Primary and Secondary Implantation in Mandibular Reconstruction: A Systematic Review and Meta-analysis.

OBJECTIVE: To identify clinical factors influencing implant placement/timing decisions, through comparing survival, success, and complication rates of primary and secondary dental implantation following mandibular reconstruction. DATA SOURCES: A systematic search was conducted in the PubMed, Embase, and Cochrane Central Register of Controlled Trials databases. REVIEW METHODS: Following a PROSPERO-registered protocol and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, clinical studies comparing primary and secondary implant placement in reconstructed mandibles were included. Two reviewers extracted patient characteristics, along with surgical, implant, and outcome data. Pooled odds ratios (OR) and risk ratios (RR) with 95% confidence intervals (CIs) were calculated using random-effects models. RESULTS: Eleven retrospective studies were included. Implant survival showed no significant difference (OR = 0.65; RR = 0.96). Implant success (OR = 0.17; RR = 0.84) and complication rates (OR = 0.50; RR = 0.64) were likewise comparable. Prosthetic rehabilitation rates were similar; however, primary implantation reduced overall rehabilitation time by approximately 3 to 6 months. CONCLUSION: Primary implantation can achieve outcomes equivalent to secondary protocols,while reducing rehabilitation time.