ObjectivesTo compare immediate implant placement (IIP) with early implant placement (EIP) for single tooth replacement in the aesthetic area in terms of aesthetic, clinical, and patient‐reported outcomes.Materials and MethodsTwo independent reviewers conducted an electronic literature search in PubMed, Web of Science, Embase, and Cochrane databases as well as a manual search to identify eligible clinical studies up to February 2023. Randomized Controlled Trials (RCTs) comparing IIP with EIP were included for a qualitative and quantitative analysis. The primary outcome was vertical midfacial soft tissue change. Secondary outcomes were horizontal midfacial soft tissue change, vertical papillary change, pink esthetic score (PES), implant survival, buccal bone thickness, marginal bone level change, patient discomfort, chair time, and patient satisfaction.ResultsOut of 1185 records, 6 RCTs were selected, reporting on 222 patients who received 222 single implants (IIP: 112 implants in 112 patients; EIP: 110 implants in 110 patients) in the anterior maxilla or mandible. Patients had a mean age ranging from 35.6 to 52.6 years and were followed between 8 and 24 months. Two RCTs showed some concerns, and four showed a high risk of bias. Four studies could be included in a meta‐analysis on the primary outcome and three only considered cases with an intact buccal bone wall. Meta‐analysis failed to demonstrate a significant difference in terms of vertical midfacial soft tissue change between IIP and EIP (mean difference: 0.31 mm, 95% CI [−0.23; 0.86], p = .260; I2 = 83%, p < .001). No significant differences were found for PES (standardized mean difference: 0.92, 95% CI [−0.23; 2.07], p = .120; I2 = 89%, p < .001), implant survival (RR: 0.98, 95% CI [0.93, 1.03], p = .480; I2 = 0%, p = .980), and marginal bone level change (mean difference: 0.03 mm, 95% CI [−0.12, 0.17], p = .700; I2 = 0%, p = .470). Insufficient data were available for meta‐analyses of other secondary outcomes.ConclusionIn low‐risk patients with an intact buccal bone wall, there seems to be no difference between IIP and EIP in terms of aesthetic and clinical outcomes. The strength of this conclusion is rated as low since studies showed an unclear or high risk of bias. In addition, state‐of‐the‐art therapy was only delivered in a minority of studies. Future RCTs should also provide data on patient‐reported outcomes since these have been underreported.

中文翻译：

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美容领域单牙置换的即刻种植与早期种植对比：系统评价和荟萃分析

目的从美学、临床和患者报告的结果方面比较美学领域的单牙替换即刻种植体植入 (IIP) 与早期种植体植入 (EIP)。 材料和方法两位独立评审员在 PubMed、Web 中进行了电子文献检索Science、Embase 和 Cochrane 数据库以及手动检索，以确定截至 2023 年 2 月的合格临床研究。纳入了比较 IIP 与 EIP 的随机对照试验 (RCT)，以进行定性和定量分析。主要结果是垂直面中部软组织变化。次要结果是水平面中部软组织变化、垂直乳头状变化、粉红色美学评分 (PES)、种植体存活率、颊骨厚度、边缘骨水平变化、患者不适、就诊时间和患者满意度。 结果 在 1185 条记录中，有 6 项随机对照试验选择，报告了 222 名患者在上颌前牙或下颌接受了 222 个单个种植体（IIP：112 名患者有 112 个种植体；EIP：110 名患者有 110 个种植体）。患者平均年龄为 35.6 至 52.6 岁，随访时间为 8 至 24 个月。两项随机对照试验显示出一些担忧，四项随机对照试验显示出较高的偏倚风险。四项研究可纳入主要结局的荟萃分析，其中三项研究仅考虑颊骨壁完整的病例。荟萃分析未能证明 IIP 和 EIP 之间垂直面中部软组织变化存在显着差异（平均差异：0.31 mm，95% CI [−0.23；0.86]，p= .260；我2= 83%，p< .001)。 PES 没有发现显着差异（标准化平均差：0.92，95% CI [−0.23；2.07]，p= .120；我2= 89%，p< .001)，种植体存活率（RR：0.98，95% CI [0.93，1.03]，p= .480；我2= 0%,p= .980）和边缘骨水平变化（平均差：0.03 mm，95% CI [−0.12, 0.17]，p= .700；我2= 0%,p= .470)。没有足够的数据可用于其他次要结局的荟萃分析。结论在颊骨壁完整的低风险患者中，IIP 和 EIP 在美观和临床结果方面似乎没有差异。由于研究显示偏倚风险不明确或较高，因此该结论的强度被评为较低。此外，只有少数研究提供了最先进的治疗方法。未来的随机对照试验还应该提供有关患者报告结果的数据，因为这些结果的报告不足。