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Accuracy of Immediate Implant Placement

Sponsor: Menoufia University • ClinicalTrials.gov ID: NCT07863700

Registry updated: 2026-10-13

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Description

This randomized clinical study will compare the accuracy of immediate implant placement performed using three different surgical approaches: freehand surgery, conventional tooth-supported static computer-guided surgery, and a tooth- and socket-supported static surgical guide. Patients requiring extraction of a mandibular first or second molar, or a retained root in the same region, followed by immediate implant placement will be enrolled. All participants will undergo three-dimensional preoperative treatment planning using cone-beam computed tomography and intraoral scanning. Participants will then be randomly allocated to one of three groups according to the assigned surgical technique. The primary outcome will be the three-dimensional accuracy of implant placement, determined by comparing the virtually planned implant position with the clinically achieved implant position. Coronal, apical, angular, and depth deviations will be evaluated using postoperative three-dimensional imaging. The study will determine whether the use of conventional tooth-supported or tooth- and socket-supported static surgical guides results in different implant positioning accuracy compared with freehand immediate implant placement.

Interventions

Freehand Immediate Implant Placement (Procedure)
Immediate implant placement performed using a freehand surgical approach without a surgical guide.
Tooth-Supported Static Computer-Guided Implant Placement (Procedure)
Immediate implant placement performed using a conventional tooth-supported static surgical guide fabricated according to the virtual implant plan.
Tooth- and Socket-Supported Static Guided Implant Placement (Procedure)
Immediate implant placement performed using a tooth- and socket-supported static surgical guide designed to obtain stabilization from both the remaining dentition and the extraction socket.

Eligibility criteria

Inclusion Criteria * Patients aged 20-56 years. * Patients requiring extraction of a mandibular first or second molar, or a retained root in the same region, followed by immediate implant placement. * American Society of Anesthesiologists (ASA) Physical Status I or II. * Satisfactory oral hygiene. * Ability to comply with the scheduled follow-up protocol. * Extraction socket classified as a Class I defect. * Treatment site planned for rehabilitation with a single-unit screw-retained implant-supported crown. * Adequate primary implant stability, defined as an insertion torque of ≥35 Ncm and/or an implant stability quotient (ISQ) of ≥60. Exclusion Criteria * Uncontrolled systemic disease. * Previous radiotherapy to the head and neck region. * Active untreated periodontal disease. * Heavy smoking of more than 10 cigarettes per day. * Bisphosphonate therapy. * Severe parafunctional habits such as bruxism. * Inability to achieve adequate primary stability, defined as an insertion torque \<35 Ncm and an ISQ \<60. * Intraoperative detection of loss of the buccal cortical plate. * Extraction socket defect exceeding Class I. * Inability to complete the required follow-up protocol.

Conditions

Edentulism in Lower Jaw

Locations

Faculty of Dentistry, Menoufia University — Shibīn al Kawm, Menoufia, Egypt

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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