The use of autogenous tooth bone graft is an efficient method of alveolar ridge preservation - meta-analysis and systematic review

Abstract

Background: Ridge resorption following tooth extraction may be reduced by alveolar ridge preservation (ARP). Previous randomized clinical trials and systematic reviews have suggested that autogenous tooth bone graft (ATB) can be an effective alternative material for ARP. However, the results are heterogeneous. Therefore, our research aimed to evaluate the efficacy of ATB in ARP.

Methods: A systematic search was conducted in Cochrane Library, Embase, MEDLINE and Scopus for studies published from inception to 31 November 2021. We searched searched for randomized, non-randomized controlled trials and case series reporting on ATB use for ARP. The primary outcome was the ridge width difference pre- and post-surgery, measured in millimetres (mm) measured on CBCT (cone beam computed tomography). The secondary outcomes were the histological results. We followed the PRISMA2020 recommendations for reporting our systematic review and meta-analysis.

Results: The analysis included eight studies for the primary and six for the secondary outcomes. The meta-analysis revealed a positive ridge preservation effect with a pooled mean difference ridge width change of -0.72 mm. The pooled mean residual graft proportion was 11.61%, and the newly formed bone proportion was 40.23%. The pooled mean of newly formed bone proportion was higher in the group where ATB originated from both the root and crown of the tooth.

Conclusions: ATB is an effective particulate graft material in ARP. Complete demineralization of the ATB tends to decrease the proportion of newly formed bone. ATB can be an attractive option for ARP.

Trial registration: The study protocol was registered on PROSPERO (CRD42021287890).

Keywords: Alveolar bone grafting; Alveolar bone loss; Alveolar preservation; Alveolar process; Socket preservation; Tooth socket.

Fig. 1

Flowchart of the selection process based on PRISMA 2020 statement. The ‘n’ indicates the total number of studies at each selection level

Fig. 2

Primary outcome: pooled mean of ridge width changes in mm. A statistically significant alveolar ridge preservation effect can be observed

Fig. 3

Pooled mean of residual graft proportion (%). No statistical significant difference can be observed between the subgroups

Fig. 4

Pooled mean of newly formed bone proportion (%). A statistical significant difference between the DDM and PDDM group can be observed

Fig. 5

Pooled mean of connective tissue proportion (%). No statistical significant difference can be observed between the subgroups