Survival and Esthetic Outcomes of Immediate Implant Placement in Infected Extraction Sites: A Scoping Review

Survival and Esthetic Outcomes of Immediate Implant Placement in Infected Extraction Sites: A Scoping Review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Systematic Review Survival and Esthetic Outcomes of Immediate Implant Placement in Infected Extraction Sites: A Scoping Review Cecilia Borda Bossana This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7003124/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Immediate implant placement in extraction sockets with active infection remains a debated topic in implant dentistry. Traditionally, the presence of periapical or periodontal infection has been considered a contraindication due to concerns about residual contamination, impaired osseointegration, and compromised esthetic results. However, recent evidence suggests that with meticulous decontamination and appropriate case selection, successful outcomes are achievable even in infected sites. Objective: This scoping review aims to explore the available scientific literature reporting on the survival rates, esthetic outcomes, and complication profiles associated with immediate implant placement in infected extraction sites. The review also analyzes the decontamination protocols used to enable safe placement in these challenging scenarios. Methods: Following PRISMA-ScR guidelines (see Figure 1), a systematic search was conducted using PubMed to identify human clinical studies evaluating immediate implant placement into infected sites with at least 12 months of follow-up. Studies eligible for inclusion reported on at least one of the following outcomes: implant survival, esthetic results (such as Pink Esthetic Score [PES] or White Esthetic Score [WES]), or post-operative biological and/or technical complications. Only prospective or retrospective clinical studies, randomized controlled trials, and case series (n ≥ 10) were included. Relevant data were extracted using a standardized spreadsheet and synthesized thematically. Results: Thirteen studies were included, totaling 453 implants placed in infected sockets. The reported implant survival rates ranged from 90% to 100%. Esthetic outcomes, measured through PES/WES, showed mean scores between 13.9 and 15.2 (see Table 1). The majority of studies used systemic antibiotics and mechanical debridement, while some included laser decontamination and guided bone regeneration. Complication rates were low, and esthetic outcomes were generally favorable, particularly when guided bone regeneration and soft tissue grafting were employed. Conclusions: Immediate implants in infected sites demonstrate high survival and acceptable esthetic outcomes, particularly when laser decontamination and guided bone regeneration are utilized. Proper case selection and infection control remain essential. Further randomized controlled trials with long-term follow-up and consistent outcome reporting are needed. Dentistry dental implants immediate implant placement peri-implantitis socket infection guided bone regeneration esthetics Full Text Additional Declarations The authors declare potential competing interests as follows: I declare that authors have no interests, affiliations, or associations that might be perceived to influence the results and/or discussion reported in this preprint submission. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7003124","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Systematic Review","associatedPublications":[],"authors":[{"id":477968999,"identity":"c03b2247-8d2e-4cf0-b044-b307bbba6a66","order_by":0,"name":"Cecilia Borda Bossana","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABDElEQVRIiWNgGAWjYFCCBBAhIcPGwAOk2RjkDMCiBhYEtfDAtBgbMDCDtEgQ0gJSD9GSuAGshQG3Fn72BMYPH2osePjYzx58XFFml76dvf/ohh8FEgz87d0J2LRI9jxglpxxDOgwnrxkwzPnknN39hxmu9kDdJjEmbMbsGkxuJHAxszbAPJLjplkYxtz7oYbyWw3eIBaDCRycWv5C9LC/wakpT7dAKjl5h9CWhhBWiTAthxOAGm5jc8WyZ6HzZI9IL9IvEs2bDh33HDDmcNmt2UMJHhw+YWfPfnghx81dXLy/bkHHzaUVcsbHG98dvPNHxs5/vZerFoYGBgbsIvzYBceBaNgFIyCUUAMAAD49FlCjNR0swAAAABJRU5ErkJggg==","orcid":"https://orcid.org/0009-0009-0468-1919","institution":"Boston University","correspondingAuthor":true,"prefix":"","firstName":"Cecilia","middleName":"Borda","lastName":"Bossana","suffix":""}],"badges":[],"createdAt":"2025-06-29 14:05:35","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":true,"conflictsOfInterestStatement":true,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":true},"doi":"10.21203/rs.3.rs-7003124/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7003124/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":85812934,"identity":"6da40004-dffb-49dd-b406-1aa255b99e07","added_by":"auto","created_at":"2025-07-02 04:20:20","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":560444,"visible":true,"origin":"","legend":"","description":"","filename":"ScopingReviewImmediateImplantPlacementinInfectedExtractionSites3.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7003124/v1_covered_072344ac-21f5-4a97-8da5-4358d6564edb.pdf"}],"financialInterests":"The authors declare potential competing interests as follows: I declare that authors have no interests, affiliations, or associations that might be perceived to influence the results and/or discussion reported in this preprint submission.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eSurvival and Esthetic Outcomes of Immediate Implant Placement in Infected Extraction Sites: A Scoping Review\u003c/strong\u003e\u003c/p\u003e","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Boston University","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"dental implants, immediate implant placement, peri-implantitis, socket infection, guided bone regeneration, esthetics","lastPublishedDoi":"10.21203/rs.3.rs-7003124/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7003124/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eImmediate implant placement in extraction sockets with active infection remains a debated topic in implant dentistry. Traditionally, the presence of periapical or periodontal infection has been considered a contraindication due to concerns about residual contamination, impaired osseointegration, and compromised esthetic results. However, recent evidence suggests that with meticulous decontamination and appropriate case selection, successful outcomes are achievable even in infected sites.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis scoping review aims to explore the available scientific literature reporting on the survival rates, esthetic outcomes, and complication profiles associated with immediate implant placement in infected extraction sites. The review also analyzes the decontamination protocols used to enable safe placement in these challenging scenarios.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFollowing PRISMA-ScR guidelines (see Figure 1), a systematic search was conducted using PubMed to identify human clinical studies evaluating immediate implant placement into infected sites with at least 12 months of follow-up. Studies eligible for inclusion reported on at least one of the following outcomes: implant survival, esthetic results (such as Pink Esthetic Score [PES] or White Esthetic Score [WES]), or post-operative biological and/or technical complications. Only prospective or retrospective clinical studies, randomized controlled trials, and case series (n ≥ 10) were included. Relevant data were extracted using a standardized spreadsheet and synthesized thematically.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThirteen studies were included, totaling 453 implants placed in infected sockets. The reported implant survival rates ranged from 90% to 100%. Esthetic outcomes, measured through PES/WES, showed mean scores between 13.9 and 15.2 (see Table 1). The majority of studies used systemic antibiotics and mechanical debridement, while some included laser decontamination and guided bone regeneration. Complication rates were low, and esthetic outcomes were generally favorable, particularly when guided bone regeneration and soft tissue grafting were employed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eImmediate implants in infected sites demonstrate high survival and acceptable esthetic outcomes, particularly when laser decontamination and guided bone regeneration are utilized. Proper case selection and infection control remain essential. Further randomized controlled trials with long-term follow-up and consistent outcome reporting are needed.\u003c/p\u003e","manuscriptTitle":"Survival and Esthetic Outcomes of Immediate Implant Placement in Infected Extraction Sites: A Scoping Review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-02 04:12:13","doi":"10.21203/rs.3.rs-7003124/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"37e49edb-8420-4cde-94ce-68afc9d97a28","owner":[],"postedDate":"July 2nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":50897919,"name":"Dentistry"}],"tags":[],"updatedAt":"2025-07-02T04:12:13+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-02 04:12:13","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7003124","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7003124","identity":"rs-7003124","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}