Five decades of research on immediate implant therapy: A modern bibliometric network analysis via Altmetric and level of evidence mapping.

AIM: To conduct a bibliometric network analysis to explore the research landscape of immediate implant placement (IIP) and provide insights into its trends and contributors. MATERIALS AND METHODS: The Scopus database was utilized as the bibliographic source, and a search strategy was implemented to identify relevant research articles. Various bibliometric parameters were extracted, including publication year, journal, authors, citations, and funding. The analysis involved examining authorship patterns, international collaborations, level of evidence, Altmetric data, and funding analysis. RESULTS: We identified a steady annual growth rate of 6.49% in IIP research. The top three countries contributing to research output were the USA, Italy, and China. Prolific authors were identified based on publication and citation metrics. International collaborations among different countries were observed. The level of evidence analysis revealed that over 30% of the articles fell into higher levels of evidence (levels 1 and 2). Altmetric data analysis indicated no significant correlations between citation counts and Altmetric Attention Score (AAS), and conversely a significant association with Mendeley readers count. Funding and open access did not significantly impact the bibliometric indices of the papers. CONCLUSIONS: The focus of research on IIP has been evolving as indicated by an exponential growth rate in this study. Only approximately 16% of the articles fit into level 1 evidence, therefore, emphasizing on higher quality level research study shortage in this field. Modern indices can be used as new bibliometric indicators as they also cover social media and online attention scores.

Therapeutic Efficacy of Bromelain in Alveolar Ridge Preservation.

Most of research in regenerative oral surgery describes materials or techniques for increasing volumetric results for implant-supported prosthesis. The use of bio-materials in alveolar ridge preservation after tooth extraction commonly leads to a delayed recovery. Bromelain is an enzyme that belongs to a family of proteolytic enzymes derived from the stem of the pineapple plant (Ananas comosus) with effectiveness in decreasing the inflammation development and swelling. The present paper reports a prospective comparative study performed in order to test the possible use of oral bromelain 40 mg in alveolar ridge preservation. Evaluations were performed at three time points after the surgery: after 2 days (t1), after 7 days (t2) and after 14 days (t3). A statistically significant difference among patients that used bromelain and patients that used placebo resulted among the use of bromelain and lower Visual Analogue Scale (VAS) at t1 (r = -0.75, p = 0.0067), t2 (r = -0.90, p = 0.0001) and t3 (r = -0.8566, p = 0.0008). Bromelain therapy reported a statistically significant difference among patients that used bromelain and patients that used placebo even with regards to the use of bromelain and postoperative swelling at t1 (r = -0.79, p = 0.0034), t2 (r = -0.81, p = 0.0020) but not at t3 (r = -0.34, p = 0.2967). With the result of the present paper, and the poorness of contraindication of the investigated drug, bromelain may be suggested to be used for patients that undergo to alveolar ridge preservation after tooth extraction.

Survival Rates and Factors Affecting the Outcome Following Immediate and Delayed Implant Placement: A Retrospective Study.

Background: Immediate implant placement into extraction sockets has become a widely acceptable treatment option to decrease treatment time and enhance esthetics. The objectives of this study were to assess and compare the survival rates of immediate and delayed implant treatment as well as to investigate the effect of patient- and site-related variables on the treatment outcome in a large-scale population-based study. Methods: Dental records of patients who received implant therapy were retrieved from the electronic records of the University of Minnesota School of Dentistry. Demographic characteristics, dental insurance status, socioeconomic status as well as medical history and tobacco use were recorded. The treatment outcome was included as a binary variable (survival/failure). Time to failure (date of procedure to date of visit with failure) was compared between immediate and delayed implant treatment in Cox regression models. Kaplan−Meier plots for the survival of both treatment modalities were created. Patient-sites without failure were censored at the last follow-up visit. Results: A total of 4519 records of implants were included. The sample mean age was 60.27 years and included 50.7% males and 12.9% tobacco users. High socioeconomic status was characterized for 82.3% of the included population and 63.0% of them were self-payers. Immediate implants were significantly more frequently placed in the maxillary arch (p < 0.001) than in the mandible. Tobacco users received more often a delayed rather than an immediate implant placement (p = 0.001). The survival rate analysis revealed there were no significant differences between immediate and delayed implant placements (p = 0.48). The mean follow-up time was 32.27 months during which 1.5% immediate and 1.1% delayed implants were removed. The estimated mean survival time for immediate implants was 68.90 months, while delayed implants placed in healed sockets showed a mean survival time of 75.11 months. A statistically significant association was found between gender (p = 0.03) and osteoporosis (p = 0.001) with treatment outcome. Conclusions: The placement of immediate implants achieved similarly high survival rates when compared to delayed implants placed in healed sites. Males and osteoporotic individuals showed significantly higher implant failure than females and non-osteoporotic patients. This study demonstrated that both immediate and delayed implant placements are sound options with predictable treatment outcome.

Comparing success of immediate versus delay loading of implants in fresh sockets: a systematic review and meta-analysis.

BACKGROUND AND AIMS: The replacement of teeth with osseointegrated implants is one of the significant advances in the field of restorative dentistry. The time interval between tooth extraction and the implant can be very short or long. This systematic review and meta-analysis aimed to collect and evaluate articles related to determining the effect of instant loading of dental implants are placed in the fresh socket initial stability on the clinical success of the implant compared to delay loading dental implants. MATERIALS AND METHODS: In this study, all the available articles indexed in leading databases, including PubMed, ISI Web of Science, Embase, PsycINFO, PROSPERO, and Scopus, were searched. The full text of the articles meeting the primary criteria to be included in this research was obtained and appraised. Data of studies were extracted if they were scored as a high or moderate level of evidence. RESULTS: A total of 2258 published articles were found through electronic database searching. After screening the titles and abstracts, and full text of articles, 16 studies met the inclusion criteria and were included in the analysis. The results of this study revealed that regarding the success rate, although there was no significant difference between immediate and delayed of dental implants, immediate procedure showed a lower incidence of bone loss in single implants. CONCLUSION: Based on the results of this study, immediate loading of dental implant, under certain conditions, is a successful treatment process and is effective in reducing treatment time. Thus, immediate loading represents a valid alternative to the traditional delayed loading rehabilitation.

Long-term results of immediate implantation in the maxillary molar area with simultaneous sinus floor elevation by the crestal approach and early loading protocol: A retrospective case series follow-up study.

Background: This study aimed to determine the long-term survival rate of implants placed in fresh sockets of extracted maxillary molars with simultaneous sinus floor elevation and early loading protocol. Methods: Nineteen maxillary molar teeth were extracted by tooth sectioning, and the sockets were debrided. Drilling for implant placement (Either Xive, Dentsply or Axiom, Antogyr) was terminated 1 mm short of the sinus floor with a pilot drill. Then, according to Summers' technique, elevation of the Schneiderian membrane and bone grafting were performed. The implants were placed according to non-submerged procedure after sinus grafting and preparation of the desired osteotomy site. Results: The implants had been in function up to 5 years and the mean time of loading was 33.12 months. Analysis of crestal bone loss records indicated a mean of -0.054±0.56 mm of bone resorption (with a range of -0.86 to +0.90 mm). The amount of crestal bone resorption on the mesial and distal surfaces of implants was -0.02±0.559 mm and -0.09±0.59 mm, respectively (P=0.232). Survival rates and success rates were 100% and 95.45%, respectively. Conclusion: Immediate implant placement in the posterior maxilla with simultaneous sinus floor augmentation and early loading was a reliable and predictable approach.

Immediate implant placement into fresh extraction sockets versus delayed implants into healed sockets: A systematic review and meta-analysis.

The aim of this systematic review and meta-analysis was to compare the survival rate of the implants and the peri-implant tissue changes associated with implants inserted in fresh extraction sockets and those inserted in healed sockets. This review has been registered at PROSPERO under the number CRD42016043309. A systematic search was conducted by two reviewers independently in the databases PubMed/MEDLINE, Embase, and the Cochrane Library using different search terms; articles published until November 2016 were searched for. The searches identified 30 eligible studies. A total of 3,049 implants were installed in a total of 1,435 patients with a mean age of 46.68 years and a minimum of 6 months of follow-up. The survival rate of delayed implants (98.38%) was significantly greater than immediate implants (95.21%) (p=.001). For the marginal bone loss (p=.32), implant stability quotients values (p=.44), and pocket probing depth (p=.94) there was no significant difference between the analysed groups. The immediate implants placed in fresh sockets should be performed with caution because of the significantly lower survival rates than delayed implants inserted in healed sockets.

Dental Implants Placed in Periodontally Infected Sites in Humans.

BACKGROUND: The purpose of the present study was to evaluate fresh socket implant outcome leaving granulomatous tissue into the bone defects. MATERIALS AND METHODS: Subjects requiring tooth extractions in periodontal infected sites were selected for this prospective study. Only patients with 4-wall defects and asymptomatic ones were included. The fresh sockets were randomly scheduled into two groups: In one group (Removal Group, RG) granulomatous tissue was removed and, in the other group (Left Group, LG) granulomatous tissue was left. Implants were positioned immediately after tooth extraction, and were loaded after 3 months in both groups. Intraoral digital radiographs were performed at temporary prosthesis placement; at 12, 24 and 36 months to evaluate marginal bone levels changes. Moreover, clinical parameters were acquired at the same time points. RESULTS: Sixty patients were included in this study. Three-hundred seventy-two implants were placed immediately after tooth extraction and, at 3-year follow-up, a survival rate of 98.66% was reported, 2 implants were lost in RG and 3 implants in LG. At 36-month follow-up, not statistically significant differences were found between RG and LG in marginal bone level changes and clinical parameters (p > 005). Moreover, not statistically significant differences were found in intragroup comparisons over time (p > 0.05). CONCLUSIONS: With the limits of this study it was concluded that granulomatous tissue left in infected fresh sockets doesn't injury dental implant outcome.

Immediate Implant Placement in Sockets with Asymptomatic Apical Periodontitis.

BACKGROUND: The purpose of the present study was to evaluate if the presence of granulation tissue in asymptomatic apical periodontitis compromised immediate implant placement. METHODS: Patients requiring extraction of one tooth (maxillary and mandibular incisive, canine or premolar) with asymptomatic apical periodontitis, were recruited for this prospective study. They were randomly scheduled into two groups: in first group (A) including 30 teeth, reactive soft tissue was debrided before implant placement, and in second group (B) including 30 teeth, reactive soft tissue was left in the apical lesion. Implants were positioned immediately after tooth extraction, and were loaded after 3 months in both groups. Cone beam computed tomography was performed before tooth extraction and at 1-year follow-up to evaluate the radiolucency around the root apex and the implant, bucco-lingual bone levels were also checked. RESULTS: Sixty patients were included in this study. Sixty implants were placed immediately after tooth extraction and, at 1-year follow-up, a survival rate of 100% was reported. After one year both groups showed absence of radiolucent zone at the apical region of implants. All fresh sockets presented a buccal-palatal bone reduction in both groups after one year, even if not statistically significant differences were found between baseline bone levels and within groups. CONCLUSIONS: Within the limitations of the present study, the immediate placement of implants into the extraction sockets with asymptomatic apical periodontitis, in presence of primary stability, did not lead to an increased rate of complications and rendered an equally favorable type of tissue integration.

A new dimension in endo surgery: Micro endo surgery.

There is an immense difference between tradizional Endodontic Surgery and Micro-Endo Surgery. Microsurgical techniques made possible and accessible results,that were unimaginable before. Under microscopic control,the operative techniques reached continous changes,allowing a better precision and quality standards. The dramatic evolution from Endo Surgery to Micro-Endo Surgery has enlarged the horizon of therapeutic options. Illumination and magnification through the Microscope has fundamentally and radically changed the way endo surgery can be performed.

Fresh-Socket Implants of Different Collar Length: Clinical Evaluation in the Aesthetic Zone.

BACKGROUND: The aim of this clinical study was to compare clinical evaluations of implants in the aesthetic zone with smooth collars of different length. MATERIALS AND METHODS: Sixty-six patients requiring extractions of one, two, or three teeth in the aesthetic zone of the maxilla were enrolled in this study. Ninety-four implants were positioned and were loaded immediately after tooth extraction. Forty-seven implants with a short smooth collar of 0.5 mm (SCI) and 47 implants with a long smooth collar of 1.8 mm (LCI) were utilized in this study and were placed using a nonsubmerged approach. Clinical (gingival index, modified plaque index, modified bleeding index, probing depth, gingival recession) and intraoral digital radiographic parameters were measured at baseline and after 6, 12, 24, and 36 months of healing to evaluate crestal bone loss levels over time. RESULTS: After a follow-up period of 36 months, a survival rate of 100% was reported. The SCI group showed a mean bone loss of 1.07 ± 0.38 mm at 12 months and 1.09 ± 0.38 mm at 36 months. The LCI group showed a mean bone loss of 0.46 ± 0.14 mm at 12 months and 0.53 ± 0.12 mm at 36 months. After the 36-month follow-up period, both groups showed stable bone levels over time. Statistically significant differences were found between groups (p < .05). No statistically significant differences were found between SCI and LCI groups with regard to clinical parameters over time. CONCLUSIONS: This study revealed significant differences in radiographically observed marginal bone loss between the two types of implant with different smooth-collar lengths, but no differences in gingival vestibular margin outcome were observed.

Immediate implant placement into fresh extraction socket in the mandibular molar sites: a preliminary study of a modified insertion technique.

BACKGROUND: Immediate implant insertion in mandibular molar extraction sockets raises a series of challenges for clinicians. PURPOSE: This preliminary study demonstrates the use of a modified insertion technique of implant placement at the time of mandibular molar extraction. MATERIALS AND METHODS: Immediate implants were placed at the time of molar extraction in 20 patients; a sulcular buccal incision with releasing periosteal incisions were made around the mandibular molar to be replaced, and implant insertion into the interseptal/interradicular bone was performed. The remnants of roots were atraumatically extracted, and the bony defects around the implant were grafted with synthetic resorbable bone substitute ß- Tricalcium phosphate, and the flap was sutured. Three months later, implants were restored with single crown fixed prostheses. Patients were followed up at 6, 12, and 18 months after insertion using periapical standardized radiographs to monitor the changes in the marginal bone level. RESULTS: Our modified insertion techniques showed an implant survival rate of 95%; one implant failed 4 weeks after insertion. No significant marginal bone loss around the implant was recorded at all times of follow-up. Satisfactory soft issue parameters were achieved. CONCLUSIONS: The combination of immediate implant placement with engagement of the interseptal/interradicular bone, atraumatic extraction of remnant roots, and concomitant regenerative therapy showed preliminary favorable outcomes. However, wider application of this technique for longer following up periods is required for further conclusive recommendations.

Outcome of single immediate implants placed in post-extraction infected and non-infected sites, restored with cemented crowns: a 3-year prospective study.

OBJECTIVES: To compare the survival of immediate implants placed in postextraction infected and non-infected sites, restored with cemented crowns. METHODS: Thirty-six implants were immediately placed in non-infected sockets (control group (CG), n=18), and in infected alveoli (test group (TG), n=18) that had been debrided, curetted, cleaned with 90% hydrogen peroxide, irradiated with yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser, and irrigated with a sterile solution. Guided bone regeneration was performed under antibiotic coverture. All study patients had both a CG and a TG site. The implant osteotomy sites were extended 3-4 mm beyond the apical extent of the sockets to achieve primary stability for the implants. The prosthetic phase occurred 4.5 months after surgery. Success criteria were accepted as the presence of implant stability, absence of a radiolucent zone around the implants, absence of mucosal suppuration, and lack of pain. Clinical evaluations were performed at baseline, and at 12, 24, and 36 months of follow-up. RESULTS: All of the implants were osseointegrated 3 months after surgery. The 3-year survival rate was 94.44% for TG, and 100% for CG. The clinical and radiographic variables tested yielded no significant differences among groups at 36 months. CONCLUSIONS: Under the tested conditions, immediate implant placement can be considered a predictable treatment option for the restoration of fresh postextraction infected sockets. CLINICAL SIGNIFICANCE: Immediate implants may be indicated for replacing teeth lost due to chronic periapical lesions with endodontic failure history when appropriate preoperative procedures are taken to clean and decontaminate the surgical sites.

Recuperação da função e estética de dente fraturado, por meio da técnica de restauração dentoalveolar imediata: um caso clínico com três anos de acompanhamento / Recovering function and aesthetics of a fractured tooth using the immediate dentoalveolar restoration technique: case report with a 3-year follow-up

o prognóstico de fratura radicular, insucesso endodôntico ou de doença periodontal avançada não é favorável. O procedimento escolhido para tratar essas condições inclui extração do dente e instalação de implantes. A fratura radicular, em especial, geralmente está associada à perda óssea da parede vestibular e, consequentemente, ao aumento do risco estético do tratamento. Esse artigo descreve a técnica de Restauração Dentoalveolar Imediata, empregada para restauração óssea de alvéolo comprometido, simultaneamente à instalação do implante, com função imediata, em paciente com fratura coronorradicular na região do incisivo central superior. O paciente foi clinicamente e tomograficamente monitorado por um período de três anos...

The prognoses of root fracture, endodontic failure or advanced periodontal disease are not favorable. The treatment of choice for such patients includes removal of the tooth and implant therapy. Root fracture is commonly associated with bone loss, especially in the buccal wall, and the aesthetic risk is increased. This article describes the use of the Immediate Dentoalveolar Restoration technique to restore a compromised socket through bone graft, implant placement and immediate function in a patient with a complicated crown-root fracture in the maxillary central incisor. The patient was followed up clinically and tomographically for 3 years...