Comparing the efficacy of self-ligating brackets v/s conventional brackets in fixed orthodontic treatment: A long term follow up study

Background:The timing of dental implant placement after tooth extraction plays a crucial role in peri-implant healing, osseointegration, and bone quality. Immediate implant placement has gained popularity due to reduced treatment time and preservation of alveolar bone, whereas delayed implant placement allows complete socket healing and bone maturation before implant insertion. However, differences in biological response between these two protocols remain controversial. Aim:To compare the biological response of immediate and delayed implant placement in terms of osseointegration and peri-implant bone quality. Materials and Methods:This prospective, randomized clinical study included 100 patients requiring single-tooth replacement. Participants were randomly divided into two groups: Group I received immediate implant placement at the time of tooth extraction (n = 50), and Group II received delayed implant placement after a 12-week healing period (n = 50). Implant stability was assessed using resonance frequency analysis at placement, 3 months, and 6 months. Peri-implant bone quality and marginal bone levels were evaluated using cone-beam computed tomography. Statistical analysis included intergroup and intragroup comparisons, with multivariate regression analysis performed to assess factors influencing outcomes. Results:The delayed implant group demonstrated significantly higher primary stability and early peri-implant bone density compared to the immediate implant group (p < 0.05). Both groups showed a significant increase in implant stability and bone density over time. At 6 months, no statistically significant differences were observed between the groups with respect to implant stability, peri-implant bone quality, or marginal bone loss. Conclusion: Although delayed implant placement offers superior early biological conditions, immediate implant placement achieves comparable osseointegration and bone quality over time. Both protocols can be considered reliable treatment options when appropriate case selection and standardized surgical techniques are applied