A prospective, controlled clinical trial evaluating the clinical radiological and aesthetic outcome after 5 years of immediately placed implants in sockets exhibiting periapical pathology.

OBJECTIVE: The aim was to compare the clinical, aesthetic and radiological outcome of immediately placed implants in sockets with or without periapical pathology 5 years after placement. MATERIALS AND METHODS: Twenty-seven patients were followed 5 years after immediate implant placement (test-group: 12 patients with periapical pathologies; control-group: 15 patients without periapical pathology). Clinical (FMBS, FMPS, CAL, keratinized mucosa), aesthetical (length of clinical crown, Papilla index), and radiological (vertical distance implant shoulder to first bone to implant contact (IS-BIC)) parameters were assessed. Both 95% confidence intervals, as well as results of statistical tests (one-sample, two-sample, paired t-test) were provided. RESULTS: After 5 years the implant survival rate was 100% for all 27 implants. In the test group the width of the keratinized mucosa increased significantly over the observation period (0.8 ± 1.0 mm). Concerning aesthetic parameters at the 3-month as well as at the 5-year examination no statistically significant difference could be found between the two groups. In the control-group the papilla mesial and distal to the implant increased statistically significant during the observation period by 0.5 ± 0.5 and 0.4 ± 0.6 index score points, respectively. The position of the gingival margin at the implant site and the two neighboring teeth remained stable. At the 5-year visit IS-BIC measured between 1.4 ± 0.5 mm (mesial, control) and 1.7 ± 0.7 mm (distal, test), no significant difference could be found between the two groups. Over the observation period no statistically significant change of IS-BIC could be found in the test- as well as in the control-group. None of the examined radiographs revealed any signs of retrograde peri-implantitis. CONCLUSION: The replacement of teeth exhibiting periapical pathologies by implants placed immediately after tooth extraction can be a successful treatment modality with no disadvantages in clinical, aesthetical and radiological parameters to immediately placed implants into healthy sockets.

A prospective, controlled clinical trial evaluating the clinical and radiological outcome after 3 years of immediately placed implants in sockets exhibiting periapical pathology.

OBJECTIVES: the aim of the present study was to compare the clinical and radiological outcome of immediately placed implants in sockets with or without periapical pathology 3 years after implant placement. MATERIALS AND METHODS: twenty-nine patients with immediate implant placement were clinically and radiologically followed 3 years after implant placement (test group: 16 patients without periapical pathology, control group: 13 patients with periapical pathologies). Clinical (full-mouth bleeding score, full-mouth plaque score, clinical attachment level measurements and width of keratinized mucosa buccaly of the implant) and radiological parameters (vertical distance from the implant shoulder to the first bone-to-implant contact [IS-BIC]) were assessed. Both 95% confidence intervals, as well as results of statistical tests (one-sample, two-sample and paired t-test) were provided. RESULTS: the implant survival rate was 100% for all 29 implants after 3 years. The clinical and radiological parameters showed no statistically significant difference between the test and the control group at 3 years (two-sample t-test). The IS-BIC was between 1.54 ± 0.88 mm (mesial, test) and 1.69 ± 0.92 mm (distal, test). Between the 1- and 3-year visit the IS-BIC increased in both groups significantly on one side of the implant: 0.30 ± 0.37 mm (mesial, test) and 0.33 ± 0.43 mm (distal, control) (one-sample t-test). None of the 13 examined radiographs of implants immediately placed in sockets with periapical pathologies revealed retrograde peri-implantitis after 3 years. CONCLUSION: it is concluded within the limitations of this study, that after careful debridement of the extraction socket, immediate placement of implants into sites with periapical pathologies can be a successful treatment modality for at least 3 years with no disadvantages in clinical and radiological parameters to immediately placed implants into healthy sockets.