Using autogenous tooth graft for alveolar ridge preservation: A systematic review and meta-analysis

Abstract

Statement of problem: A meta-analysis of the efficacy of autogenous tooth graft (ATG) for alveolar ridge preservation is still lacking given that earlier articles did not present a quantified synthesis or have a control group in their evaluation of the performance of ATG in comparison with other available materials.

Purpose: The purpose of this systematic review and meta-analysis was to critically assess the existing literature on the efficacy of ATG for alveolar ridge preservation.

Material and methods: The Scopus, MEDLINE/PubMed, and Cochrane Library databases were searched, with additional searches in the nonpeer-reviewed literature, screening for clinical studies that compared ATG with empty sockets or other materials and reported results on alveolar ridge dimensional changes or bone formation. A meta-analysis was performed using the standardized mean difference for the comparisons of alveolar ridge changes and the mean difference for bone formation. The random-effect model was implemented in all analyses.

Results: Fourteen studies were included. Regarding ridge width, a significant difference was noted between the ATG and empty sockets (SMD=1.60, 95% CI=0.53 to 2.66, P=.003). No significant difference was recorded compared with other grafts. As for ridge height, the results revealed no significant difference between the ATG and empty sockets and other grafts (P>.05). Moreover, no difference in bone formation between the ATG and empty sockets was seen (P>.05), while ATG demonstrated a higher percentage of bone formation than other grafts (MD=12.01, 95% CI=3.86 to 20.15, P=.004). Based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, the evidence on ridge width and bone formation was moderate, while the ridge height outcome was of a low level.

Conclusions: Most of the studies included had a small sample size with potential risk of bias. Within these limitations, ATG could be an alternative for alveolar ridge preservation, as it demonstrates the ability to preserve volume and regenerate new bone in the grafted area.