Non-Cochrane · intervention · PM42599344
Tenting screw (tent pole) technique in vertical and horizontal alveolar ridge augmentations: a systematic review and meta-analysis.
Sarfaraz Bita, Amid Reza, Azadi Ali, et al. · Maxillofacial plastic and reconstructive surgery · 2026 · PubMed · doi:10.1186/s40902-026-00522-y
Findings
35 findings
| Population | ||||
|---|---|---|---|---|
| Adults with vertical alveolar ridge atrophy | Tenting screw/tent-pole technique as the sole space-maintenance method in vertical ridge augmentation | None (single-arm pooled mean) | Vertical bone gain (mm) Final evaluation (mostly 9-12 months post-operation) · Meta-regression: evaluation period | Meta-regression coefficient 0.39 [0.04, 0.73] GRADE not reported 12 studies |
| Adults with vertical alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in vertical ridge augmentation | None (single-arm pooled mean) | Vertical bone gain (mm) Overall of surgical-stage subgroup plot | Pooled mean 6.00 [4.24, 7.76] GRADE not reported 10 studies |
| Adults with vertical alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in vertical ridge augmentation | None (single-arm pooled mean) | Vertical bone gain (mm) < 12 months · Evaluation period < 12 months | Pooled mean 4.51 [2.65, 6.38] GRADE not reported 8 studies |
| Adults with vertical alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in vertical ridge augmentation | None (single-arm pooled mean) | Vertical bone gain (mm) >= 12 months · Evaluation period >= 12 months | Pooled mean 7.25 [4.63, 9.88] GRADE not reported 4 studies |
| Adults with vertical alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in vertical ridge augmentation | None (single-arm pooled mean) | Vertical bone gain (mm) Overall of collagen-membrane subgroup plot | Pooled mean 5.50 [3.69, 7.32] GRADE not reported 8 studies |
| Adults with vertical alveolar ridge atrophy | Tenting screw/tent-pole technique as the sole space-maintenance method in vertical ridge augmentation | None (single-arm pooled mean) | Vertical bone gain (mm) Final evaluation (mostly 9-12 months post-operation) · Meta-regression: defect size | Meta-regression coefficient 1.05 [0.99, 1.12] GRADE not reported 12 studies |
| Adults with vertical alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in vertical ridge augmentation | None (single-arm pooled mean) | Vertical bone gain (mm) | Pooled mean 5.43 [3.79, 7.07] GRADE not reported 12 studies |
| Adults with vertical alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in vertical ridge augmentation | None (single-arm pooled mean) | Vertical bone gain (mm) Overall of graft-type subgroup plot | Pooled mean 4.97 [3.22, 6.71] GRADE not reported 10 studies |
| Adults with horizontal alveolar ridge atrophy | Tenting screw/tent-pole technique as the sole space-maintenance method in horizontal ridge augmentation | None (single-arm pooled mean) | Horizontal bone gain (mm) Final evaluation (mostly 9-12 months post-operation) · Meta-regression: defect size | Meta-regression coefficient 0.51 [0.30, 0.72] GRADE not reported 13 studies |
| Adults with vertical alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in vertical ridge augmentation (one-staged procedure) | None (single-arm pooled mean) | Vertical bone gain (mm) One-staged augmentation/implant placement | Pooled mean 8.34 [6.12, 10.55] GRADE not reported 3 studies |
| Adults with vertical alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in vertical ridge augmentation (two-staged procedure) | None (single-arm pooled mean) | Vertical bone gain (mm) Two-staged procedure | Pooled mean 4.99 [3.05, 6.93] GRADE not reported 7 studies |
| Adults with vertical alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in vertical ridge augmentation with allograft particles | None (single-arm pooled mean) | Vertical bone gain (mm) Allograft alone | Pooled mean 2.46 [1.81, 3.11] GRADE not reported 4 studies |
| Adults with vertical alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in vertical ridge augmentation with allograft + xenograft particles | None (single-arm pooled mean) | Vertical bone gain (mm) Allograft + xenograft | Pooled mean 4.35 [3.84, 4.87] GRADE not reported 2 studies |
| Adults with vertical alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in vertical ridge augmentation with autograft particles | None (single-arm pooled mean) | Vertical bone gain (mm) Autograft alone | Pooled mean 8.26 [4.44, 12.08] GRADE not reported 2 studies |
| Adults with vertical alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in vertical ridge augmentation with autograft + xenograft particles | None (single-arm pooled mean) | Vertical bone gain (mm) Autograft + xenograft | Pooled mean 7.37 [5.15, 9.60] GRADE not reported 2 studies |
| Adults with vertical alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in vertical ridge augmentation with non-cross-linked resorbable collagen membrane | None (single-arm pooled mean) | Vertical bone gain (mm) Non-cross-linked resorbable collagen membrane | Pooled mean 5.54 [3.09, 7.98] GRADE not reported 6 studies |
| Adults with vertical alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in vertical ridge augmentation with cross-linked resorbable collagen membrane | None (single-arm pooled mean) | Vertical bone gain (mm) Cross-linked resorbable collagen membrane | Pooled mean 5.35 [3.83, 6.88] GRADE not reported 2 studies |
| Adults with vertical alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in vertical ridge augmentation without complementary PRF/PRP | None (single-arm pooled mean) | Vertical bone gain (mm) Without complementary PRF/PRP | Pooled mean 6.10 [4.20, 8.01] GRADE not reported 8 studies |
| Adults with vertical alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in vertical ridge augmentation with complementary PRF/PRP | None (single-arm pooled mean) | Vertical bone gain (mm) With complementary PRF/PRP | Pooled mean 4.09 [1.05, 7.13] GRADE not reported 4 studies |
| Adults with horizontal alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in horizontal ridge augmentation | None (single-arm pooled mean) | Horizontal bone gain (mm) Overall of graft-type subgroup plot | Pooled mean 3.66 [3.22, 4.09] GRADE not reported 12 studies |
| Adults with horizontal alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in horizontal ridge augmentation | None (single-arm pooled mean) | Horizontal bone gain (mm) < 12 months · Evaluation period < 12 months | Pooled mean 3.85 [3.54, 4.16] GRADE not reported 11 studies |
| Adults with horizontal alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in horizontal ridge augmentation | None (single-arm pooled mean) | Horizontal bone gain (mm) >= 12 months · Evaluation period >= 12 months | Pooled mean 2.41 [1.71, 3.10] GRADE not reported 2 studies |
| Adults with horizontal alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in horizontal ridge augmentation | None (single-arm pooled mean) | Horizontal bone gain (mm) | Pooled mean 3.62 [3.21, 4.02] GRADE not reported 13 studies |
| Adults with horizontal alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in horizontal ridge augmentation (one-staged procedure) | None (single-arm pooled mean) | Horizontal bone gain (mm) One-staged procedure | Pooled mean 3.24 [2.22, 4.27] GRADE not reported 4 studies |
| Adults with horizontal alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in horizontal ridge augmentation (two-staged procedure) | None (single-arm pooled mean) | Horizontal bone gain (mm) Two-staged procedure | Pooled mean 3.78 [3.43, 4.14] GRADE not reported 9 studies |
| Adults with horizontal alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in horizontal ridge augmentation with allograft particles | None (single-arm pooled mean) | Horizontal bone gain (mm) Allograft | Pooled mean 2.65 [1.54, 3.76] GRADE not reported 2 studies |
| Adults with horizontal alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in horizontal ridge augmentation with allograft + xenograft particles | None (single-arm pooled mean) | Horizontal bone gain (mm) Allograft + xenograft | Pooled mean 3.91 [3.42, 4.40] GRADE not reported 3 studies |
| Adults with horizontal alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in horizontal ridge augmentation with autograft + xenograft particles | None (single-arm pooled mean) | Horizontal bone gain (mm) Autograft + xenograft | Pooled mean 3.73 [2.62, 4.85] GRADE not reported 3 studies |
| Adults with horizontal alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in horizontal ridge augmentation with xenograft particles | None (single-arm pooled mean) | Horizontal bone gain (mm) Xenograft | Pooled mean 4.22 [3.97, 4.46] GRADE not reported 4 studies |
| Adults with horizontal alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in horizontal ridge augmentation without complementary PRF/PRP | None (single-arm pooled mean) | Horizontal bone gain (mm) Without complementary PRF/PRP | Pooled mean 3.41 [2.91, 3.92] GRADE not reported 9 studies |
| Adults with horizontal alveolar ridge atrophy | Tenting screw/tent-pole technique as sole space-maintenance method in horizontal ridge augmentation with complementary PRF/PRP | None (single-arm pooled mean) | Horizontal bone gain (mm) With complementary PRF/PRP | Pooled mean 3.99 [3.45, 4.53] GRADE not reported 4 studies |
| Adults with horizontal alveolar ridge atrophy | Tenting screw/tent-pole technique with bone particles in horizontal ridge augmentation | Conventional GBR with bone particles (no bone block) and conventional titanium screws | Horizontal bone gain difference (mm) Autograft + xenograft | MD 1.33 [0.35, 2.32] GRADE not reported 2 studies · 82 participants |
| Adults with horizontal alveolar ridge atrophy | Tenting screw/tent-pole technique with bone particles in horizontal ridge augmentation | Conventional GBR with bone particles (no bone block) and conventional titanium screws | Horizontal bone gain difference (mm) Allograft + xenograft | MD 0.14 [-0.59, 0.87] GRADE not reported 2 studies · 94 participants |
| Adults with horizontal alveolar ridge atrophy | Tenting screw/tent-pole technique with bone particles in horizontal ridge augmentation | Conventional GBR with bone particles (no bone block) and conventional titanium screws | Horizontal bone gain difference (mm) Overall of graft-type subgroup plot | MD 0.63 [-0.14, 1.40] GRADE not reported 4 studies · 176 participants |
| Adults with horizontal alveolar ridge atrophy | Tenting screw/tent-pole technique with bone particles in horizontal ridge augmentation | Conventional GBR with bone particles (no bone block) and conventional titanium screws | Horizontal bone gain difference (mm) 9 to 12 months follow-up | MD 0.49 [0.00, 0.97] 0.49 [0, 0.97] mm Moderate Downgraded: imprecision 5 studies · 173 participants |
Included primary studies 23
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Abd Elfattah 2021 EVALUATION OF "TENT-POLE" GRAFTING TECHNIQUE FOR RECONSTRUCTION OF MANDIBULAR RIDGE VERTICAL DEFECTS (CLINICAL AND RADIOGRAPHIC STUDY) DOI:10.21608/adjalexu.2021.144845 | 2021 | this review only | not stated | not extracted yet |
| Caldwell 2015 Lateral Alveolar Ridge Augmentation Using Tenting Screws, Acellular Dermal Matrix, and Freeze-Dried Bone Allograft Alone or with… DOI:10.11607/prd.2260 | 2015 | this review only | not stated | not extracted yet |
| Cesar Neto 2020 The positive effect of tenting screws for primary horizontal guided bone regeneration: A retrospective study based on cone‐beam computed… DOI:10.1111/clr.13630 | 2020 | this review only | not stated | not extracted yet |
| Chacon 2024 Vertical Ridge Augmentation Using Collagen Membrane and Tenting Screws in the Esthetic Zone: A Case Series DOI:10.11607/prd.6373 | 2024 | this review only | not stated | not extracted yet |
| Daga 2018 Tentpole technique for bone regeneration in vertically deficient alveolar ridges: A prospective study DOI:10.1016/j.jobcr.2017.11.002 | 2018 | this review only | not stated | not extracted yet |
| Deeb 2017 How Effective Is the Tent Screw Pole Technique Compared to Other Forms of Horizontal Ridge Augmentation? DOI:10.1016/j.joms.2017.05.037 | 2017 | this review only | not stated | not extracted yet |
| Farias 2021 Horizontal Bone Augmentation in the Posterior Atrophic Mandible and Dental Implant Stability Using the Tenting Screw Technique DOI:10.11607/prd.5137 | 2021 | this review only | not stated | not extracted yet |
| Golob Deeb 2020 Effect of postoperative steroids on clinical outcomes and radiographic findings of horizontal alveolar ridge augmentation: A retrospective… DOI:10.1002/jper.19-0198 | 2019 | this review only | not stated | not extracted yet |
| Golob Deeb 2021 Effect of biologic materials on the outcomes of horizontal alveolar ridge augmentation: A retrospective study DOI:10.1002/cre2.343 | 2020 | this review only | not stated | not extracted yet |
| Guillen 2021 Evaluation of the screw tent-pole technique for the repair of anterior maxilla width defects: a prospective, randomized, split-mouth study DOI:10.1016/j.ijom.2020.10.008 | 2021 | this review only | not stated | not extracted yet |
| Isik 2021 Comparison of Autogenous Block Bone Graft and Screw Tent-Pole Techniques for Vertical Bone Augmentation in the Posterior Mandible: A… DOI:10.1177/2320206820976010 | 2020 | this review only | not stated | not extracted yet |
| Keddar 2024 Horizontal ridge augmentation using guided bone regeneration with an association of particulate allografts mixed with platelet-rich… DOI:10.1016/j.jormas.2024.101872 | 2024 | this review only | not stated | not extracted yet |
| Korpi 2012 Long-Term Follow-Up of Severely Resorbed Mandibles Reconstructed Using Tent Pole Technique Without Platelet-Rich Plasma DOI:10.1016/j.joms.2012.07.027 | 2012 | this review only | not stated | not extracted yet |
| Le 2010 Screw “Tent-Pole” Grafting Technique for Reconstruction of Large Vertical Alveolar Ridge Defects Using Human Mineralized Allograft for… DOI:10.1016/j.joms.2009.04.059 | 2010 | this review only | not stated | not extracted yet |
| Le 2016 Treatment of Labial Soft Tissue Recession Around Dental Implants in the Esthetic Zone Using Guided Bone Regeneration With Mineralized… DOI:10.1016/j.joms.2016.04.015 | 2016 | this review only | not stated | not extracted yet |
| Lin 2025 Novel early vertical ridge augmentation technique DOI:10.1016/j.jds.2024.10.025 | 2025 | this review only | not stated | not extracted yet |
| Marx 2002 Severely resorbed mandible: Predictable reconstruction with soft tissue matrix expansion (tent pole) grafts DOI:10.1053/joms.2002.33856 | 2002 | this review only | not stated | not extracted yet |
| Melek 2022 DOI:10.23805/jo.2022.14.5 | NR | this review only | not stated | not extracted yet |
| Stumpf 2024 DOI:10.3290/j.qi.b4479067 | NR | this review only | not stated | not extracted yet |
| Wang 2025 Tenting Screw Technique for Horizontal Alveolar Bone Augmentation in the Anterior Maxilla: A 1‐ to 5‐Year Retrospective Study DOI:10.1111/clr.14428 | 2025 | this review only | not stated | not extracted yet |
| Yang 2023 Radiographic evaluation of the tenting screw technique in horizontal alveolar bone augmentation: A retrospective study DOI:10.1111/cid.13213 | 2023 | this review only | not stated | not extracted yet |
| Yoon 2025 Retrospective Radiographic Evaluation of Ridge Dimensional Changes After Vertical Augmentation Using the Novel Wide-Head Tent Pole Screw… PMID:40558901 | 2025 | this review only | not stated | not extracted yet |
| Yuan 2020 Comparison of in‐situ bone ring technique and tent‐pole technique for horizontally deficient alveolar ridge in the anterior maxilla DOI:10.1111/cid.12887 | 2020 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adult human individuals with vertical and/or horizontal alveolar ridge atrophies | Adults (18 to 81 years) with vertical and/or horizontal ridge defects (n=909 patients; 24 studies) |
| Intervention | Tenting screw/tent-pole technique (including tenting screws integrated into abutments) in alveolar ridge augmentation, with adjuncts such as bone particles, PRF/PRP and collagen membranes; bone blocks and titanium mesh excluded | Screw tent-pole technique or tent-pole implant abutments with particulate grafts and collagen membranes (24 studies; 23 in meta-analysis) |
| Comparison | Other augmentation techniques / conventional GBR | Single-arm pooling in 22 of 23 meta-analyzed studies; conventional GBR without bone blocks in 5 cohort studies (horizontal gain) |
| Outcomes | Short-term (<12 months) and long-term (>12 months) success/failure of bone augmentation; vertical and horizontal bone gain, implant survival | Vertical bone gain (12 studies); horizontal bone gain (13 studies); horizontal bone gain difference versus conventional GBR (5 studies); complications narrative |
| Study designs | Randomized and non-randomized original human clinical studies; case reports/series with fewer than 10 patients excluded | 4 RCTs, 13 cohorts/case series, 7 non-randomized interventional studies |
| Timing | Short-term (<12 months) and long-term (>12 months) | Mostly 9 to 12 months post-operation; 6 studies reported beyond 12 months |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | No | No | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: Yes | NRSI: Partial Yes · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Partial Yes · NRSI: No | NRSI: No · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | No | Yes | no |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |