Comparison of peri-implant modifications between immediate implantation and delayed implantation

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Introduction: We speak of immediate implantation (II) when it is performed before the total healing of the alveolus in order to take advantage of the hemodynamic and scarring modifications generated by the avulsion to promote osseointegration. Unlike delayed implantation (De), which is performed when the bone tissues are fully consolidated. Objective: The objective of our study is to compare two implant techniques: extraction immediate implantation and delayed implantation with respect to soft and hard tissue modifications. In the maxillary and mandibular sector including all sextants with the exclusion of wisdom teeth. Materials and method: It’s a study prospective and comparative, it was performed on 102 implant sites, from December 2016 to March 2021, divided into two groups, 54 cases of delayed implantation and 48 cases immediate implantation in both jaws and including all sextants. The oral cavity can be divided into six frames; we therefore speak of a sextant. The sextants are respectively: the upper right premolar-molar group, the maxillary incisor-canine, the upper left premolar-molar, the lower left premolar-molar, the mandibular incisor-canine and finally the premolar lower right molar. Patients were followed for 6 months, during which time tissue changes and osseointegration were assessed using a NABERS periodontal probe and Radio Visio Graphy (RVG). Results: We did not obtain any rejection in the 2 techniques. For immediate implantation: osseointegration (OI) was obtained especially at 4 months for most of the implants. The loss of keratinized fibro mucosa (KFM) was localized to the mandible, it concerned sextant 4, much more for bone type 3 and 1, on the other hand the gain was observed at the level of sextant 1 and 6, especially for type 2 bone. The gain in the mesial bony crest (MBC) and distal bone (DBC) were higher in the male gender in the II compared to the female gender. The mesial fibro mucosa (MFM) was superior compared to the distal fibro mucosa (DFM) at 1 month and at 6 months. For delayed implantation: Osseointegration (OI) was mainly at 5 months for most of the implants. The loss of the keratinized fibro mucosa was localized at the level of the two maxillae. The gain in the mesial bony crest and distal bone were higher in the female gender in the (De) compared to the male gender Conclusion :It is difficult to find a consensus within the current literature as to the superior interest of the technique compared to the other but at the end of this work, we can conclude after the analysis of our results that the II is preferable to IR because it makes it possible to reduce manipulations on the soft tissues, limit the resorption of hard tissues and the filling of the papillae more quickly after loading of the implant more than in the delayed technique, this of course if the preservation of the papillae was performed during the dental extraction, hence an atraumatic or so-called periodontal extraction.