10‐year prospective cohort study of immediate extraction implants placed in 3 clinical situations

Abstract

Background It is an established practice to place implants in immediate extraction sockets with or without periapical pathology, and though studies present high implant survival rates, it has been observed that human studies are limited to a small number of cases or if the sample size is larger, the study was for a short duration of time. The current study bridges the gap by analyzing large data for immediate extraction implants over a 10-year period in 3 different clinical situations Aim/Hypothesis To classify data based on the reason for extraction and its assessment for overall survival rate over a 10-year period thus establishing norms for case selection, favourable surgical techniques and maintenance protocol for long term implant success in immediate extraction implant cases. Material and Methods Data of Xive implants placed in fresh extraction sockets in a single dental practice with a follow-up of 10 years was obtained. Based on the reason for tooth extraction the data was classified as non-restorable teeth with healthy periodontium (Group A-control), periodontally involved teeth with no periapical infection (Group B- experimental) and teeth with chronic periapical infection non-treatable by endodontic therapy (Group C- experimental). These data were further screened and filtered based on the size of implant placed post-surgery, the use of membrane and extent of bone defect. Marginal bone levels, pocket probing depth and bleeding on probing were measured at 12–15 months, 4.5 to 5 years and 10 to 11 years post-cementation. Patient satisfaction for function was assessed. Results 179 implants were taken up for assessments. 57 implants from group A+ 62 implants from group B+ and 60 implants from group C. Mean bone loss comparisons between group A and Group B was statistically significant (0.5319 mm for 12–15 months, 0.6173 mm for 4.5 to 5 years and 0.6557 mm for 10–11 years), mean bone loss comparisons between group A and Group C was statistically significant (0.4996 mm for 12–15 months, 0.6015 mm for 4.5 to 5 years and 0.6692 mm for 10–11 years), whereas, mean bone loss comparisons between group B and Group C was statistically insignificant (0.0323 mm for 12–15 months, 0.0158 mm for 4.5 to 5 years and 0.0135 mm for 10–11 years). Pocket depth, because of its methodology of measurement gave non-conclusive statistics. Number of cases of mucositis and periimplantitis across all 3 groups and over 10-year observation period was statistically insignificant. Conclusion and Clinical Implications With surgical protocols used in the study, implants placed into fresh extraction sites for replacement of teeth with pre-existing infected lesion or pre-existing periodontal infection show higher bone loss as compared to those without infection, however overall, success rate of all these implants is comparable to one another over a 10-year period.