Early implant placement versus ridge preservation and delayed implant placement: Analysis of profilometric, clinician‐ and patient‐reported outcomes from a two‐centre RCT

Abstract

AbstractObjectivesTo compare early implant placement (EP) to alveolar ridge preservation and delayed implant placement (ARP/DP) in terms of contour changes, along with clinician‐ and patient‐reported outcome measures (PROMs) until the delivery of the implant‐supported restoration.Materials and MethodsPatients with a failing single tooth in the maxilla or mandible were recruited in two centres. After tooth extraction, patients were randomly assigned (1:1) to either EP or ARP/DP. At abutment connection and crown delivery, the buccal contour changes at 3 mm below the mucosal margin (primary outcome) along with clinician‐ (ease of treatment) and patient‐reported outcomes were assessed using numeric rating scales and OHIP‐14.ResultsA total of 46 patients were analysed. The mean buccal contour at abutment connection decreased by −1.2 ± 0.6 mm in group EP and −1.6 ± 0.8 mm in group ARP/DP (estimated mean difference; 0.45 [95%CI, −0.02; 0.94]; p = .061) with no significant differences between the groups. ARP/DP was consistently easier than EP across all stages of the surgery (estimated mean difference; 2.0 [95%CI, 1.3; 2.7] p < .001): during flap elevation (EP: 4.8 vs. ARP/DP: 1.6), implant placement (EP: 5.7 vs. ARP/DP: 2.2) and wound closure (EP: 3.4 vs. ARP/DP: 1.6). Both interventions improved quality of life but patients who underwent ARP/DP were significantly more satisfied at the time of crown delivery (ARP/DP: 9.6 vs. EP: 9.1, p = .02).ConclusionsEP and ARP/DP show no significant differences in buccal contour changes, aesthetics and patient‐reported outcomes. However, ARP/DP is an easier procedure at all stages of the surgery compared to EP and could therefore be the preferred therapy for less experienced clinicians.