%0 Journal Article
%T Immediate implant placement with or without socket grafting: A systematic review and meta-analysis.
%A Seyssens L
%A Eeckhout C
%A Cosyn J
%J Clin Implant Dent Relat Res
%V 24
%N 3
%D Jun 2022
%M 35313067
%F 4.259
%R 10.1111/cid.13079
%X <B>OBJECTIVE: </B>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).<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.