Immediate implant placement in damaged extraction sockets: a systematic review and meta-analysis of randomized controlled trials.

OBJECTIVES: The aim of the study was to observe whether immediate implant placement into damaged extraction sockets is a successful modality for treating hopeless teeth that require extraction. DATA SOURCES: An electronic search was carried out through four databases (PubMed/MEDLINE, Web of Science, Scopus, and ScienceDirect) to identify randomized controlled trials (2013 to 2023) to understand whether immediate implant placement in damaged sockets is a successful treatment. The focus question was, 'In a patient with a hopeless tooth that needs extraction with the indication for dental implant treatment, is immediate implant placement in damaged extraction sockets, compared to undamaged sockets or healed sites, an effective method for the replacement of hopeless teeth and achieving a favorable clinical result?' The risk of bias was appraised and a meta-analysis using random effect was applied. RESULTS: Five studies with 135 patients and 138 implants were included. The implant survival rate was 100% for all studies and period evaluated; the pink esthetic score (PES) scores had no statistically significant result for all articles that evaluated this parameter; the soft tissue changes was reported by two studies: one found no significant differences and the other showed that the test group experienced reduced soft tissue loss at the 1-year evaluation (measured with digital intraoral scanners); another two studies assessed the marginal bone loss, presenting no differences between groups. The meta-analysis showed homogeneity between the studies. There was an equilibrium among the groups in the various studies included, and age tended to be lower in the test group. The buccal bone tissue and pink esthetic score showed favoritism for the test group but without statistical significance. CONCLUSION: This study suggests that immediate implant placement in the presence of buccal bone defects can achieve comparable clinical and radiologic outcomes to traditional methods in the short term of the limited studies available. It was not possible to evaluate the buccal aspect through radiographs. Bone regeneration was essential to reach optimal results. It is important to emphasize that immediate implant placement requires adherence to rigorous criteria to ensure functionally acceptable results.