Flapless Immediate Implant Placement With and Without Bone Grafting: A Systematic Review and Meta-Analysis

IF 2.2 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical and Experimental Dental Research Pub Date : 2025-07-23 DOI:10.1002/cre2.70182

Saeed Sadat Mansouri, Farhan Musaie, Abbas Mirzaei, Samad Samadizadeh, Salar Chaychi Salmasi, Tahereh Bitaraf

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引用次数: 0

Abstract

Objectives

This study aims to evaluate the influence of bone grafting peri-implant gap on the changes in hard and soft tissues following flapless immediate implantation.

Material and Methods

A comprehensive research process was undertaken, including electronic searches of databases such as Embase, PubMed, Web of Science, and Cochrane, as well as a manual search. This approach identified relevant clinical studies until March 2024. Randomized controlled trials (RCTs) that compared flapless immediate implant placement with and without bone grafting were selected for qualitative assessment. Meta-analyses were conducted where feasible. The protocol was registered in PROSPERO with code CRD42024499377, ensuring transparency and accountability in our research.

Results

Out of 1065 articles, 5 RCTs were included, involving 179 patients who underwent placement of 179 immediate implants (92 with bone grafting and 87 without) with follow-up periods ranging from 6 to 12 months. Analysis revealed no significant differences in horizontal bone changes within 0 to 3 mm apical to the bone crest between the two groups (weighted mean difference [WMD]: 0.147 (−0.012, 0.306), I²: 0.0%; standardized mean difference [SMD]: 0.337 (−0.016, 0.690), I²: 0.0%). However, significant differences were observed in horizontal bone changes at 4–5 mm apical to the reference point, favoring bone grafting (WMD: 0.484 (0.142, 0.826), I²: 75.4%; SMD: 0.794 (0.402, 1.186), I²: 36.6%). No significant differences were found in vertical midfacial soft tissue changes between the groups (WMD: 0.300 (−0.425, 1.024), I²: 62.4%; SMD: 0.213 (−0.339, 0.764), I²: 60.2%). Data limitations precluded meta-analyses on additional outcomes such as mesial and distal papillary alterations and vertical bone level changes.

Conclusion

Flapless immediate dental implants with a bone graft may enhance alveolar bone preservation, warranting further investigation.

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无瓣即刻种植体植入与不植骨：系统回顾和荟萃分析

目的探讨植骨种植周间隙对即刻无瓣种植后硬、软组织变化的影响。材料和方法进行了全面的研究过程，包括Embase、PubMed、Web of Science和Cochrane等数据库的电子检索，以及人工检索。该方法确定了相关的临床研究，直到2024年3月。随机对照试验（rct）比较无瓣即刻种植体植入与不植骨进行定性评估。可行时进行meta分析。该协议已在PROSPERO注册，代码为CRD42024499377，确保了我们研究的透明度和问责制。结果在1065篇文章中，纳入了5项随机对照试验，涉及179例患者，他们接受了179例即刻种植体的放置（92例植骨，87例未植骨），随访时间为6至12个月。分析显示，两组患者骨尖至骨嵴0 ~ 3mm范围内水平骨变化无显著差异(加权平均差[WMD]: 0.147 (- 0.012, 0.306), I2: 0.0%；标准化平均差[SMD]: 0.337 (- 0.016, 0.690), I2: 0.0%)。然而，在4-5 mm的根尖水平骨变化与参考点有显著差异，有利于植骨(WMD: 0.484 (0.142, 0.826), I2: 75.4%；Smd: 0.794 (0.402, 1.186), i2: 36.6%)。各组间垂直面中软组织变化差异无统计学意义(WMD: 0.300 (- 0.425, 1.024), I2: 62.4%；Smd: 0.213(−0.339,0.764),i2: 60.2%)。数据限制排除了对其他结果的荟萃分析，如近端和远端乳头改变和垂直骨水平改变。结论无瓣即刻种植体联合植骨可有效保护牙槽骨，值得进一步研究。

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来源期刊

Clinical and Experimental Dental Research DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

3.30

自引率

5.60%

发文量

165

审稿时长

26 weeks

期刊介绍： Clinical and Experimental Dental Research aims to provide open access peer-reviewed publications of high scientific quality representing original clinical, diagnostic or experimental work within all disciplines and fields of oral medicine and dentistry. The scope of Clinical and Experimental Dental Research comprises original research material on the anatomy, physiology and pathology of oro-facial, oro-pharyngeal and maxillofacial tissues, and functions and dysfunctions within the stomatognathic system, and the epidemiology, aetiology, prevention, diagnosis, prognosis and therapy of diseases and conditions that have an effect on the homeostasis of the mouth, jaws, and closely associated structures, as well as the healing and regeneration and the clinical aspects of replacement of hard and soft tissues with biomaterials, and the rehabilitation of stomatognathic functions. Studies that bring new knowledge on how to advance health on the individual or public health levels, including interactions between oral and general health and ill-health are welcome.