Implant placement in impaction-associated edentulous sites (IAES) presents significant challenges, with various strategies proposed but no clear guidelines. This systematic review was conducted in accordance with PRISMA guidelines through a comprehensive literature search of PubMed, Scopus, and Web of Science to assess different dental implant placement strategies for IAES. Data on study and patient characteristics, management approaches, follow-up duration, implant outcomes, and complications were extracted and synthesized qualitatively. A total of 100 cases with 174 implants from 50 studies were included. Maxillary canines were the most frequently impacted teeth at implant sites (n = 76), and 26 impacted retained roots (IRRs) were identified. Cases were managed either by removing the impacted entity before implantation or by preserving it in situ. Since two cases involved both management approaches, the strategy-level classification included 47 extraction-based and 55 preservation-based entries. Of the 93 implants in the extraction group, equal implant success and survival rates of 98.92% were observed, with a mean follow-up duration of 25.7 ± 24.1 months. Among 81 implants in the non-extraction group, implant success and survival rates were 85.18% and 92.59%, respectively, with a mean follow-up duration of 53.0 ± 34.2 months. Overall, nearly all reported implant-related complications occurred in cases where implants contacted the impacted structure, predominantly in IRRs. Implant placement in IAES may be associated with favorable outcomes when direct contact with impacted structures is avoided. In contrast, implant-impacted entity contacts may pose a higher risk of complications. However, given the substantial heterogeneity among the included studies and lack of controlled designs, the observed differences between these two approaches should be interpreted descriptively rather than as comparative evidence. Based on the limited available low-level evidence, implant placement through impacted structures remains a novel yet high-risk approach that requires further validation.
Mohammadreza Kashefi Baher, S. Atarbashi-Moghadam, F. Atarbashi-Moghadam et al.· Journal of Stomatology Oral...· 0 citations
Dental implant placement requires prerequisites, such as the quality and quantity of the available bone. Oral and maxillofacial fibro-osseous lesions (FOLs) are a group of intraosseous benign lesions, consisting of cemento-osseous dysplasia (COD), fibrous dysplasia (FD), and cemento-ossifying fibroma (COF), characterized by progressive replacement of normal bone tissue by fibrous connective tissue comprising varying amounts of mineralized substances, and consequently, the quality of the bone tissue. The aim of this study is to provide information for clinicians on the risks of implant insertion into these types of lesions. The ISI Web of Science, PubMed, and Scopus databases were searched based on the following PICO: The PICO question of the present study is as follows: What are the failure rates and treatment plan options (O) of implant placement (I) in patients with a fibro-osseous lesion who need an implant treatment at the site of the lesion (P)? Of the 301 identified studies, 39 eligible studies (16 on COD, 14 on FD, and nine on COF) were included in the present systematic review. Overall, 40 and 56 implants were placed in healthy areas near the lesions, in the grafted tissues placed in the location of the removed lesions, or within the COD and FD lesions, respectively. All of the 29 implants in the group of COF lesions were placed in the healed or grafted tissue, replacing the resected COF-affected areas. The failure rate of implants placed in the studies investigating COD, FD, and COF lesions were 22.50%, 7.14%, and 10.34%, respectively. Treatment options for implant placement in COD and FD lesions were reported as removing the lesion and waiting for the bone to be healed (with or without grafting), placing implant in the healthy bone near the lesion, or placing the implant embedded in the lesion. However, all of COF lesions were removed (mostly with resection) and dental implants were placed in the grafted tissue. Considering the limitations of the present study, it can be concluded that it would be more appropriate to avoid placing dental implants into the COD and FD lesions and inserting the implants in the surrounding healthy bone, healed, or grafted bone tissues are preferred. However, due to the neoplastic nature of COF removing the lesions prior to the implant insertion is crucial.
F. Atarbashi-Moghadam, Amirali Farahani Afsaryeh, S. Atarbashi-Moghadam et al.· Maxillofacial plastic and re...· 0 citations