Clinical and esthetic outcomes of immediate implant placement compared to alveolar ridge preservation: a systematic review and meta-analysis

The aim of this systematic review was to evaluate the efficacy of immediate implant placement (IIP) compared to implants placed after alveolar ridge preservation (ARP) in terms of clinical, esthetic, and patient-reported outcomes. A manual and electronic search (National Library of Medicine) was performed for controlled clinical trials, with at least 12 months of follow-up. Primary outcome variable was implant survival and secondary outcomes were marginal bone level (MBL) (change), pink esthetic score (PES), mid-facial mucosal level (change), papilla index score, complications, and patient-reported outcomes. A total of 10 publications were included (7 randomized clinical trials and 3 controlled clinical trials). The results from the meta-analyses showed that survival rate was significantly lower in the IIP group compared to ARP group [RR = 0.33; 95% CI (0.14; 0.78); p = 0.01]. No significant differences between the two groups were observed regarding radiographic MBL, PES scores, or mid-facial mucosal level (p > 0.05). The results from this systematic review and meta-analysis showed that IIP had lower survival rates and similar esthetic results when compared to ARP. Clinicians should weigh the benefits and disadvantages of each intervention to select the optimal timing of implant placement.