ABSTRACT
Background:
This study aims to compare the long-term success rates of immediate implant placement and delayed implant placement in patients with periodontally compromised teeth.
Materials and Methods:
A total of 30 patients presenting with periodontally compromised teeth requiring extraction and subsequent implant placement were enrolled in this retrospective study. Patients were divided into two groups based on the timing of implant placement: Group A (immediate implant placement) and Group B (delayed implant placement). Implants were placed according to standard protocols. Patient records were reviewed for implant survival, peri-implant bone loss, and prosthetic complications. Data were statistically analyzed using appropriate tests.
Results:
The mean follow-up period was 5 years. In Group A, the implant survival rate was 90%, while in Group B, it was 83%. The mean peri-implant bone loss was 1.5 mm in Group A and 2.2 mm in Group B. Prosthetic complications were observed in three cases in Group A and five cases in Group B. The differences in implant survival and bone loss between the two groups were not statistically significant (P > 0.05).
Conclusion:
Both immediate implant placement and delayed implant placement demonstrated comparable long-term success rates in patients with periodontally compromised teeth
KEYWORDS: Delayed implant placement, immediate implant placement, implant survival, peri-implant bone loss, periodontally compromised teeth, prosthetic complications
INTRODUCTION
Periodontal diseases often lead to compromised tooth stability, necessitating extractions. The decision to perform immediate implant placement aims to optimize treatment efficiency by reducing the overall treatment timeline and preserving peri-implant soft tissue contours.
Several factors contribute to the choice between immediate and delayed implant placement, including the extent of periodontal disease, bone quality, and patient-specific considerations. Immediate implant placement aims to capitalize on the existing alveolar bone and maintain the peri-implant architecture, potentially leading to shorter treatment duration.[1] On the other hand, delayed implant placement offers the advantage of allowing for complete resolution of inflammatory processes and reestablishment of healthy soft and hard tissues prior to implant insertion.[2]
The current literature provides conflicting evidence regarding the superiority of immediate versus delayed implant placement in patients with periodontally compromised teeth. While some studies have reported favorable outcomes for immediate implant placement, including reduced bone resorption and enhanced esthetics,[3] others have advocated for delayed placement to ensure optimal tissue healing and minimize peri-implant complications.[4]
This study seeks to contribute to this ongoing discussion by comparing the long-term success rates of immediate implant placement and delayed implant placement in patients with periodontally compromised teeth. Through a retrospective analysis of implant survival, peri-implant bone loss, and prosthetic complications, we aim to provide valuable insight into the clinical considerations guiding implant timing in cases of periodontal compromise.
MATERIALS AND METHODS
Study design
This retrospective comparative study aimed to assess and compare the long-term success rates of immediate implant placement and delayed implant placement in patients with periodontally compromised teeth. The study was conducted in accordance with ethical guidelines and received approval from the Institutional Review Board (IRB).
Patient selection
Thirty patients who had undergone dental implant placement for periodontally compromised teeth were included in the study. Patients were identified from the clinic’s records and categorized into two groups based on the timing of implant placement: Group A (immediate implant placement) and Group B (delayed implant placement).
Implant placement
Implant placement was performed according to established protocols. In Group A, immediate implant placement was carried out immediately following tooth extraction. In Group B, a delayed approach was employed, with implant placement occurring after a healing period of 3 months. Standardized implant systems were used for both groups.
Clinical and radiographic evaluation
Patient records, including clinical notes and radiographs, were reviewed to assess implant survival, peri-implant bone loss, and prosthetic complications. Implant survival was defined as the presence of a stable implant without mobility or radiographic signs of peri-implant radiolucency. Peri-implant bone loss was measured from the implant shoulder to the most coronal point of bone-to-implant contact on periapical radiographs.
Prosthetic complications
Prosthetic complications, such as screw loosening, fracture of prosthetic components, or framework fractures, were recorded for each patient. These complications were evaluated as binary outcomes (presence/absence).
Statistical analysis
Descriptive statistics were used to summarize patient demographics and clinical characteristics. Implant survival rates, peri-implant bone loss, and prosthetic complications were compared between the two groups using appropriate statistical tests, including Chi-square tests and independent t-tests. Statistical significance was set at P < 0.05.
RESULTS
Patient demographics
A total of 30 patients were included in the study, with 15 patients in each group. The mean age in Group A was 45 years (range: 35–55), and in Group B, it was 48 years (range: 40–60). The distribution of gender and tooth location was balanced between the two groups.
Implant survival
The implant survival rates for Group A (immediate implant placement) and Group B (delayed implant placement) are summarized in Table 1. There was no statistically significant difference in implant survival rates between the two groups (P > 0.05).
Table 1.
Implant survival rates
| Group | Implant survival rate (%) |
|---|---|
| Group A | 90 |
| Group B | 83 |
Peri-Implant bone loss
The mean peri-implant bone loss values for Group A and Group B are presented in Table 2. While Group A exhibited a mean peri-implant bone loss of 1.5 mm, Group B showed a mean peri-implant bone loss of 2.2 mm. The differences in bone loss between the two groups were not statistically significant (P > 0.05).
Table 2.
Peri-implant bone loss (mm)
| Group | Mean peri-implant bone loss (mm) |
|---|---|
| Group A | 1.5 |
| Group B | 2.2 |
Prosthetic complications
The incidence of prosthetic complications in each group is summarized in Table 3. In Group A, prosthetic complications were observed in three cases (20%), while in Group B, five cases (33.3%) experienced complications. However, the difference in prosthetic complications between the two groups was not statistically significant (P > 0.05).
Table 3.
Incidence of prosthetic complications
| Group | Prosthetic complications (n) |
|---|---|
| Group A | 3 |
| Group B | 5 |
The results of this study indicate that both immediate and delayed implant placement strategies demonstrate comparable long-term success rates in patients with periodontally compromised teeth. The implant survival rates, peri-implant bone loss values, and incidence of prosthetic complications were not significantly different between the two groups.
DISCUSSION
The comparable implant survival rates between the immediate implant placement group (Group A) and the delayed implant placement group (Group B) are in line with previous research that has reported similar outcomes.[1,2] The survival rates observed in both groups, 90% in Group A and 83% in Group B, underscore the feasibility of both implant timing strategies in periodontally compromised cases. These results align with studies that have reported high success rates for immediate implant placement, even in compromised extraction sockets.[3]
Peri-implant bone loss is a crucial parameter that influences the long-term stability of dental implants. In this study, the mean peri-implant bone loss was 1.5 mm in Group A and 2.2 mm in Group B. While there was a numerical difference between the two groups, this difference was not statistically significant. These findings resonate with previous research that has shown similar peri-implant bone loss patterns in immediate and delayed implant placement scenarios.[4] The marginal bone loss observed in this study is within the range of what is considered acceptable for successful implant therapy.[5]
Prosthetic complications are another critical aspect of implant treatment that can impact patient satisfaction and treatment outcomes. The incidence of prosthetic complications in this study was slightly higher in the delayed implant placement group (Group B) compared to the immediate implant placement group (Group A). However, this difference was not statistically significant. This aligns with the notion that the timing of implant placement may not be the sole determinant of prosthetic complications; other factors such as occlusal considerations, patient compliance, and restoration design can also play a significant role.[6]
CONCLUSION
In conclusion, this study highlights the comparable long-term success rates of immediate and delayed implant placement in patients with periodontally compromised teeth. Implant survival rates, peri-implant bone loss values, and prosthetic complication rates were not significantly different between the two groups. These findings underscore the importance of individualized treatment planning and careful consideration of patient factors when determining the optimal timing for implant placement in periodontally compromised cases.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
REFERENCES
- 1.Buser D, Weber HP, Donath K, Fiorellini JP, Paquette DW, Williams RC. Soft tissue reactions to non-submerged unloaded titanium implants in beagle dogs. J Periodontol. 1992;63:225–35. doi: 10.1902/jop.1992.63.3.225. [DOI] [PubMed] [Google Scholar]
- 2.Botticelli D, Berglundh T, Lindhe J. Hard-tissue alterations following immediate implant placement in extraction sites. J Clin Periodontol. 2004;31:820–8. doi: 10.1111/j.1600-051X.2004.00565.x. [DOI] [PubMed] [Google Scholar]
- 3.Araújo MG, Sukekava F, Wennström JL, Lindhe J. Ridge alterations following implant placement in fresh extraction sockets: An experimental study in the dog. J Clin Periodontol. 2005;32:645–52. doi: 10.1111/j.1600-051X.2005.00726.x. [DOI] [PubMed] [Google Scholar]
- 4.Schropp L, Wenzel A, Kostopoulos L, Karring T. Bone healing and soft tissue contour changes following single-tooth extraction: A clinical and radiographic 12-month prospective study. Int J Periodontics Restorative Dent. 2003;23:313–23. [PubMed] [Google Scholar]
- 5.Lang NP, Pun L, Lau KY, Li KY, Wong MC. A systematic review on survival and success rates of implants placed immediately into fresh extraction sockets after at least 1 year. Clin Oral Implants Res. 2012;23(Suppl 5):39–66. doi: 10.1111/j.1600-0501.2011.02372.x. [DOI] [PubMed] [Google Scholar]
- 6.Sghaireen MG, Alduraywish AA, Srivastava KC, Shrivastava D, Patil SR, Al Habib S, et al. Comparative Evaluation of Dental Implant Failure among Healthy and Well-Controlled Diabetic Patients-A 3-Year Retrospective Study. Int J Environ Res Public Health. 2020;17:5253. doi: 10.3390/ijerph17145253. doi: 10.3390/ijerph17145253. [DOI] [PMC free article] [PubMed] [Google Scholar]
