Immediate implant placement with simultaneous bone augmentation versus delayed implant placement following alveolar ridge preservation: A clinical and radiographic study.

Objective: The present study aimed to evaluate the clinical and radiographic outcomes of immediate implant placement (IIP) with guided bone regeneration (GBR) as compared to delayed implant placement (DIP) following alveolar ridge preservation (ARP) and to identify the potential risk factors influencing these outcomes.

Methodology: A total of 56 patients (IIP = 28 vs. DIP = 28) with class I or II bony defects received 56 implants were included. GBR procedure using Bio-Oss® bone substitute mixed with advanced platelet-rich fibrin (A-PRF) and covered by Bio-Gide® membrane and additional A-PRF membrane was performed either simultaneously with the IIP or earlier at the time of ARP in DIP. Clinical and 3-D radiographic analyses of bone level, thickness, and density were performed at three-time intervals (T1, immediately; T2, 6-7 months; and T3, 1.5 to 2 years post-implantation), corresponding to the neck, coronal, middle, and apex of implants.

Results: The survival rate was 100% in both groups. IIP showed significant favorable outcomes regarding distal marginal bone level (anterior maxilla, T1-T3) and neck and coronal horizontal facial bone thickness (HFBT) (posterior maxilla, T1; and anterior maxilla, T1-T3, respectively) compared to DIP. However, DIP showed significant facial bone density at the neck and coronal parts in the anterior maxilla (T1) and the coronal part in the posterior maxilla (T3). The facial marginal bone level change was positively correlated with HFBT change (P = 0.007), which is negatively correlated with the secondary implant stability (P = 0.019). The implant region (anterior or posterior maxilla) was the only factor affecting on Implant stability quotient value (ISQ) and change in HFBT (P ˂ 0.05).

Conclusion: Overall, the IIP combined with GBR in the post-extraction sites with pre-implant class I or II bony defects had some favorable outcomes compared to DIP after ARP. However, the clinical outcomes, ISQ value, and changes in bone level, thickness, and density from T1-T3 were comparable.