Bone Grafting In Jumping Distance: A Systematic Review & Meta-Analysis

Immediate implant placement in the anterior maxilla requires stringent case selection and careful treatment planning to optimize functional and esthetic outcomes. Factors such as root position, labial cortical plate thickness and extent of jumping distance should be taken into account. The aim of this systematic review was to study the effect of bone grafting in the jumping distance on the outcome of immediately placed implants in anterior maxilla. A comprehensive literature was done in four major health sciences databases. The inclusion criteria was studies that reported at least a follow-up of six months and having an intact buccal cortical plate before implant placement. Primary outcome was the amount of radiographic bone loss. The risk of bias in the included studies was evaluated by using Cochrane risk of bias tool. Out of seven studies, only one study reported statistically significant bone loss in no grafting group (p=0.001). Four studies showed some extent of bone loss in no grafting group but the difference was statistically non-significant (p≥0.05). The forest plot depicted slightly less bone loss in bone grafting group but the difference was statistically non-significant (p=0.50). Only three studies measured the jumping distance before implant placement. Bone grafting in the jumping distance appears to yield less bone loss among immediately placed implants in anterior maxilla (irrespective of the jumping distance). However, in comparison to no bone grafting approach, the difference is not statistically significant