This systematic study was conducted to evaluate the survival rate of immediate implants in sites displaying chronic periapical lesions after using different disinfection methods. A systematic literature search was conducted according to PRISMA guidelines. Clinical trials published in English between the years 2012 and 2023 were selected. Randomized clinical trials (RCT) and cohort human clinical trials evaluating the survival rate of implants placed in infected sockets with a control group and a follow-up period ≥3 months were included. All in vitro, animal, and pilot studies, case reports, and case series were excluded. Cohort studies were evaluated using the Newcastle-Ottowa scale. Cochrane Risk of bias assessment tool version 2 (RoB 2) was used for the selected RCT. Seven studies were included. Five of them were Cohort studies, and 2 of them were RCT. None of the studies met the requirements for quantitative meta-analysis due to their heterogeneity of data. Two hundred and fifty-nine patients and 663 implants were evaluated. The survival rate of implants in reviewed studies ranged from 94.4% to 100%. All studies used curettage in test groups as primary debridement in infected sockets. There were no statistically significant differences (p<0.05) in implant survival rates when additional disinfection techniques were used: rinsing with chlorhexidine, and sequestrectomy using Er, Cr: YSGG laser. Analysis of the studies shows that a variety of measures can be used to increase the possibility of implant integration, but without careful curettage of the alveolus, additional disinfection measures are ineffective.
