Ali Amiri, Babak Naziri, Amir Azizi, Saeed Hasani Mehraban, Juliane Pereira Butze


Background: One of the most important challenges in dental implant placement is supporting and preserving soft tissue and bone structures. Numerous studies on fixation of soft and hard tissues at the single or double teeth site have reported immediate placement using a flapless protocol, while many studies have reported fewer results in molar extraction solutions. The current study aims to determine the clinical outcome of peri-implant soft and hard tissues following immediate implant placement.

Materials & Methods: This study was conducted in the Department of Orthodontics, College of Stomatology, Xi’an Jiaotong University, Xi’an, China, from January 2021 to September 2021. In this systematic review, the search strategy was to screen electronically all relevant, authentic articles on databases of Embase, LIVIVO, EBSCO, Web of Science, LILACS, Scopus, and PubMed, published from 2011 to September 2021. Risk ratio (RR) was determined for implant failure, and mean differences (MD) were determined for soft tissue, horizontal and vertical buccal bone resorption by 95% CI, Inverse-variance, and fixed effect model or Mantel-Haenszel method between the intervention (bone substitute material) and control (no bone substitute material) groups through Stata/MP v.16.

Results: Risk ratio of implant failure was similar in intervention and control group 0.02 (RR=0.02; 95%CI=-0.04 to 0.08; p=0.49). Mean differences were statistically greater in intervention than control group for soft tissue 1.65 mm (95%CI=1.05 to 2.25; p=0.00), horizontal bone resorption -0.47 mm (95%CI=-0.77 to -0.17 mm; p=0.00) and vertical buccal bone resorption -0.14 mm (95%CI=-0.24 to -0.03 mm; p=0.01).

Conclusion: Our findings revealed no significant difference in implant failure between an intervention (bone substitute material) and control (no bone substitute material) groups. Mean differences were statistically greater in the intervention than the control group for soft tissue, horizontal bone resorption, and vertical buccal bone resorption. Using bone substitute material can improve long-term peri-implant soft tissue, horizontal and vertical buccal bone resorption. It is recommended to use bone-substitute material with a thin buccal plate.


Bone; Tissues; Teeth; Bone Resorption; Bone Substitutes; Meta-analysis; Systematic Review; Risk Ratio.

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