Is Bone Graft or Guided Bone Regeneration Needed When Placing Immediate Dental Implants? A Systematic Review.

AIMS: To systematically review the effect and type of bone graft and guided bone regeneration around immediate implants on hard and soft tissue changes. METHODS: Three electronic databases were searched up to June 2015. Outcomes consisted of hard and soft tissue dimensional changes. RESULTS: Eight studies were included according to inclusion criteria. Immediate implants with bone grafting had superior soft tissue stability and preserved horizontal ridge dimension and buccal plate thickness, when compared to no grafting. The use of a barrier alone significantly decreased buccal plate resorption and the remaining defects around the implants, and the use of both bone graft and membrane aided in soft tissue preservation. The optimal type of bone graft material was a combination of cortical autogenous and synthetic particulate when compared to each separately, whereas no difference was found between demineralized allograft and hydroxyapatite in decreasing bone loss. CONCLUSIONS: Quantitative data analysis was not possible due to heterogeneity of the included studies. Further randomized clinical trials with homogenous samples and proper controls are needed to support the results of this report.