and dynamic computer-assisted implant surgery (CAIS) systems in a fresh extraction socket and healed ridge. A randomized in vitro study was conducted. Twenty 3D-printed maxillary models and 80 implants were used. One experienced researcher placed the implants using either the static navigation or dynamic navigation system. Accuracy was measured by overlaying the real position in the postoperative CBCT on the virtual presurgical placement of the implant in a CBCT image. Descriptive and bivariate analyses of the data were performed. In the fresh sockets, the mean deviation was 1.24 ± 0.26 mm (entry point), 1.69 ± 0.34 mm (apical point), and 3.44 ± 1.06° (angle discrepancy) in the static CAIS group, and 0.60 ± 0.29 mm, 0.78 ± 0.33 mm, and 2.47 ± 1.09° in the dynamic CIAS group, respectively. In the healed ridge, the mean deviation was 1.09 ± 0.17 mm and 1.40 ± 0.30 mm, and 2.12 ± 1.11° in the static CAIS group, and 0.80 ± 0.29 mm, 0.98 ± 0.37 mm, and 1.69 ± 0.76° in the dynamic CIAS group, respectively. Compared with the static CAIS system, the dynamic CAIS system resulted in significantly lower entry and apical errors in both fresh sockets and healed ridges. Differences in bone morphology therefore seem to have little effect on accuracy in the dynamic CAIS group. [ABSTRACT FROM AUTHOR]

The aim of this model-base study was to compare the accuracy of implant placement between static and dynamic computer-assisted implant surgery (CAIS) systems in a fresh extraction socket and healed ridge. A randomized in vitro study was conducted. Twenty 3D-printed maxillary models and 80 implants were used. One experienced researcher placed the implants using either the static navigation or dynamic navigation system. Accuracy was measured by overlaying the real position in the postoperative CBCT on the virtual presurgical placement of the implant in a CBCT image. Descriptive and bivariate analyses of the data were performed. In the fresh sockets, the mean deviation was 1.24 ± 0.26 mm (entry point), 1.69 ± 0.34 mm (apical point), and 3.44 ± 1.06° (angle discrepancy) in the static CAIS group, and 0.60 ± 0.29 mm, 0.78 ± 0.33 mm, and 2.47 ± 1.09° in the dynamic CIAS group, respectively. In the healed ridge, the mean deviation was 1.09 ± 0.17 mm and 1.40 ± 0.30 mm, and 2.12 ± 1.11° in the static CAIS group, and 0.80 ± 0.29 mm, 0.98 ± 0.37 mm, and 1.69 ± 0.76° in the dynamic CIAS group, respectively. Compared with the static CAIS system, the dynamic CAIS system resulted in significantly lower entry and apical errors in both fresh sockets and healed ridges. Differences in bone morphology therefore seem to have little effect on accuracy in the dynamic CAIS group.

The present review aimed to evaluate the difference of dental implant failure rates and marginal bone loss (MBL) between implants inserted in fresh extraction sockets or healed sites. Electronic search was undertaken in three databases, plus manual search of journals, including studies randomized or not. Meta-analyses were performed besides meta-regressions, in order to verify how the odds ratio (OR) and MBL were associated with follow-up time. The review included 163 publications. Altogether, there were 17,278 and 38,738 implants placed in fresh extraction sockets and healed sites, respectively. Pairwise meta-analyses showed that implants in sockets had a higher failure risk in comparison to healed sites: OR 1.349, all studies included; OR 2.070, only prospective non-RCTs; OR 2.487, only RCTs (all p < 0.001). The difference in implant failure between the groups was statistically significant in the maxilla (OR 1.616, p = 0.029), but not in the mandible (OR 2.192, p = 0.075). The MBL mean difference (MD) between the groups was −0.053 mm (p = 0.089). There was an estimated decrease of 0.003 in OR (p = 0.284) and an increase of 0.006 mm (p = 0.036) in the MBL MD between groups for every additional month of follow-up. In conclusion, implants placed in fresh extraction sockets present higher risk of failure than implants placed in healed sites.

Purpose: The aim of this study was to evaluate the clinical and radiographic outcome of dental implants immediately placed and loaded into fresh extraction sockets after 18 months. Materials and Methods: Twenty-seven patients, 15 women and 12 men, received a total of 160 implants; 150 were placed immediately after extraction. The sockets in the study had fully preserved walls, and 10 were placed in healed sites. Immediately after surgical procedure, all patients received the temporary prosthetic reconstruction in occlusion. Five months postsurgery, definitive metal-ceramic restorations were cemented on abutments. Follow-up visits were performed for the assessment of clinical parameters. Intraoral digital radiographic examinations were performed 3 and 18 months after implant placement. Results: Minor swelling of the gingival mucosa was observed, but no mucositis or flap dehiscence with suppuration were found. Mean marginal bone loss 1 year 18 months after immediate loading was 0.65 ± 0.58 mm to the mesial side and 0.84 ± 0.69 mm to the distal side in the maxilla and 1.13 ± 0.51 mm mesially and 1.24 ± 0.60 mm distally in the mandible. There was no difference between splinted and nonsplinted implants with respect to marginal bone loss. Discussion and Conclusion: Within the limits of this clinical study, the results indicate that immediate loading of implants placed in immediate extraction sites can be carried out successfully. [ABSTRACT FROM AUTHOR]

For the past two decades, immediate dental implant placement has been an acceptable procedure. Immediate implant placement into fresh extraction socket reduces the treatment time, cost, preserves the gingival aesthetics and increases the comfort of the patient. Several bone grafts have been used to minimise the bony defects surrounding immediately placed implants. In this article; a case has been reported in which extraction was carried out under local anaesthesia followed by immediate implant placement in fresh extraction socket with bovine-derived xenograft (BDX). Clinical and radiographic examination revealed width and length of the tooth for selecting implant size and design. Immediate placement and early loading of dental implant provides advantages like fewer surgical procedures, shorter treatment time, and improved aesthetic and psychological confidence. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was comparison of clinical and radiographic outcomes of immediate post-extraction implants with or without the use of pure platelet-rich plasma (P-PRP) in the short- and medium-term follow-up. Methods: A retrospective analysis was performed to assess soft tissue healing, implant and prosthesis survival, marginal bone level changes and biological complications. Results: A total of 109 partially edentulous patients with 126 implants were included in this analysis. At 4-5 years after loading, cumulative survival rate in test group was 97.4% and in control group was 97.8%, with no significant differences. After 5 years of function, marginal bone loss (MBL) in test group was 0.8 ± 0.35 and 1.02 ± 0.27 mm for immediate and delayed loading, respectively, and in control group was 0.6 ± 0.16 and 0.8 ± 0.89 mm for immediate and delayed loading, respectively. No significant differences in MBL were observed intragroups and intergroups at any time point considered. Soft tissue healing score was significantly higher in test group compared to the control at 3 and 7 days after surgery, with significant differences. Conclusions: P-PRP implant group showed a better soft tissue management and wound healing in the first 7 days after surgery compared to non-P-PRP implant group. In the medium-term follow-up, comparable clinical and radiographic outcomes were noticed between two groups. [ABSTRACT FROM AUTHOR]

Implant placement in maxillary anterior region has most aesthetic challenges in implant dentistry because tooth loss lead to bone resorption and collapse of gingival architecture, which lead to aesthetic compromise and inadequate bone for implant placement. Immediate implant placement into fresh extraction socket reduces the treatment time, cost, preserved the gingival aesthetic and increases the comfort of the patient. This article describes the procedure for immediate implant placement in fresh extraction socket and early loading of implant with zirconia crown. Clinical and radiographic examination revealed width and length of the tooth for selecting implant size and design. Cement retained zirconia crown was used for early loading. Implant was successfully loaded and was functional during 36 months follow up period. Immediate placement and early loading of dental implant provides advantages like fewer surgical procedures, shorter treatment time, and improved aesthetic and psychological confidence.

The aim of this retrospective study was to assess the outcome of immediate single-tooth implant placement and provisionalisation in the aesthetic zone regarding hard and soft peri-implant tissue parameters and patient-related outcome measures in a private practice. All consecutively treated patients with single-tooth immediate implant placement and provisionalisation between the period 1 January 2006 and 1 April 2013 in a referral practice in Amsterdam, the Netherlands, were included in the study. Fifty-one patients of a total of 64 could be examined at follow-up ( Tfollow-up). Radiographs were present from implant placement ( Tplacement), after definitive crown placement ( Tdefinitive), and new radiographs were taken at the follow-up appointment ( Tfollow-up). Next to this, soft tissue parameters, patients' satisfaction and professionals' aesthetic scores were measured at Tfollow-up. Implant survival was 96·9% after a mean follow-up period of 4 years following implant placement. At definitive crown placement, mean marginal bone-level loss was 0·25 mm ( SD 0·19). Mean marginal bone-level loss following definitive crown placement was 0·06 mm ( SD 0·10) ( Tdefinitive to Tfollow-up) after a mean follow-up period of 4 years. Plaque index, bleeding index and gingival index scores were low. Patients' satisfaction was rated very high: 9·0 ( SD 0·7). Professionals aesthetic score was 16·49 ( SD 1·86). From this study can be concluded that immediate placement of implants followed by immediate provisionalisation resulted in a high survival rate, minimum peri-implant bone loss, very good aesthetics and satisfied patients after a mean follow-up period of 4 years. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to measure the stability and crestal bone level changes of indigenously developed implants in fresh extraction sockets. Materials and Methods: Forty implants were placed immediately in fresh extraction sockets in 27 patients in the age group of 18-65 years. Clinical assessment of stability was made using resonance frequency analysis (RFA) at the time of placement of implant at 3, 6, and 12 months postoperatively, and radiographic crestal bone changes were evaluated using digital radiograph at 0, 6, and 12 months. The distance between the first visible bone-implant contact and implant shoulder was measured, and crestal bone lo--up period of 12 months. The mean radiographic bone loss was 0.67 mm at the end of 12 months. The results emphasized that there was no significant bone loss. Out of forty dental implants, two failed in the early phase. Thus, the survival rate of implants placed in fresh extraction socket was 95% at the end of 12 months. Conclusion: Immediate placed implants can attain adequate level of primary stability. These stability levels improve with time, reaching similar values irrespective of the initial stability. About 50% of mean crestal bone loss occurred during the first 6 months after implant placement suggesting several factors other than occlusal load affecting bone levels around implants. The present study also finds a negative correlation between the crestal bone loss and stability values in terms of ISQ at a statistically significant value. [ABSTRACT FROM AUTHOR]

The aim of this study is to assess the clinical and radiographic success of endosseous implants placed in fresh extraction sockets and healed extraction sockets. Material and Method: The study was conducted in 6 patients divided into two groups. In group I, the endosseous implants were placed in healed extraction sockets and in group II, implants were placed in fresh extraction sockets. A standard two stage surgical protocol of implant placement was used in both the groups. All implants were assessed for esthetics, occlusion, stability and complications. Results and conclusion: Esthetic appearance of the replaced teeth was scored as excellent at two sites in group I as compared to three sites in group II. Occlusion was found to be satisfactory in both the groups throughout the follow up period. Also, there was no implant failure in both the groups except for minor complications. [ABSTRACT FROM AUTHOR]

Objectives: To test the null hypothesis of no difference in the implant failure rates, postoperative infection and marginal bone loss for the insertion of dental implants in fresh extraction sockets compared to the insertion in healed sites, against the alternative hypothesis of a difference. Data: Main search terms used in combination: dental implant, oral implant, resh extraction socket, immediate placement, immediate insertion, immediate implant. Sources: An electronic search was undertaken in July/2014, in PubMed, Web of Science, Cochrane Oral Health Group Trials Register plus hand-searching. Study selection: Eligibility criteria included clinical human studies, either randomized or not. Conclusions: The search strategy resulted in 73 publications, with 8,241 implants inserted in sockets (330 failures, 4.00%), and 19,410 in healed sites (599 failures, 3.09%). It is suggested that the insertion of implants in fresh extraction sockets affects the failure rates (RR 1.58, 95% CI 1.27-1.95, P < 0.0001). The difference was not statistically significant when studies evaluating implants inserted in maxillae or in mandibles were pooled, or when the studies using implants to rehabilitate patients with full-arch prostheses were pooled; however, it was significant for the studies that rehabilitated patients with implant-supported single crowns and for the controlled studies. There was no apparent significant effect on the occurrence of postoperative infection or on the magnitude of marginal bone loss. The results should be interpreted with caution due to the potential for biases and to the presence of uncontrolled confounding factors in the included studies, most of them not randomized. Clinical significance: The question whether immediate implants are more at risk for failure than implants placed in mature bone has received increasing attention in the last years. As the philosophies of treatment alter over time, a periodic review of the different concepts is necessary to refine techniques and eliminate unnecessary procedures. This would form a basis for optimum treatment. [ABSTRACT FROM AUTHOR]

There is a growing need for patients to be rehabilitated with a fixed, implant-supported prosthesis immediately after surgery. The present study aims to describe the results of a modified prosthetic and surgical protocol of computer-assisted implant insertion and immediate loading in edentulous jaws with extraction sockets. Ten patients were consecutively treated with a modified computer assisted implant surgery protocol and screw-retained provisional metal-acrylic prosthesis prepared ahead of surgery and delivered immediately. Overall, 60 implants (Nobel Replace Tapered Groovy) were inserted, of which 22 were inserted in fresh extraction sockets. Definitive prosthesis was delivered after 6-12 months. Outcome measures were radiographic marginal bone-level changes, survival of implants, and patient satisfaction. The follow-up period was of at least 12 months. All the patients felt comfortable and none withdrew from the study. No implants were lost, resulting in a cumulative survival rate of 100 %. Radiological estimation showed a mean peri-implant marginal bone loss of 1.4 ± 0.3 mm. No other complications, biological or mechanical, were recorded. In all cases, patients appeared to be very satisfied with the aesthetic and function. Within the limitations of this study, our data seem to validate this surgical and prosthetic protocol with valid functional and aesthetic results when applied in selected cases. [ABSTRACT FROM AUTHOR]

Implant placement in maxillary anterior region has most aesthetic challenges in implant dentistry because tooth loss lead to bone resorption and collapse of gingival architecture, which lead to aesthetic compromise and inadequate bone for implant placement. Immediate implant placement into fresh extraction socket reduces the treatment time, cost, preserved the gingival aesthetic and increases the comfort of the patient. This article describes the procedure for immediate implant placement in fresh extraction socket and early loading of implant with zirconia crown. Clinical and radiographic examination revealed width and length of the tooth for selecting implant size and design. Cement retained zirconia crown was used for early loading. Implant was successfully loaded and was functional during 36 months follow up period. Immediate placement and early loading of dental implant provides advantages like fewer surgical procedures, shorter treatment time, and improved aesthetic and psychological confidence. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to investigate cellular activity of the cervical portion of peri-implant tissue due to immediate loading after implant placement following tooth extraction from the dog mandible, in terms of morphological, immunohistochemical and molecular characteristics. Material and methods: A sand-blasted implant was inserted into the root septum bone of each extraction socket and was connected to a superstructure made from resin and then covered with an expanded polytetrafluoroethylene membrane. Implants without the superstructure were used as the non-loading control group. Animals were sacrificed 1-3 weeks later and specimens were observed using light microscopy and mRNA levels were analyzed by real-time polymerase chain reaction. Results: The new bone formation ratio in the loading group at 3 weeks was significantly higher than in the non-loading group. Alkaline phosphatase (ALP)-positive cells were observed in tissues around the implant surface in both groups at each of the time periods. More osteocalcin (OCN)-positive cells were observed in the non-loading group than in the loading group at 2 weeks. The expression of ALP mRNA in the loading group was significantly up-regulated compared with the non-loading group ( P<0.05). The expression of OCN mRNA in the loading group was significantly up-regulated compared with the non-loading group at 2 weeks ( P<0.05). Conclusion: These results suggest that immediate loading after implant placement following tooth extraction osteogenic affects cellular activity of cervical portion of peri-implant tissue. To cite this article: Sato R, Matsuzaka K, Kokubu E, Inoue T. Immediate loading after implant placement following tooth extraction up-regulates cellular activity in the dog mandible. Clin. Oral Impl. Res. xx, 2011; 000-000. doi: 10.1111/j.1600-0501.2010.02118.x [ABSTRACT FROM AUTHOR]

de Sanctis M, Vignoletti F, Discepoli N, Muñoz F, Sanz M. Immediate implants at fresh extraction sockets: an experimental study in the beagle dog comparing four different implant systems. Soft tissue findings. J Clin Periodontol 2010; 37: 769-776 doi: . Objectives: To evaluate whether different implants placed immediately upon tooth extraction may affect the dimension and composition of the peri-implant soft tissues. Material and Methods: Eight beagle dogs received implants randomly installed into the distal socket of 3P3 and 4P4. Four commercially available implant systems were evaluated: 3i Osseotite Certain straight; Astra MicroThread™-OsseoSpeed™; Thommen SPI Element®; and Straumann ITI standard. Each animal provided four test implant sites. All animals were sacrificed 6 weeks after implant placement, providing specimens for the evaluation of the soft tissue dimensions by histometric analysis. Results: The biological width at 6 weeks after implant placement consisted of a junctional epithelium measuring between 2 and 2.7 mm and a connective tissue component between 1 and 1.8 mm with no statistical differences among the four implant systems. Conclusion: This study failed to demonstrate differences in the soft tissue healing outcome when placing four different implant systems into fresh extraction sockets. Nevertheless, the length of the epithelium achieved with the four implant systems is longer than what has been reported when placing implants in healed-ridge experimental models. [ABSTRACT FROM AUTHOR]

Objectives: To describe the differences in bone healing, when placing four different implant systems in fresh extraction sockets. Material and Methods: Eight beagle dogs received implants randomly installed into the distal socket of three P3 and four P4. Four-implant systems were evaluated. Each animal provided four test implant sites. All animals were sacrificed at 6 weeks after implant placement, providing specimens for histo-morphometric analysis of bone to implant contact (BIC), bone area, new bone formation, as well as histometric measurements of the ridge alterations. Results: No statistically significant difference was observed among the four-implant systems. The mean BIC % ranged between 58.5% and 72.1%. Bone modelling of the buccal plate was marked and amounted approximately to 2.5 mm, independently of the system used. Conclusion: This study failed to demonstrate differences in the healing pattern after 6 weeks when placing four different implant systems in fresh extraction sockets. In spite of achieving predictable osteointegration with the four implants studied, the occurrence of buccal bone resorption may limit the use of this surgical approach. [ABSTRACT FROM AUTHOR]

Aims: To describe the early phases of healing at the alveolar ridge around dental implants placed into fresh extraction sockets and to study whether (i) the dimension of the socket and (ii) a new implant surface nano-topography may have any influence. Materials and Methods: Sixteen beagle dogs received 64 test (new surface) and control implants randomly placed at the distal socket of 3P3 and 4P4. The implant shoulder was levelled with the marginal buccal bone crest. Animals were sacrificed at 4 h, 1, 2, 4 and 8 weeks for histological examination. Results: Bone loss occurred at the buccal crest between the 4-h and 1-week healing intervals, being more pronounced at the third premolar site [vertical bone loss between day 0 and 8 weeks 1.1 (0.5) mm]. The corresponding loss at the fourth premolar site was 0.3 (0.5) mm. Test sites containing implants with discrete crystalline deposition nano-particles' surface exhibited less buccal bone resorption than control sites at 8 weeks. Conclusion: Dimensions of the socket influenced the process of wound healing of implants placed into fresh extraction sockets, with more bone loss in the narrower sockets; however, the implant surface nano-topography seemed to have a limited effect in the healing of this implant surgical protocol. [ABSTRACT FROM AUTHOR]

Objectives: Describe the early phases of tissue integration in implants placed into fresh extraction sockets and test whether a new implant surface nano-topography (DCD nano-particles, Nanotite™) promotes early osseointegration when compared with minimally rough surface implants (DAE, Osseotite®). Material and Methods: Sixteen beagle dogs received 64 test and control implants randomly installed into the distal socket of 3P3 and 4P4. Histomorphometric analysis of bone to implant contact (BIC) and bone area was performed at 4 h, 1, 2, 4 and 8 weeks. Results: Wound healing initiated with a coagulum that was substituted by a provisional matrix at 1 week. Bone formation started concomitant to a marked bone resorption. At 2 weeks, woven bone formation was evident and gradually remodelled into lamellar bone at 4 and 8 weeks. BIC increased similarly throughout the study in both groups with a tendency to higher percentages for the test devices at 2 and 4 weeks. The influence of the DCD nano-particles was more evident at the fourth premolar site. Conclusion: Osseointegration occurred similarly at both implant groups, although the socket dimension appeared to influence bone healing. It is suggested that the enhanced nano-topography has a limited effect in the immediate implant surgical protocol. [ABSTRACT FROM AUTHOR]

The present review aimed to evaluate the difference of dental implant failure rates and marginal bone loss (MBL) between implants inserted in fresh extraction sockets or healed sites. Electronic search was undertaken in three databases, plus manual search of journals, including studies randomized or not. Meta-analyses were performed besides meta-regressions, in order to verify how the odds ratio (OR) and MBL were associated with follow-up time. The review included 163 publications. Altogether, there were 17,278 and 38,738 implants placed in fresh extraction sockets and healed sites, respectively. Pairwise meta-analyses showed that implants in sockets had a higher failure risk in comparison to healed sites: OR 1.349, all studies included; OR 2.070, only prospective non-RCTs; OR 2.487, only RCTs (all p < 0.001). The difference in implant failure between the groups was statistically significant in the maxilla (OR 1.616, p = 0.029), but not in the mandible (OR 2.192, p = 0.075). The MBL mean difference (MD) between the groups was -0.053 mm ( p = 0.089). There was an estimated decrease of 0.003 in OR ( p = 0.284) and an increase of 0.006 mm ( p = 0.036) in the MBL MD between groups for every additional month of follow-up. In conclusion, implants placed in fresh extraction sockets present higher risk of failure than implants placed in healed sites.