Purpose: The objective of this systematic review is to assess the impact of implant placemen at different periods on the aesthetic and clinical outcomes, in the aesthetic zone.
Material and methods: Literature screening was conducted in PubMed, ScienceDirect and Cochrane library databases. Relevant articles were chosen according to selection criteria and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data was collected from studies published from 2017-2022 in English.
Results: Nine articles were included, where a total of 495 implants were placed, from which 250 were immediate, 109 early, and 136 delayed. Immediate implants showed no statistical difference in Pink Esthetic Score (PES) contrasted to delayed implants. Immediate implants showed significantly higher PES in comparison to early implants (MD= -0.76 with 95% CI= -1.50 to -0.02; P=0.04). The probing depth (PD) was considerably greater in the immediate implants when compared to delayed (MD= -0.62 with 95% CI= -1.05 to -0.18; P=0.005), and the plaque index (PI) was statistically greater in early implants compared to immediate implants (MD= 0.15 with 95% CI= 0.11 to 0.19; P<0.00001). All other soft tissue outcomes showed equal results. The marginal bone level (MBL) loss was statistically higher in early implants compared to immediate implants (MD= 0.09 with 95% CI= 0.02 to 0.16; P=0.02).
Conclusion: immediate implants had significantly superior PES, marginal bone loss, and plaque index results when compared to early implants. The probing depth was significantly higher in the immediate group compared to the delayed group. All other outcomes showed no significant difference between the three implant groups. It is important to highlight the limitations of this review such as the small number of studies included and the few reports on aesthetic indices.