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Clin Oral Implants Res. 2009 Jul;20(7):645-59. doi: 10.1111/j.1600-0501.2009.01725.x.

Immediate restoration/loading of immediately placed single implants: is it an effective bimodal approach?

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  • 1Oral Implantology Research Group, Sir John Walsh Research Institute, School of Dentistry, University of Otago, Dunedin, New Zealand.



To compare systematically the survival and radiographic marginal bone level changes of two immediate implant protocols in the aesthetic region; immediate single implant restoration/loading in extraction sockets (the bimodal approach) compared with the same in healed sites.


A literature search of electronic databases, Cochrane Oral Health Group's Trials Register, National Research Register, conference proceedings and abstracts was performed without language restriction up to 1 August 2008. Hand searching included several dental journals and authors were contacted for missing information. Controlled trials that compared immediate restoration/loading of single implants placed in extraction sites with those placed in healed sites were selected. The meta-analysis was prepared according to the guidelines of the Quality of Reporting of Meta-analyses statement. The data were analysed using RevMan version 5.0 software. A fixed effects model was chosen with standardized mean differences for continuous data, and risk ratios for dichotomous data with 95% confidence intervals.


Ten studies with 629 implants were included. Immediate single implant restoration/loading in extraction sockets in the aesthetic zone was associated with significantly higher risk of implant failure (risk ratio of 3.62, 95% confidence interval 1.15-11.45, P=0.03). However, the bimodal approach showed favourable marginal bone changes after 1 year.


The review and meta-analysis supported the potential advantages offered by this bimodal approach, but indicated a higher risk when compared with immediate restoration/loading in healed ridges. Further long-term, well-conducted, randomized-controlled studies are needed to confirm the validity of this treatment option.

[PubMed - indexed for MEDLINE]
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