Impact of Immediate vs Delayed Dental Implants on Survival, Patient Satisfaction, and Quality of Life

Purpose This randomised controlled trial investigated whether immediate placement confers any advantage over delayed placement with respect to implant survival (primary outcome), peri-implant health, patient-reported satisfaction (VAS) and oral-health-related quality of life (OHIP-14). Methods and Materials This study included 220 patients with missing teeth, randomly divided into a control group (n = 110) and an observation group (n = 110) using a random number table (block = 10, concealed allocation). Baseline variables (age, sex, BMI, tooth site, aetiology and oral hygiene habits) showed no statistically significant between-group differences (all P > 0.05). The control group received delayed implants, while the observation group received immediate implants. Outcomes measured included implant survival rate, periodontal indexes (PD, mPLI, mSBI), aesthetic evaluation (PES, WES), quality of life (OHIP-14), and patient satisfaction (VAS). Attachment level in the satisfaction assessment refers to the perceived gingival margin position relative to the restoration, evaluated subjectively by patients using a visual analogue scale rather than clinical probing measurements. Results At 1 year, implant survival rates were 95.45% (105/110) in the immediate group versus 92.73% (102/110) in the delayed group, with no statistically significant difference (χ2 = 0.736, P = 0.391). The observation group demonstrated significantly lower mean values compared to the control group for PD (3.16 ± 0.51 mm vs 3.39 ± 0.59 mm), mPLI (0.95 ± 0.38 vs 1.21 ± 0.54), and mSBI (0.85 ± 0.47 vs 1.01 ± 0.35) (all P < 0.05). The PES total scores were significantly higher in the observation group than the control group (12.18 ± 1.13 vs 11.34 ± 1.30, P < 0.001), as were WES total scores (7.78 ± 0.99 vs 7.23 ± 1.10, P < 0.001). After 1 year of implantation, OHIP-14 total scores in the observation group were significantly lower than those in the control group (3.20 ± 1.33 vs 4.15 ± 1.23, P < 0.001). The satisfaction scores for Attachment Level (8.12 ± 1.05 vs 7.45 ± 1.18), Colour (8.67 ± 0.89 vs 8.15 ± 1.12), and Chewing Function (8.89 ± 0.94 vs 8.23 ± 1.08) were significantly higher in the observation group than in the control group (all P < 0.05). Conclusion Based on the primary outcome of 1-year implant survival, there was no significant difference between immediate and delayed implantation. However, immediate implantation demonstrated superior secondary outcomes, including periodontal-related indexes, aesthetic effects, quality of life, and patient satisfaction. These findings suggest that immediate implantation may offer clinical advantages in early functional and aesthetic outcomes without compromising implant survival, providing patients with reduced treatment duration and improved peri-implant tissue preservation.