Background and Objectives: The present systematic review and meta-analysis were conducted to evaluate and compare the long-term clinical outcomes of immediate implants placed into fresh sockets with and without periapical pathology. Materials and Methods: After the search and review of the literature in the electronic databases, 109 publications were achieved. The titles and abstracts of 66 publications were screened. After the evaluation of the full text of 22 publications, based on the inclusion criteria, six controlled clinical studies were included in this systematic review and meta-analysis. Results: The statistical calculation showed no heterogeneity among the studies included. The implant survival was 99.6% in the test (socket with periapical pathology) and control (socket without periapical pathology) groups of all the clinical trials. The results of the meta-analysis showed no statistically significant difference between test and control groups regarding the marginal bone level and the width of keratinized mucosa in all the studies. Other parameters indicating plaque level, bleeding on probing, and gingival recession also did not differ between test and control groups at the final follow-up in nearly all studies. Conclusions: Within the limitation of this systemic review and meta-analysis, the obtained data suggest that implants immediately placed into the extraction sockets of teeth exhibiting periapical pathology can be successfully osseointegrated for an extended period.

Background and Objectives: This systematic review and meta-analysis aimed to evaluate the efficacy of xenogeneic collagen matrix (XCM) in combination with a coronally advanced flap (CAF) in the management of multiple gingival recessions and to compare its outcomes with those achieved using the conventional connective tissue graft (CTG) + CAF approach. Materials and Methods: After searching and reviewing the literature in the electronic databases PubMed/PMC, Google Scholar, ScienceDirect, Cochrane Library, and LILACS, 601 publications were found. The titles and abstracts of 543 publications were screened. After evaluating the full text of 290 publications, based on the inclusion criteria, four randomized controlled clinical trials were included in the systematic review and meta-analysis. In all the studies, the test group was treated with XCM + CAF, whereas in the control group, CTG + CAF was used. Results: Clinical attachment level (CAL), gingival recession depth (GR), keratinized tissue width (KTW), and complete root coverage (CRC) statistically significantly (p < 0.05) improved in both groups in all of the studies. Inter-group comparison showed better results in the control group in individual studies. All clinical trials reported a statistically significant (p < 0.05) decrease in surgery time and less postoperative pain in the test group. The meta-analysis of KTW (−0.438 [95% CI, −0.714 to −0.163], p < 0.002) and GR (0.35 [95% CI, 0.098 to 0.602], p < 0.001) showed a significant difference between the test and the control groups in all of the studies. CAL (0.78 [95% CI, −0.305 to 0.461], p > 0.05) showed no statistically significant difference between test and control groups. Conclusions: CTG + CAF remains the gold standard in root coverage procedures. However, XCM offers a less invasive alternative with improved patient comfort, less postoperative pain, shorter surgical time, and acceptable clinical outcomes.