Cochrane · intervention · CD010176

Interventions for replacing missing teeth: alveolar ridge preservation techniques for dental implant site development

Atieh, MA, Alsabeeha, NHM, Payne, AGT, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library

Oral Health Implants and prosthodontics3 versionsAMSTAR 2: not assessed

Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.

Questions

current version

GRADE rated

No studies

Included studies

as reported

No studies 17 · 38.6%Ungraded 2 · 4.5%Very low 22 · 50%Low 3 · 6.8%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Review question

Element	Planned (methods)	Found (results)
Population	Adult participants aged 18 years or older, in good general health (including participants with well-controlled systemic disease), who required extraction of one or more permanent teeth, in mandibular or maxillary, molar or non-molar sites, with consideration of future delayed placement of dental implants	426 participants with 524 extraction sites
Intervention	Any method of ARP (including use of grafting materials, biologics, and growth factors) and techniques (including guided bone regeneration (GBR) and socket seal) with or without any type of barrier membrane after tooth extraction	Xenograft versus extraction (n=7); Alloplast versus extraction (n=1); Allograft versus xenograft (n=3); Alloplast versus xenograft (n=2); Alloplast with and without membrane (n=1); Allograft with and without synthetic cell-binding peptide P-15 (n=1); Demineralised bone matrix single versus multiple particle size (n=1)
Comparison	Extraction alone (no ARP was performed); or another type of ARP	Extraction alone (n=8); Xenograft (n=3); Alloplast without membrane (n=1); Allograft without P-15 (n=1); DBM multiple particle size (n=1)
Outcomes	Changes in bucco-lingual/palatal width of alveolar ridge; Changes in vertical height of alveolar ridge; Complications (discomfort, pain and swelling); Need for additional augmentation prior to implant placement; Aesthetic outcomes of future prosthodontic rehabilitation; Implant failure rate; Peri-implant marginal bone level changes; Changes in probing depth (PD) at teeth adjacent to the extraction site; Changes in clinical attachment level (CAL) at teeth adjacent to the extraction site; Prosthodontic outcomes of rehabilitation	Changes in bucco-lingual/palatal width (n=14); Changes in vertical height (n=13); Complications (n=10); Need for additional augmentation (n=7); Implant failure rate (n=3); Peri-implant marginal bone level changes (n=1); Changes in probing depth (n=1)
Study designs	All RCTs on the use of ARP techniques, with at least six months of follow-up	RCT (n=16): parallel-group and split-mouth designs
Timing	At least six months of follow-up, regarded as the period from tooth extraction until the final measurements of the alveolar ridge prior to or at the time of implant placement	Six months (n=12); six to eight months (n=1); seven months (n=1); eight months (n=1); nine months (n=1)

Search date: 2021-03. Databases: Cochrane Oral Health's Trials Register; CENTRAL; MEDLINE Ovid; Embase Ovid; LILACS BIREME Virtual Health Library; Web of Science Conference Proceedings; Scopus; ProQuest Dissertations and Theses; OpenGrey; ClinicalTrials.gov; WHO International Clinical Trials Registry Platform

Questions and results

Current version only

ARP with xenograft (bone graft) vs Extraction alone

Population: Adults aged 18 years or older, in good general health (including well-controlled systemic disease), requiring extraction of one or more permanent teeth (mandibular or maxillary, molar or non-molar), with consideration of future delayed dental implant placement

CD010176.PUB3 (current) · 7 questions

Outcome	Effect	Evidence	Status / GRADE
Complications (e.g. discomfort, pain and swelling) 6 to 36 months same question in other reviews	1 trial (Cha 2019) reported delayed healing with partial exposure of the buccal plate at suture removal by 1 participant in the test group; another trial (Festa 2013) reported pain and swelling	2 studies · 54 participants	Low Downgraded: risk of bias, imprecision
Peri-implant marginal bone level changes 7 months same question in other reviews	Peri-implant marginal bone level changes obtained after 7 months (Barone 2012); no statistically significant differences between the two groups (Analysis 1.5)	1 study	Ungraded
Changes in bucco-lingual/palatal width of alveolar ridge (mm) 6 to 36 months same question in other reviews	MD -1.18 [-1.82, -0.54]	6 studies · 184 participants	Very low Downgraded: risk of bias, inconsistency
Aesthetic outcomes of future prosthodontic rehabilitation 6 to 36 months same question in other reviews	Outcome not reported	0 studies	No studies
Implant failure rate 6 to 36 months same question in other reviews	RR 1.0 [0.07, 14.9]	2 studies · 70 participants	Very low Downgraded: risk of bias, imprecision
Changes in vertical height of alveolar ridge (mm) 6 to 36 months same question in other reviews	MD -1.35 [-2.0, -0.7]	6 studies · 184 participants	Very low Downgraded: risk of bias, inconsistency
Need for additional augmentation prior to implant placement 6 to 36 months same question in other reviews	RR 0.68 [0.29, 1.62] -126 [-199, -19] per 1000 (fewer)	4 studies · 154 participants	Very low Downgraded: risk of bias, imprecision, inconsistency