title: Immediate versus delayed implant placement after anterior single tooth extraction: the timing randomized controlled clinical trial.
abstract: To compare need for bone augmentation, surgical complications, periodontal, radiographic, aesthetic and patient reported outcomes in subjects receiving implant placement at the time of extraction (Immediate Implant) or 12 weeks thereafter.
  
  
  
  Subjects requiring single tooth extraction in the anterior and premolar areas were recruited in seven private practices. Implant position and choice of platform were restoratively driven. Measurements were performed by calibrated and masked examiners.
  
  
  
  IMI was unfeasible in 7.5% of cases. One hundred and 24 subjects were randomized. One implant was lost in the IMI group. IMI required bone augmentation in 72% of cases compared with 43.9% for delayed (p = 0.01), while wound failure occurred in 26.1% and 5.3% of cases, respectively (p = 0.02). At 1 year, IMI had deeper probing depths (4.1 ± 1.2 mm versus 3.3 ± 1.1 mm, p < 0.01). A trend for greater radiographic bone loss was observed at IMI over the initial 3-year period (p-trend < 0.01). Inadequate pink aesthetic scores were obtained in 19% of delayed and in 42% of IMI implant cases (p = 0.03). No differences in patient reported outcomes were observed.
  
  
  
  Immediate implant placement should not be recommended when aesthetics are important, IMI should be limited to selected cases. Longer follow-up is needed to assess differences in complication rates.
authors.affiliation: European Research Group on Periodontology, Genova, Italy.|Department of Periodontology, Hong Kong University, Hong Kong SAR, China.
authors.forename: Maurizio S
authors.initials: MS
authors.lastname: Tonetti
authors.affiliation: European Research Group on Periodontology, Genova, Italy.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Cortellini
authors.affiliation: European Research Group on Periodontology, Genova, Italy.
authors.forename: Filippo
authors.identifier: 0000-0001-8780-7306
authors.initials: F
authors.lastname: Graziani
authors.affiliation: European Research Group on Periodontology, Genova, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Cairo
authors.affiliation: European Research Group on Periodontology, Genova, Italy.
authors.forename: Niklaus P
authors.initials: NP
authors.lastname: Lang
authors.affiliation: European Research Group on Periodontology, Genova, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Abundo
authors.affiliation: European Research Group on Periodontology, Genova, Italy.
authors.forename: Gian Paolo
authors.initials: GP
authors.lastname: Conforti
authors.affiliation: European Research Group on Periodontology, Genova, Italy.
authors.forename: Siegfried
authors.initials: S
authors.lastname: Marquardt
authors.affiliation: European Research Group on Periodontology, Genova, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Rasperini
authors.affiliation: European Research Group on Periodontology, Genova, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Silvestri
authors.affiliation: European Research Group on Periodontology, Genova, Italy.
authors.forename: Beat
authors.initials: B
authors.lastname: Wallkamm
authors.affiliation: European Research Group on Periodontology, Genova, Italy.
authors.forename: Anton
authors.initials: A
authors.lastname: Wetzel
mesh_terms: D003758:Dental Implantation, Endosseous / Q000379:methods*; D005260:Female; D006801:Humans; D057893:Immediate Dental Implant Loading; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method; D013997:Time Factors; D014081:Tooth Extraction
keywords: bone augmentation; dental implants; human; randomized controlled clinical trial; tooth extraction