Clinical Evaluation of Immediate Implantation in Molars with Chronic Apical Periodontitis and Chronic Periodontitis

Abstract

To evaluate the clinical efficacy of immediate implant placement in molars affected by chronic apical periodontitis and chronic periodontitis, 50 patients admitted to a city-based southwest stomatological hospital in mainland China between July 2023 and July 2024 who required tooth extraction due to chronic apical periodontitis or chronic periodontitis and met the inclusion criteria were selected as samples. They were randomly assigned to an experimental group (Group A) and a control group (Group B), with 25 patients in each one. The experimental group underwent immediate implant placement, while the control group underwent delayed implant placement 3–6 months after extraction and all surgeries were performed by the same implant surgeon. The study compared the effects of the two treatment modalities on implant retention, complications, implant stability, surrounding soft tissue, vertical and horizontal margins, and peri-implant gaps. Results showed that at the 12-month postoperative follow-up, implant retention rates were high in both groups, with no statistically significant difference in retention rates between groups (P > 0.05). Regarding complication rates, the immediate implant group showed a significantly lower incidence than the delayed implant group, with a statistically significant difference (P < 0.05); immediately after post-operation, there was no statistically significant difference in ISQ scores between the two groups (P > 0.05). At 6 months postoperatively, ISQ scores in both groups had increased significantly compared to the immediate postoperative period, with statistically significant intra-group differences (P < 0.05). Furthermore, the ISQ score in the immediate implant group was higher than that in the delayed implant group, with a statistically significant intra-group difference (P < 0.05); at the 12-month follow-up after crown restoration, the periodontal probing depth (PD), modified sulcus bleeding index (mSBI), and modified plaque index (mPI) were all lower in the immediate implant group than those in the delayed implant group, with statistically significant differences between groups (P < 0.05); at 12 months post-surgery, both the vertical and horizontal dimensions of the peri-implant gap were significantly reduced compared to the immediate post-operative period, and the differences between different time points within the group were statistically significant (P < 0.05). In conclusion, for molars with chronic apical periodontitis and chronic periodontitis that meet the indications, immediate implant placement combined with non-submerged healing and no bone grafting in the jump space, provided that thorough debridement, precise implantation, and initial stability are ensured, offers reliable efficacy, fewer complications, and excellent bone preservation. Thus, this approach can be considered as a preferred clinical treatment option and worthwhile to be applied on a larger scale.