Non-Cochrane · intervention · PM42740459
Efficacy of engineered scaffolds for horizontal and vertical ridge augmentation: A systematic review and meta-analysis.
Saleh Muhammad H A, Calciolari Elena, Ng Ethan, et al. · Journal of periodontology · 2026 · PubMed · doi:10.1002/jper.70103
Findings
32 findings
| Population | ||||
|---|---|---|---|---|
| Adults with alveolar ridge deficiency undergoing staged augmentation | Customized CAD/CAM titanium mesh | None | Volumetric bone gain (mm³) Overall | MEAN 1307 [1000, 1700] Low Downgraded: risk of bias, imprecision, inconsistency 5 studies · 83 participants |
| Adults with alveolar ridge deficiency undergoing staged augmentation | Customized CAD/CAM titanium mesh | None | Vertical bone gain (mm) Overall | MEAN 5.64 [5.26, 6.02] Moderate Downgraded: risk of bias, imprecision 5 studies · 145 participants |
| Adults with alveolar ridge deficiency undergoing staged augmentation | Customized CAD/CAM titanium mesh | None | Horizontal bone gain (mm) 4–10 months | MEAN 4.96 [4.48, 5.44] Moderate Downgraded: risk of bias, imprecision 3 studies · 77 participants |
| Adults with alveolar ridge deficiency undergoing staged augmentation | Customized CAD/CAM titanium mesh with resorbable membrane | None | Horizontal bone gain (mm) With resorbable membrane | MEAN 5.64 [5.02, 6.26] GRADE not reported 2 studies · 55 participants |
| Adults with alveolar ridge deficiency undergoing staged augmentation | Customized CAD/CAM titanium mesh with resorbable membrane | None | Volumetric bone gain (mm³) With resorbable membrane | MEAN 1715 [1200, 2200] GRADE not reported 3 studies · 51 participants |
| Adults with alveolar ridge deficiency undergoing staged augmentation | Customized CAD/CAM titanium mesh with resorbable membrane | None | Vertical bone gain (mm) With resorbable membrane | MEAN 4.26 [3.62, 4.9] GRADE not reported 3 studies · 95 participants |
| Adults undergoing alveolar ridge augmentation with engineered scaffolds (horizontal and vertical defects) | Engineered (CAD/CAM customized) scaffold, mainly customized CAD/CAM titanium mesh with bone graft | None (single-arm pooled mean; no between-scaffold comparison) | Late complications (>=4 weeks), % >= 4 weeks after surgery · University and hospital · Without resorbable membrane | Pooled proportion 18.0 [7.5, 28.4] GRADE not reported 3 studies · 52 participants |
| Adults undergoing alveolar ridge augmentation with engineered scaffolds (horizontal and vertical defects) | Engineered (CAD/CAM customized) scaffold, mainly customized CAD/CAM titanium mesh with bone graft | None (single-arm pooled mean; no between-scaffold comparison) | Late complications (>=4 weeks), % >= 4 weeks after surgery · University and hospital · Overall (customized CAD-CAM titanium mesh) | Pooled proportion 16.5 [7.3, 25.7] Low Downgraded: risk of bias, imprecision, inconsistency 3 studies · 61 participants |
| Adults undergoing alveolar ridge augmentation with engineered scaffolds (horizontal and vertical defects) | Engineered (CAD/CAM customized) scaffold, mainly customized CAD/CAM titanium mesh with bone graft | None (single-arm pooled mean; no between-scaffold comparison) | Early complications (<4 weeks), % < 4 weeks after surgery · University and hospital · Overall (customized CAD-CAM titanium mesh) | Pooled proportion 24.3 [17.8, 30.8] Low Downgraded: risk of bias, imprecision, inconsistency 6 studies · 123 participants |
| Adults undergoing alveolar ridge augmentation with engineered scaffolds (horizontal and vertical defects) | Engineered (CAD/CAM customized) scaffold, mainly customized CAD/CAM titanium mesh with bone graft | None (single-arm pooled mean; no between-scaffold comparison) | Overall complications, irrespective of timing and membrane use, % Irrespective of timing · University and hospital · Overall | Pooled proportion 21.7 [16.4, 27.0] GRADE not reported Studies not reported |
| Adults undergoing alveolar ridge augmentation with engineered scaffolds (horizontal and vertical defects) | Engineered (CAD/CAM customized) scaffold, mainly customized CAD/CAM titanium mesh with bone graft | None (single-arm pooled mean; no between-scaffold comparison) | Early complications (<4 weeks), % < 4 weeks after surgery · University and hospital · With resorbable membrane | Pooled proportion 21.4 [10.1, 32.6] GRADE not reported 3 studies · 51 participants |
| Adults with alveolar ridge deficiency undergoing staged augmentation | Customized CAD/CAM titanium mesh without resorbable membrane | None | Vertical bone gain (mm) Without resorbable membrane | MEAN 6.36 [5.96, 6.76] GRADE not reported 2 studies · 50 participants |
| Adults with alveolar ridge deficiency undergoing staged augmentation | Customized CAD/CAM titanium mesh without resorbable membrane | None | Early complications (%) <4 weeks · Without resorbable membrane | Proportion (%) 25.6 [17.6, 33.5] GRADE not reported 5 studies · 72 participants |
| Adults with alveolar ridge deficiency undergoing staged augmentation | Customized CAD/CAM titanium mesh without resorbable membrane | None | Volumetric bone gain (mm³) Without resorbable membrane | MEAN 900 [750, 1050] GRADE not reported 2 studies · 32 participants |
| Adults with alveolar ridge deficiency undergoing staged augmentation | Engineered scaffolds and other study interventions | None | Volumetric bone gain (mm³) Multivariate meta-regression: Defect type (combined vs. horizontal) | Meta-regression coefficient 720.135 [286.0307, 1154.2383] GRADE not reported Studies not reported |
| Adults with alveolar ridge deficiency undergoing staged augmentation | Engineered scaffolds and other study interventions | None | Vertical bone gain (mm) Univariate meta-regression: Age | Meta-regression coefficient 0.1682 [0.0568, 0.2797] GRADE not reported Studies not reported |
| Adults with alveolar ridge deficiency undergoing staged augmentation | Engineered scaffolds and other study interventions | None | Horizontal bone gain (mm) Univariate meta-regression: Smoking (light smokers vs. non‐smokers) | Meta-regression coefficient -2.429 [-4.232, -1.2628] GRADE not reported Studies not reported |
| Adults with alveolar ridge deficiency undergoing staged augmentation | Engineered scaffolds and other study interventions | None | Volumetric bone gain (mm³) Univariate meta-regression: Graft Material (Ref: 3DHA + Xenograft): Autogenous Particles + Xenograft | Meta-regression coefficient 868.0872 [434.7582, 1301.4162] GRADE not reported Studies not reported |
| Systemically healthy partially dentate adults requiring horizontal ridge augmentation with simultaneous implant placement (FQ1) | Engineered (CAD/CAM customized) scaffold with or without bone graft or membrane | Same surgical procedure without an engineered scaffold | Defect resolution (%) at re-entry or implant placement | no estimate extracted No studies found 0 studies |
| Adults with alveolar ridge deficiency undergoing staged augmentation | Engineered scaffolds and other study interventions | None | Vertical bone gain (mm) Multivariate meta-regression: Defect type: Combined versus horizontal | Meta-regression coefficient 3.11 [2.121, 3.899] GRADE not reported Studies not reported |
| Adults with alveolar ridge deficiency undergoing staged augmentation | Engineered scaffolds and other study interventions | None | Volumetric bone gain (mm³) Multivariate meta-regression: Group (Ref. ti‐PTFE): RM + PRF | Meta-regression coefficient -850.237 [-1643.3471, -57.1277] GRADE not reported Studies not reported |
| Adults with alveolar ridge deficiency undergoing staged augmentation | Engineered scaffolds and other study interventions | None | Volumetric bone gain (mm³) Multivariate meta-regression: Graft Material (Ref: 3DHA + Xenograft): Autogenous Particles + Xenograft | Meta-regression coefficient 745.2934 [403.2456, 1087.3412] GRADE not reported Studies not reported |
| Adults with alveolar ridge deficiency undergoing staged augmentation | Engineered scaffolds and other study interventions | None | Volumetric bone gain (mm³) Multivariate meta-regression: Maxilla (%) | Meta-regression coefficient -21.5784 [-32.7284, -10.4283] GRADE not reported Studies not reported |
| Adults with alveolar ridge deficiency undergoing staged augmentation | Engineered scaffolds and other study interventions | None | Volumetric bone gain (mm³) Univariate meta-regression: Defect type (combined vs. horizontal) | Meta-regression coefficient 852.847 [450.8426, 1254.8523] GRADE not reported Studies not reported |
| Adults with alveolar ridge deficiency undergoing staged augmentation | Engineered scaffolds and other study interventions | None | Vertical bone gain (mm) Univariate meta-regression: Defect type: Combined versus horizontal | Meta-regression coefficient 4.4292 [2.5584, 6.3000] GRADE not reported Studies not reported |
| Adults with alveolar ridge deficiency undergoing staged augmentation | Engineered scaffolds and other study interventions | None | Vertical bone gain (mm) Univariate meta-regression: Smoking (Light vs. non‐smokers) | Meta-regression coefficient -1.122 [-2.7376, -0.217] GRADE not reported Studies not reported |
| Adults with alveolar ridge deficiency undergoing staged augmentation | Engineered scaffolds and other study interventions | None | Vertical bone gain (mm) Multivariate meta-regression: Smoking (Light vs. non‐smokers) | Meta-regression coefficient -0.781 [-2.11, -0.111] GRADE not reported Studies not reported |
| Adults with alveolar ridge deficiency undergoing staged augmentation | Engineered scaffolds and other study interventions | None | Horizontal bone gain (mm) Univariate meta-regression: Surgeon experience (reference: graduate students): Expert surgeons | Meta-regression coefficient 2.422 [0.911, 5.487] GRADE not reported Studies not reported |
| Adults with alveolar ridge deficiency undergoing staged augmentation | Engineered scaffolds and other study interventions | None | Volumetric bone gain (mm³) Univariate meta-regression: Maxilla (%) | Meta-regression coefficient -26.0233 [-38.1266, -13.9199] GRADE not reported Studies not reported |
| Adults with alveolar ridge deficiency undergoing staged augmentation | Engineered scaffolds and other study interventions | None | Vertical bone gain (mm) Univariate meta-regression: Time | Meta-regression coefficient 1.3363 [0.0931, 2.5795] GRADE not reported Studies not reported |
| Adults with alveolar ridge deficiency undergoing staged augmentation | Engineered scaffolds and other study interventions | None | Volumetric bone gain (mm³) Univariate meta-regression: Group (Ref. ti‐PTFE): RM + PRF | Meta-regression coefficient -945.83 [-1813.9347, -77.7253] GRADE not reported Studies not reported |
| Systemically healthy partially dentate adults requiring vertical ridge augmentation with simultaneous implant placement (FQ3) | Engineered (CAD/CAM customized) scaffold with or without bone graft or membrane | Same surgical procedure without an engineered scaffold | Defect resolution (%) at re-entry or implant placement | no estimate extracted No studies found 0 studies |
Included primary studies 26
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Wang 2023 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Ciocca 2018 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Ciocca 2018 Prosthetically CAD-CAM-Guided Bone Augmentation of Atrophic Jaws Using Customized Titanium Mesh: Preliminary Results of an Open… PMID:29303418 | 2018 | this review only | not stated | not extracted yet |
| Cucchi 2020 matched by author and year (probable) | NR | this review only | Early complications (<4 weeks), %; Vertical bone gain (mm) | not extracted yet |
| Cucchi 2020 Clinical and volumetric outcomes after vertical ridge augmentation using computer-aided-design/computer-aided manufacturing (CAD/CAM)… PMID:32758217 | 2020 | this review only | not stated | not extracted yet |
| Cucchi 2021 matched by author and year (probable) | NR | this review only | Horizontal bone gain (mm); Vertical bone gain (mm); Early complications (<4 weeks), % | not extracted yet |
| Cucchi 2021 Vertical and horizontal ridge augmentation using customized CAD/CAM titanium mesh with versus without resorbable membranes. A randomized… PMID:34551168 | 2021 | this review only | not stated | not extracted yet |
| Cucchi 2024 matched by author and year (probable) | NR | this review only | Early complications (<4 weeks), %; Vertical bone gain (mm) | not extracted yet |
| Cucchi 2024 Complication, vertical bone gain, volumetric changes after vertical ridge augmentation using customized reinforced PTFE mesh or Ti-mesh. A… PMID:39180274 | 2024 | this review only | not stated | not extracted yet |
| De Santis 2022 matched by author and year (probable) | NR | this review only | Horizontal bone gain (mm); Vertical bone gain (mm); Early complications (<4 weeks), % | not extracted yet |
| De Santis 2022 Custom Bone Regeneration (CBR): An Alternative Method of Bone Augmentation-A Case Series Study. PMID:36012978 | 2022 | this review only | not stated | not extracted yet |
| El Morsy 2020 Assessment of 3-dimensional bone augmentation of severely atrophied maxillary alveolar ridges using patient-specific poly ether-ether… PMID:32103625 | 2020 | this review only | not stated | not extracted yet |
| El-Morsy 2020 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Felice 2024 matched by author and year (probable) | NR | this review only | Horizontal bone gain (mm); Vertical bone gain (mm); Early complications (<4 weeks), % | not extracted yet |
| Felice 2024 A randomised controlled trial comparing the effectiveness of guided bone regeneration with polytetrafluoroethylene titanium-reinforced… PMID:39283222 | 2024 | this review only | not stated | not extracted yet |
| Giragosyan 2024 matched by author and year (probable) | NR | this review only | Horizontal bone gain (mm); Early complications (<4 weeks), % | not extracted yet |
| Giragosyan 2024 Linear bone gain and healing complication rate comparative outcomes following ridge augmentation with custom 3D printed titanium mesh vs… PMID:39257255 | 2024 | this review only | not stated | not extracted yet |
| Lizio 2022 matched by author and year (probable) | NR | this review only | Vertical bone gain (mm); Early complications (<4 weeks), % | not extracted yet |
| Lizio 2022 Guided bone regeneration using titanium mesh to augment 3-dimensional alveolar defects prior to implant placement. A pilot study. PMID:35305283 | 2022 | this review only | not stated | not extracted yet |
| Mekcha 2023 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Mekcha 2023 Customized 3D printed nanohydroxyapatite bone block grafts for implant sites: A case series. PMID:35858803 | 2023 | this review only | not stated | not extracted yet |
| Mohamed 2023 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Mohamed 2023 Guided Bone Regeneration for Horizontal Maxillary Alveolar Ridge Augmentation Using Patient-Specific Solid Titanium Barriers: A Case Series. PMID:36219140 | 2023 | this review only | not stated | not extracted yet |
| Mounir 2019 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Mounir 2019 Assessment of three dimensional bone augmentation of severely atrophied maxillary alveolar ridges using prebent titanium mesh vs… PMID:30895678 | 2019 | this review only | not stated | not extracted yet |
| Wang 2023 Clinical and radiographic outcomes of customized allogeneic bone block versus autogenous bone block for ridge augmentation: 6 Month… PMID:36054285 | 2023 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
| Review | Shared studies | Jaccard |
|---|---|---|
| Effects of Non-Pharmacological Interventions on Degree of Thirst and Oral Mucosal Moisture in Critically Ill Patients: A Systematic Review… (2026) | 1 | 0.02 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Systemically healthy partially dentate adults (>=18 years) with horizontal or vertical ridge deficiency requiring staged or simultaneous-implant ridge augmentation (FQ1 to FQ4) | 241 patients (mean age 47.1 years), 202 defects (12.4% horizontal, 27.2% vertical, 60.4% combined); all staged protocol; FQ2 and FQ4 only |
| Intervention | Ridge augmentation with an engineered scaffold (CAD/CAM customized blocks or barriers such as PEEK, titanium mesh, polylactic acid), alone or with bone graft or membrane | Customized CAD/CAM titanium mesh (9 studies), PEEK scaffolds (2), 3D hydroxyapatite block (1), customized allogeneic bone block (1), mostly with autogenous plus xenogeneic bone |
| Comparison | Same surgical procedure without an engineered scaffold | Pooled single-arm means; comparator arms (Ti-reinforced PTFE, autogenous block, pre-bent mesh) not pooled comparatively; no study answered FQ1 or FQ3 |
| Outcomes | Primary: defect resolution at re-entry (simultaneous implant) or bone gain (horizontal, vertical, volumetric) at re-entry (staged); secondary: complications (early <4 weeks, late >=4 weeks), PROMs, bone quality and density | Horizontal bone gain (3 studies), vertical bone gain (5), volumetric bone gain (5), early complications (6), late complications (3); PROMs and histology described narratively |
| Study designs | RCTs, prospective clinical studies and prospective case series with >=4 months follow-up and >=8 patients | 13 studies (6 single-center RCTs, 7 prospective case series); 9 in quantitative analysis |
| Timing | >=4 months follow-up after regenerative procedure | 6 to 9 months follow-up (range 4 to 10 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 | Yes | no |
| 4Comprehensive literature searchcritical | Partial Yes | Yes | no |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | Yes | Yes | yes |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: Yes | NRSI: Yes · RCT: Yes | no |
| 10Funding of included studies reported | Yes | No | no |
| 11Appropriate meta-analysis methodscritical | RCT: No · NRSI: No | NRSI: No · RCT: No | no |
| 12Impact of risk of bias on the pooled results | No | Yes | no |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |