Midfacial Soft Tissue Recession Following Immediate Implant Placement with Bone Grafting in the Esthetic Area: A Systematic Review and Meta-analysis.

Purpose: To systematically analyze the outcomes of immediate implant placement (IIP) with bone grafting in the esthetic area. Materials and

Methods

PubMed, Embase, and Cochrane CENTRAL were searched. Prospective studies reporting midfacial soft tissue recession (primary outcome) of single-tooth IIP with bone grafting in the esthetic area were included. Risks of bias were assessed. Meta-analysis, sensitivity analysis, and meta-regression were undertaken.

Results

A total of 13 studies and 421 patients were included, with a follow-up length of 1 to 10 years in function. The weighted mean (95% CI) of midfacial soft tissue recession was 0.33 (0.21, 0.46) mm and 0.54 (0.16, 0.93) mm after 1 year and 5 years in function. Meta-regression indicated that after 1 year in function, there was 0.33 mm less midfacial soft tissue recession with soft tissue grafting (P = .021), while there was 0.58 mm more soft tissue recession (P = .007) in defect extraction sockets. Implant survival was 97.8%, and all failures were early failures. Peri-implant soft and hard tissue stability, peri-implant health, esthetic outcomes, and patient satisfaction were predictable within the follow-up period.

Conclusion

Midfacial soft tissue recession showed an ongoing status in IIP with bone grafting in the esthetic area within 5 years in function. For extraction sockets with a thin gingival biotype or deficient buccal bone wall, soft tissue grafting was recommended.