Abstract：
OBJECTIVE: To assess the effect of grafting the gap (SG) between the implant surface and alveolar socket on hard and soft tissue changes following single immediate implant placement (IIP).
METHODS: Two independent reviewers conducted an electronic literature search in Pubmed, Web of Science, Embase and Cochrane databases as well as a manual search to identify eligible clinical studies up to August 2021. Randomized controlled trials (RCTs) comparing IIP with and without SG were included for a qualitative analysis. Meta-analyses were performed when possible.
RESULTS: Out of 3627 records, 15 RCTs were selected and reported on 577 patients who received 604 single immediate implants (IIP + SG: 298 implants in 292 patients; IIP: 306 implants in 285 patients) with a mean follow-up ranging from 4 to 36 months. Two RCTs showed low risk of bias. Meta-analysis revealed 0.59 mm (95% CI [0.41; 0.78], p < 0.001) or 54% less horizontal buccal bone resorption following IIP + SG when compared to IIP alone. In addition, 0.58 mm (95% CI [0.28; 0.88], p < 0.001) less apical migration of the midfacial soft tissue level was found when immediate implants were installed with SG. A trend towards less distal papillary recession was found (MD 0.60 mm, 95% CI [-0.08; 1.28], p = 0.080) when SG was performed, while mesial papillae appeared not significantly affected by SG. Vertical buccal bone changes were also not significantly affected by SG. Insufficient data were available for meta-analyses on horizontal midfacial soft tissue changes, pink esthetic score, marginal bone level changes, probing depth and bleeding on probing. Based on GRADE guidelines, a moderate recommendation for SG following IIP can be made.
CONCLUSIONS: SG may contribute to horizontal bone preservation and soft tissue stability at the midfacial aspect of immediate implants. Therefore, SG should be considered as an adjunct to IIP in clinical practice.
METHODS: Two independent reviewers conducted an electronic literature search in Pubmed, Web of Science, Embase and Cochrane databases as well as a manual search to identify eligible clinical studies up to August 2021. Randomized controlled trials (RCTs) comparing IIP with and without SG were included for a qualitative analysis. Meta-analyses were performed when possible.
RESULTS: Out of 3627 records, 15 RCTs were selected and reported on 577 patients who received 604 single immediate implants (IIP + SG: 298 implants in 292 patients; IIP: 306 implants in 285 patients) with a mean follow-up ranging from 4 to 36 months. Two RCTs showed low risk of bias. Meta-analysis revealed 0.59 mm (95% CI [0.41; 0.78], p < 0.001) or 54% less horizontal buccal bone resorption following IIP + SG when compared to IIP alone. In addition, 0.58 mm (95% CI [0.28; 0.88], p < 0.001) less apical migration of the midfacial soft tissue level was found when immediate implants were installed with SG. A trend towards less distal papillary recession was found (MD 0.60 mm, 95% CI [-0.08; 1.28], p = 0.080) when SG was performed, while mesial papillae appeared not significantly affected by SG. Vertical buccal bone changes were also not significantly affected by SG. Insufficient data were available for meta-analyses on horizontal midfacial soft tissue changes, pink esthetic score, marginal bone level changes, probing depth and bleeding on probing. Based on GRADE guidelines, a moderate recommendation for SG following IIP can be made.
CONCLUSIONS: SG may contribute to horizontal bone preservation and soft tissue stability at the midfacial aspect of immediate implants. Therefore, SG should be considered as an adjunct to IIP in clinical practice.
摘要：
目的：评估移植植入物表面和牙槽窝之间的间隙（SG）对单次立即植入（IIP）后硬和软组织变化的影响。
方法：两名独立审稿人在Pubmed，WebofScience,Embase和Cochrane数据库以及手动搜索，以确定截至2021年8月的合格临床研究。包括比较有和没有SG的IIP的随机对照试验（RCT）进行定性分析。在可能的情况下进行荟萃分析。
结果：在3627条记录中，选择了15项RCTs，并报告了577例患者，这些患者接受了604例一次性植入物（IIPSG：292例患者中的298例植入物；IIP：285例患者中的306例植入物），平均随访时间为4至36个月。两个RCT显示低偏倚风险。Meta分析显示0.59mm（95%CI[0.41；0.78]，p<0.001）或与单独的IIP相比，IIPSG后的水平颊骨吸收减少了54％。此外,0.58毫米（95%CI[0.28；0.88]，p<0.001）当用SG安装即时植入物时，发现中面部软组织水平的根尖迁移较少。发现远端乳头状凹陷减少的趋势(MD0.60mm，95%CI[-0.08；1.28]，p=0.080)执行SG时，而中乳头似乎没有受到SG的明显影响。SG对垂直颊骨的改变也没有显着影响。对于面部中部软组织水平变化的荟萃分析数据不足，粉红色的审美得分，边缘骨水平变化，探测深度和探测出血。根据等级准则，可以在IIP之后对SG提出适度建议。
结论：SG可能有助于即刻种植体中面的水平骨保存和软组织稳定性。因此,在临床实践中，SG应被视为IIP的辅助手段。
方法：两名独立审稿人在Pubmed，WebofScience,Embase和Cochrane数据库以及手动搜索，以确定截至2021年8月的合格临床研究。包括比较有和没有SG的IIP的随机对照试验（RCT）进行定性分析。在可能的情况下进行荟萃分析。
结果：在3627条记录中，选择了15项RCTs，并报告了577例患者，这些患者接受了604例一次性植入物（IIPSG：292例患者中的298例植入物；IIP：285例患者中的306例植入物），平均随访时间为4至36个月。两个RCT显示低偏倚风险。Meta分析显示0.59mm（95%CI[0.41；0.78]，p<0.001）或与单独的IIP相比，IIPSG后的水平颊骨吸收减少了54％。此外,0.58毫米（95%CI[0.28；0.88]，p<0.001）当用SG安装即时植入物时，发现中面部软组织水平的根尖迁移较少。发现远端乳头状凹陷减少的趋势(MD0.60mm，95%CI[-0.08；1.28]，p=0.080)执行SG时，而中乳头似乎没有受到SG的明显影响。SG对垂直颊骨的改变也没有显着影响。对于面部中部软组织水平变化的荟萃分析数据不足，粉红色的审美得分，边缘骨水平变化，探测深度和探测出血。根据等级准则，可以在IIP之后对SG提出适度建议。
结论：SG可能有助于即刻种植体中面的水平骨保存和软组织稳定性。因此,在临床实践中，SG应被视为IIP的辅助手段。
