Placement of immediate dental implants in extraction sockets exhibiting the apical pathosis. A meta-analysis

Osamah Mohammed AlMugeiren; Ahmad Salem Assari; Khalid Abdullah Alshehri; Mohammed Abdulaziz Alsharidah; Abdulelah N Alotaibi; Abdullah Hamad Alzaid

doi:10.1016/j.jobcr.2024.03.008

Placement of immediate dental implants in extraction sockets exhibiting the apical pathosis. A meta-analysis

J Oral Biol Craniofac Res. 2024 May-Jun;14(3):290-300. doi: 10.1016/j.jobcr.2024.03.008. Epub 2024 Apr 4.

Authors

Osamah Mohammed AlMugeiren¹, Ahmad Salem Assari², Khalid Abdullah Alshehri³, Mohammed Abdulaziz Alsharidah³, Abdulelah N Alotaibi³, Abdullah Hamad Alzaid³

Affiliations

¹ Preventive Dentistry Department, College of Medicine and Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia.
² Oral and Maxillofacial Surgery and Oral Diagnostic Sciences Department, College of Medicine and Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia.
³ College of Medicine and Dentistry , Riyadh Elm University, Riyadh, Saudi Arabia.

Abstract

Objectives: It is commonly accepted that immediate implantation is the best option for patients since it shortens the time patients must wait for ultimate restoration and provides a predictable functional and aesthetic result. However, this approach is still controversial in patients with apical pathosis. The goal of this systematic review and meta-analysis was to determine the efficacy of immediate implant insertion in patients with apical pathosis.

Material and methods: Between 2000 and 2023, PRISMA-compliant keywords were used to search PubMed, MEDLINE, CENTRAL, and the Cochrane Library. All English-language clinical studies that met PICOS criteria were included in a manual search. The included studies' demographic profile and event data for immediate dental implantation success in patients with or without apical pathosis were meta-analyzed using RevMan. The implant survival rate was assessed using risk ratio of plaque index and bleeding index. Begg's test using MedCalc and RevMan risk of bias assessment assessed publication bias.

Results: A meta-analysis of 10 trials with 849 dental implantation patients found a substantial difference in initial implant placement success rates in infected sites. The pooled risk ratio for plaque index is 0.59 (95% CI: 0.36-0.96) with heterogeneity of Tau² = 0.62, chi² = 109.69, df = 11, I² = 90%, z = 2.12, and p < 0.05. While, the pooled risk ratio for bleeding index is 0.77 (95% CI: 0.60 to 0.98) with Tau² = 0.16, chi² = 103.67, df = 11, I² = 89%, z = 2.12, and p < 0.05. The pooled odds ratio of implant survival rate is 2.08 (95% CI: 1.56 to 1.79) with Tau² 0.16; chi² 52.43; df 9; I² 83%; z 4.93 and p < 0.05. As evidenced by the funnel plot and statistically insignificant Begg's test p values of 0.45.

Conclusion: The placement of immediate implants in locations affected by apical pathosis is a clinically beneficial surgery, resulting in favorable aesthetic and functional outcomes for patients.

Keywords: Apical pathosis”; “Bleeding index”; “Dental implantation”; “Immediate implantation technique”; “Implant survival rate”; “Meta-analysis”; “Periodontally infected sites”; “Plaque index”; “Systematic review”.