Effect of Immediate Placement and Loading of Compressive Versus Conventional Implants (Implants)

Effect of Immediate Placement and Loading of Compressive Versus Conventional Implants After Atraumatic Extraction Extraction (A Randomized Controlled Clinical Trial)

The current study aims to compare immediate placement and loading of compressive versus conventional dental implants after atraumatic extraction regarding the effectiveness, bone resorption and survival of each of them.

Study Overview

• Status: Recruiting
• Conditions: Other Endosseous Dental Implant Failure
• Intervention / Treatment: Procedure: Immediate implant placement and loading; Procedure: Immediate implant placement and loading

Detailed Description

Oral health and oral health care are crucial for maintaining good chewing, digestion, speaking, attractiveness, and psychological well-being. The absence of one or more teeth, regardless of the cause, can have a negative impact on oral health. The most significant consequence for the patient is the compromised look, which is often the main motivation for seeking prosthodontic treatment. Tooth loss can result from various factors, such as congenital absence, trauma, dental disorders (such as caries or periodontal disease), and mechanical failure. Tooth loss can also happen as a result of associated several systemic disorders such cancer, cardiovascular disease, diabetes mellitus, and osteoporosis. Hence, it is crucial to uphold not just optimal dental hygiene, but also general well-being.

Patients may experience actual or perceived adverse consequences after the loss of one or more teeth. The psychological impacts can vary from modest to neuroticism. Tooth loss leads to a decrease in self-assurance, a tendency to avoid laughing in public, and a reluctance to establish intimate connections, particularly when the front teeth are absent.

Extensive research and clinical practice over the past few decades have unequivocally proven the effectiveness of implant dentistry. Traditionally, implants were placed in sockets that had already healed and loaded in a typical (delayed) manner.

The extraction of a tooth results in fast resorption of the alveolar ridge in both vertical and horizontal dimensions during the initial months post-extraction. In anterior teeth, reduced tissue impairs cosmetic modifications that obstruct prosthetic rehabilitation. The reduction in edge thickness, alteration of gingival contour, and loss of dental papilla, accompanied by the emergence of black gaps, are observed in these instances. Atraumatic extractions, the insertion of implants in the alveoli of excised teeth, and quick provisionalization have been suggested as alternatives to preserve tissue volume and contour, while reducing expenses and treatment duration.

Traditionally, dental implants have been submerged for a period of 3-6 months during osseointegration in order to minimize the risk of implant failure due to movements at the implant interface, as noted by Adell et al. Concerns were raised regarding the extended duration of this interval, prompting the suggestion of quick loading with a partial restoration during surgery. Nevertheless, there were significant instances of implant failure attributed to the fibrous encapsulation of the implants. Subsequent advancements in surgical technique, implant structure, and masticatory forces have provided evidence supporting the efficacy of quick loading treatments.

The concept of "Immediate loading" was introduced in the early 1990s. Today, over 15 years of clinical and histological research have proven its merits (13). The anterior mandible has been extensively researched, with a focus on immediate function, which is now considered a common operation. Nevertheless, subsequent research has indicated that this idea may be applicable to additional areas of the jaw, as long as the implant is initially stable (14, 15).

The "Compressive" implant is a singular implant featuring compressive threads. It is utilized for both single and multiple restorations with immediate loading in the maxilla and mandible, provided there is sufficient bone tissue. Implants can be positioned using either a flap or flapless technique, with the implants put subcrestally. Implant implantation is feasible immediately after tooth extraction, provided there is adequate bone tissue. It may be utilized in conjunction with Basal implants. The abutment direction may be modified by up to 15° in relation to the implant axis. Abutment of the implant specifically engineered for cement-retained prostheses.

Scientific evidence is increasingly demonstrating that osseointegration can occur in implants placed directly into recently extracted sockets. Implant dentistry has made another significant advancement with the potential for immediately loading implants into recently removed tooth sockets. Research has demonstrated that using both a bone graft and a membrane in cases where there is a bone deficiency in the area of implant placement leads to a higher quality and quantity of regenerated bone compared to using only a bone graft or a membrane alone.

An immediate implant placement refers to the placement of a dental implant directly into a socket that has just been created by the extraction of a tooth. Immediate loading refers to the process of attaching the prosthesis to the implant on the same day the implant is inserted, applying a certain amount of pressure during biting in a centered position.

Implants can be placed in fresh extraction sockets which means they can be inserted during the same visit as the tooth extraction. This approach has several benefits: it reduces complications, shortens the overall treatment time by minimizing surgical procedures, improves the patient's psychological experience, and can improve the appearance of the implant. Moreover, the timely insertion of an implant following tooth extraction can assist in preserving the bone crest and achieving optimal implant placement from a prosthetic perspective.

Existing literature indicates that the short-term survival rates for implants implanted immediately, early, delayed, or late are comparable and roughly 95%. Immediate implant insertion can be successfully performed in all areas of the jaws, however, it is more difficult to replace implants in the molar regions. Immediate implant placement can still be considered even in cases of chronic infection, as it is not an absolute contraindication.

• Study Type: Interventional
• Enrollment (Estimated): 30
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: ahmed alghandour, phd; Phone Number: 002 01224567435; Email: ahmed.nagi@dent.bsu.eg

Study Locations

• Egypt
  • Banī Suwayf, Egypt
    • Recruiting
    • Beni-Suef University
    • Contact: ahmed Beni-suef university, phd

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Medically free patient
• Males and females
• Non-smoker patients
• Age ranging from 20-40 years
• Badly destructed upper premolar teeth that require implants, bone covering 2/3 of the root and of sufficient bone volume.

Exclusion Criteria:

• Patients with systemic conditions known to affect the periodontal status and healing such as uncontrolled diabetes and osteoporosis
• Heavy smokers
• Unfavorable position of the tooth or remaining roots
• Vitamin D deficiency,
• Periapical lesion/ periodontal affection

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Immediate placement of conventional endosteal implants; Removal of non restorable tooth then immediate placement of conventional implants then immediate loading	Procedure: Immediate implant placement and loading; Preoperative Cone beam; Articaine 4% local anesthesia in two sides; Piezoelectric device used around the badly decay tooth; Ensuring the preservation of the associated gingiva and papillae.; Following the elevation of the flap, atraumatic extraction by using piezoelectric device: A. The teeth will be retrieved without stress. B. The Conventional dental implant will be put directly into the alveolar bone c. Placement of healing abutment in conventional implant and measurement d. Stability measured using AnyCheck or periotest device of both implants and crestal bone level by periodontal probe postoperatively. e. Suturing f. Cone beam xray postoperatively g. Postoperative instructions and medications h. after one week immediate loading by placement of temporary pmma crown; Procedure: Immediate implant placement and loading; Preoperative Cone beam; Articaine 4% local anesthesia in two sides; Piezoelectric device used around the badly decay tooth; Ensuring the preservation of the associated gingiva and papillae.; Following the elevation of the flap, atraumatic extraction by using piezoelectric device: A. The teeth will be retrieved without stress. B. The Compressive dental implant will be put directly into the alveolar bone c. Stability measured using AnyCheck or periotest device of both implants and crestal bone level by periodontal probe postoperatively. d. Suturing e. Cone beam xray postoperatively f. Postoperative instructions and medications g. after one week immediate loading by placement of temporary pmma crown
Active Comparator: Immediate placement of compressive implants; Removal of non restorable tooth then immediate placement of compressive implants then immediate loading	Procedure: Immediate implant placement and loading; Preoperative Cone beam; Articaine 4% local anesthesia in two sides; Piezoelectric device used around the badly decay tooth; Ensuring the preservation of the associated gingiva and papillae.; Following the elevation of the flap, atraumatic extraction by using piezoelectric device: A. The teeth will be retrieved without stress. B. The Conventional dental implant will be put directly into the alveolar bone c. Placement of healing abutment in conventional implant and measurement d. Stability measured using AnyCheck or periotest device of both implants and crestal bone level by periodontal probe postoperatively. e. Suturing f. Cone beam xray postoperatively g. Postoperative instructions and medications h. after one week immediate loading by placement of temporary pmma crown; Procedure: Immediate implant placement and loading; Preoperative Cone beam; Articaine 4% local anesthesia in two sides; Piezoelectric device used around the badly decay tooth; Ensuring the preservation of the associated gingiva and papillae.; Following the elevation of the flap, atraumatic extraction by using piezoelectric device: A. The teeth will be retrieved without stress. B. The Compressive dental implant will be put directly into the alveolar bone c. Stability measured using AnyCheck or periotest device of both implants and crestal bone level by periodontal probe postoperatively. d. Suturing e. Cone beam xray postoperatively f. Postoperative instructions and medications g. after one week immediate loading by placement of temporary pmma crown

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
stability	using AnyCheck Device from 1 to 100	6 months
Pain after the surgery	using visual analogue scale from 1 to 10	6 months
Crestal Bone resorption and deposition	using cone beam computed tomography .	6 months
Crestal bone loss	using periodontal probe	6 months

Collaborators and Investigators

• Sponsor: Ahmed Nagi Alghandour

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2025
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): December 1, 2026

Study Registration Dates

• First Submitted: April 30, 2026
• First Submitted That Met QC Criteria: May 15, 2026
• First Posted (Actual): May 22, 2026

Study Record Updates

• Last Update Posted (Actual): May 22, 2026
• Last Update Submitted That Met QC Criteria: May 15, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: 202626

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No