Radiographic Evaluation of Malpositioning in Immediate and Early Dental Implant Placement: A Cross-Sectional Study Publisher

Summary: Can immediate dental implant placement (IIP) reduce malposition risk? Research suggests it lowers complications vs early placement (EIP). Timing and position matter! #DentalResearch #Implants

Waleed Khalid F ; Kadkhoda Z ; Raee A ; Mosavat F ; Younespour S
Source: Journal of Advanced Periodontology and Implant Dentistry Published:2026

Abstract

Introduction: Dental implants are commonly used to replace missing teeth. Immediate implant placement (IIP) has now become an increasingly common strategy to reduce treatment time. Dental implant malposition occurs when an implant is placed at an inappropriate dimension through the bone, which leads to a variety of aesthetic and functional complications. Therefore, this study aimed to compare immediate implant placement (IIP) and early implant placement (EIP) with respect to malposition. Methods: This cross-sectional study analyzed existing clinical records and accompanying periapical (PA) radiographs of 67 immediate implant placements (IIP) and 152 early implant placements (EIP). All the implants had originally been placed by senior periodontics residents. Postoperative PA radiographs obtained at the time of surgery were reviewed to assess implant malpositioning. Dental implant malposition was defined as mesiodistal angulation ≥ 15° or inadequate proximity ( < 1.5 mm to adjacent teeth or < 3 mm to adjacent implants). The associations between variables and malpositioning were assessed using both univariate and multivariable logistic regression. Results: A total of 219 implants were included from 85 individuals, comprising 31 males (36.47%) and 54 females (63.53%), with a mean age of 49.88 ± 14.06 (range: 20‒80). Multivariable logistic regression analysis indicated that both the timing of implant placement and the implant position (maxilla vs. mandible) significantly influenced the risk of malpositioning. IIP was associated with a lower probability of malpositioning than EIP (adjusted OR = 0.38; 95% CI: 0.16–0.90; P = 0.03; Nagelkerke R² = 0.10). Conclusion: Within the limitations of this cross-sectional study, multivariable regression analysis indicated that both the timing and position of implant placement are predictors of malpositioning. IIP demonstrated a lower risk of malpositioning compared with EIP, while maxillary placement remained a significant risk factor. © 2026 The Author(s).