Immediate Placement or Immediate Restoration/Loading of Single Implants for Molar Tooth Replacement: A Systematic Review and Meta-analysis

Purpose: This systematic review and meta-analysis assessed the survival of immediately placed single implants in fresh molar extraction sites and immediately restored/loaded single molar implants in healed molar sites. Materials and Methods: A search of the main electronic databases, including the Cochrane Oral Health Group's Trials Register, was conducted up to November 1, 2008. The meta-analysis was prepared in accordance with the guidelines of the Academy of Osseointegration Workshop on the State of the Science on Implant Dentistry. The data were analyzed with statistical software. Results: For immediately placed molar implants, nine studies describing 1,013 implants were included to support a survival rate of 99.0%. There were no significant differences between immediate and delayed loading/restoration in molar sites (relative risk of 0.30, 95% confidence interval 0.05 to 1.61; P = .16). For immediate restoration/loading of single implants in healed molar sites, seven studies with 188 single implants were identified. In this case, the implant survival rate was 97.9%, with no difference between immediate and delayed loading (relative risk of 3.0, 95% confidence interval: 0.33 to 27.16; P = .33). Favorable marginal bone level changes in the immediate loading group were detected at 12 months (mean difference of -0.31, 95% confidence interval: -0.53 to -0.096; P = .005). Conclusions: The protocols of immediate placement and immediate restoration/loading of single implants in mandibular molar regions showed encouraging results. Keywords: dental implants, immediate loading, immediate placement, immediate restoration, meta-analysis, single implant, systematic review