Validity of a regenerative procedure for a minor bone defect with immediate implant placement: a systematic review and meta-analysis

Abstract

Objective: This systematic review evaluates implant survival and the change in the width of the horizontal ridge following immediate implant placement with or without a regenerative procedure.

Materials and methods: An electronic search of MEDLINE, EMBASE, and the LILACS database of the Cochrane Central Register of controlled trials was performed, along with a manual search, up to April 2018. Randomized controlled trials (RCTs) and quasi-randomized controlled clinical trials (CCTs) with >10 subjects were eligible for this systematic review. A meta-analysis of the risk difference in implant failure between the regenerative and non-regenerative procedure groups was performed using a fixed-effect model. In addition, a meta-analysis of the change in alveolar bone width was conducted using a fixed-effect model.

Results: Seven studies (six RCTs and one CCT) were included. A meta-analysis of three studies found no statistically significant risk difference in implant failure between the regenerative procedure and non-regenerative procedure groups. A meta-analysis of four studies showed that horizontal shrinkage of the alveolar ridge in the site of immediate implant placement was statistically significantly lower with the regenerative procedure than without it (<1 year follow up studies: weighted mean difference (WMD) 0.75 mm, 95% confidence interval 0.41–1.09, p < .00001; ≥1 year follow up study: WMD 1.22, 95% confidence interval 0.52–1.91, p = .00006; total: WMD 0.84 mm, 95% confidence interval 0.53–1.14, p < .00001).

Conclusion: Within the study limitations, immediate implant placement with a regenerative procedure showed similar implant survival and less shrinkage of the ridge width than immediate implant placement without a regenerative procedure. Due to the high risk of bias and small sample sizes of the included studies, further clinical studies are warranted to draw definitive conclusions.

Keywords:

• Guided bone regeneration
• bone graft
• implant survival
• immediate implant

Acknowledgements

The authors hereby acknowledge the diligent support provided by the Dental Research Institute, Seoul National University, in the management of this study. The authors also thank eWorldEditing for technical support.

Disclosure statement

No potential conflict of interest was reported by the authors.