Received by the Editorial Office: April 21, 2026
Accepted for publication: June 13, 2026
Published online: June 30, 2026
UDC: 616.314-089.843
DOI: 10.70113/1815-9443.2026.25.99.002
CHANGES IN PERI-IMPLANT TISSUES AFTER IMMEDIATE, EARLY AND DELAYED DENTAL IMPLANTATION
Begulo B.M.1, Bolat D.B.1, Skvortsov N.V.1, Tulegenov A.D.1, Fanarov A.B.1, Zamurayeva A.U.2, Egizbekova A.B.2, Kemelova G.B.2
1 Second-year students, School of Dentistry, NpJSC “Astana Medical University”, Almaty, Kazakhstan
2 Department of Orthopedic and Pediatric Dentistry, NpJSC “Astana Medical University”, Almaty, Kazakhstan
Introduction. Modern dental implantology uses different protocols for implant placement after tooth extraction: immediate, early (immediate-delayed) and delayed implantation. The timing of implant placement may influence hard- and soft-tissue remodeling, peri-implant mucosal stability, esthetic outcome and the need for regenerative procedures.
Objective. To summarize and compare literature data on changes in peri-implant hard and soft tissues after immediate, early and delayed dental implantation, with attention to clinical and esthetic consequences.
Materials and methods. This manuscript was revised as a narrative literature review. The electronic search was focused on PubMed/MEDLINE publications from 2010 to 2024, with additional manual screening of references from relevant systematic reviews, meta-analyses and consensus papers. The search combinations included terms related to immediate implant placement, early implant placement, delayed implant placement, peri-implant tissues, soft-tissue changes, hard-tissue changes, marginal bone loss and esthetic outcomes. Publications with case-report, case-series, cohort or case-control design were not used as the main evidence base. Because the initial search protocol did not contain a PRISMA flow chart, quantitative screening statistics or formal risk-of-bias assessment, the article is positioned as a narrative rather than systematic review.
Results. Immediate implantation is clinically justified only in favorable conditions, including intact socket walls, sufficient facial bone wall thickness, absence of acute infection, adequate soft-tissue phenotype and primary implant stability. Early implantation after soft-tissue healing, usually within 4-8 weeks, may provide additional keratinized mucosa and reduce the risk of infection while preserving the possibility of simultaneous augmentation. Delayed implantation after complete bone healing remains relevant in cases with severe defects, inflammation or patient-related contraindications, but it is more often associated with ridge-volume loss and the need for bone grafting.
Discussion. The available evidence should be interpreted critically because the included publications differ in study design, follow-up duration, definitions of implant placement timing, baseline socket conditions, tissue phenotype, augmentation protocols and outcome measures. Comparable implant survival does not mean identical behavior of hard and soft peri-implant tissues; bone remodeling, mucosal recession, esthetic stability, need for augmentation and complication risk must be assessed separately.
Conclusion. The timing of implantation should be selected individually according to bone phenotype, soft-tissue condition, esthetic zone requirements, inflammatory status, patient-related factors and the possibility of primary stability. No universal protocol can be considered superior for all clinical outcomes.
Keywords: immediate implantation; early implantation; delayed implantation; peri-implant tissues; hard tissue; soft tissue; tissue regeneration; esthetic outcome.
