EFFECT OF DIFFERENT GRAFTING MATERIALS ON ALVEOLAR RIDGE PRESERVATION

Objectives: The purpose of this systematic review was to assess the effect of several grafting materials on alveolar bone resorption after teeth extraction. Materials & methods: Electronic literature searches in MEDLINE (PubMed) and Cochrane (CENTRAL) were performed, in addition to a manual search through all periodontics and implantology-related journals, for publications in the period from January 1st, 2009, to February 1st, 2021. The primary focus was related to studies comparing alveolar ridge preservation reporting quantitative outcomes of hard tissue changes. Results: In total,18 randomized controlled studies were included. Mean difference values were calculated with the use of quantitative statistical analysis (RevMan) for split-mouth and parallel study designs. The pooled magnitude of bone resorption was calculated for different dimensions of the alveolar bone process after teeth extraction: for horizontal dimension. Meta-analyses were performed for the use of any graft without membranes compared to empty sockets or specifically for different kinds of grafts (with or without membranes) again compared to empty sockets. Further, a direct comparison was available from studies comparing xenografts either with allografts or alloplasts. Conclusion: Within the limitation of this systematic review, there is a decrease in alveolar bone resorption after teeth extraction as an impact of bone substitute use, with minimal variations between bone graft materials. Overall, in several outcome parameters, it was noticed that the xenograft materials had the highest amount of bone preservation, and the least magnitude for the alveolar bone reservation was accompanied with the use of alloplastic bone substitutes with a recommendation to make searches about combinations of alloplastic bone substitutes, but confidence intervals were strongly overlapping. Hence, final judgment on any superior graft material cannot be reached from actual available clinical evidence.