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J Adv Periodontol Implant Dent. Inpress.
doi: 10.34172/japid.026.4041
  Abstract View: 35

Original Article

Radiographic evaluation of malpositioning in immediate and early dental implant placement: A cross-sectional study

Fatima Waleed Khalid ORCID logo, Zeinab Kadkhoda* ORCID logo, Amir Raee* ORCID logo, Farzaneh Mosavat ORCID logo, Shima Younespour ORCID logo
*Corresponding Authors: Email: zkadkhoda@sina.tums.ac.ir; Email: amirraee@yahoo.com

Abstract

Background: Dental implants are regularly used to restore tooth loss. 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. This can lead to a variety of aesthetic and functional complications. Therefore, this study aimed to compare immediate implant placement (IIP) and early implant placement (EIP) regarding the occurrence of 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 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 to 80). Multivariable logistic regression analysis indicated that both timing of implant placement and position of Implant (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 and according to the multivariable regression, 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.
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Submitted: 28 Sep 2025
Revision: 29 Nov 2025
Accepted: 24 Feb 2026
ePublished: 06 May 2026
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