Non-Cochrane · intervention · PM42827641
Component network meta-analysis of scaffold materials, platelet-rich fibrin and barrier membranes for alveolar ridge preservation.
Zhang Jian, Zhong Jie, Huang Shihan, et al. · Frontiers in oral health · 2026 · PubMed · doi:10.3389/froh.2026.1949538
Findings
Population Adults undergoing permanent tooth extraction
52 findings
| Dentin graft | Natural healing/blood clot | Horizontal ridge-width change | MD -2.07 [-3.17, -0.97] Low Downgraded: risk of bias, inconsistency 1 study · 14 participants |
| Xenograft + barrier membrane | Natural healing/blood clot | Horizontal ridge-width change | MD -1.78 [-2.57, -0.99] Low Downgraded: risk of bias, inconsistency 3 studies · 45 participants |
| Xenograft + barrier membrane | Natural healing/blood clot | Buccal vertical ridge-height change | MD -2.23 [-3.53, -0.93] Low Downgraded: risk of bias, inconsistency 3 studies · 45 participants |
| Allograft + barrier membrane | Natural healing/blood clot | Horizontal ridge-width change | MD -1.78 [-3.06, -0.5] Low Downgraded: risk of bias, inconsistency 1 study · 5 participants |
| Allograft + barrier membrane | Natural healing/blood clot | Buccal vertical ridge-height change | MD -3.03 [-4.86, -1.2] Low Downgraded: risk of bias, inconsistency 1 study · 5 participants |
| Dentin graft + PRF | Natural healing/blood clot | Buccal vertical ridge-height change | MD -2.49 [-3.85, -1.12] Low Downgraded: risk of bias, inconsistency 1 study · 8 participants |
| Dentin graft + PRF | Natural healing/blood clot | Horizontal ridge-width change | MD -1.52 [-2.26, -0.78] Low Downgraded: risk of bias, inconsistency 1 study · 8 participants |
| Alloplast + barrier membrane | Natural healing/blood clot | Buccal vertical ridge-height change | MD -1.65 [-3.12, -0.17] Low Downgraded: risk of bias, inconsistency 2 studies · 38 participants |
| Alloplast + barrier membrane | Natural healing/blood clot | Horizontal ridge-width change | MD -1.45 [-2.4, -0.5] Low Downgraded: risk of bias, inconsistency 2 studies · 38 participants |
| Allograft + PRF | Natural healing/blood clot | Buccal vertical ridge-height change | MD -1.26 [-2.38, -0.14] Low Downgraded: risk of bias, inconsistency 3 studies · 34 participants |
| Allograft + PRF | Natural healing/blood clot | Horizontal ridge-width change | MD -1.28 [-1.93, -0.63] Low Downgraded: risk of bias, inconsistency 3 studies · 34 participants |
| Xenograft + PRF | Natural healing/blood clot | Horizontal ridge-width change | MD -0.93 [-1.97, 0.1] Very low Downgraded: risk of bias, imprecision, inconsistency 1 study · 10 participants |
| Allograft | Natural healing/blood clot | Buccal vertical ridge-height change | MD -0.72 [-1.57, 0.12] GRADE not reported 2 studies |
| Allograft | Natural healing/blood clot | Buccal vertical ridge-height change | MD -0.81 [-1.67, 0.05] Very low Downgraded: risk of bias, imprecision, inconsistency 5 studies · 78 participants |
| Allograft | Natural healing/blood clot | Horizontal ridge-width change | MD -0.77 [-1.28, -0.27] Low Downgraded: risk of bias, inconsistency 5 studies · 78 participants |
| Allograft | Natural healing/blood clot | Horizontal ridge-width change | MD -1.03 [-1.3, -0.75] GRADE not reported 2 studies |
| Collagen scaffold | Natural healing/blood clot | Horizontal ridge-width change | MD -0.46 [-1.24, 0.32] GRADE not reported 2 studies · 26 participants |
| Collagen scaffold | Natural healing/blood clot | Buccal vertical ridge-height change | MD -0.89 [-2.13, 0.36] Very low Downgraded: risk of bias, imprecision, inconsistency 2 studies · 26 participants |
| PRF | Natural healing/blood clot | Buccal vertical ridge-height change | MD -0.31 [-0.73, 0.11] GRADE not reported 5 studies |
| PRF | Natural healing/blood clot | Horizontal ridge-width change | MD -0.29 [-0.84, 0.26] GRADE not reported 5 studies |
| PRF | Natural healing/blood clot | Buccal vertical ridge-height change | MD -0.5 [-1.12, 0.13] GRADE not reported 8 studies · 185 participants |
| PRF | Natural healing/blood clot | Horizontal ridge-width change | MD -0.36 [-0.75, 0.03] GRADE not reported 8 studies · 185 participants |
| Alloplast + PRF | Natural healing/blood clot | Buccal vertical ridge-height change | MD -0.6 [-1.72, 0.52] Very low Downgraded: risk of bias, imprecision, inconsistency 1 study · 30 participants |
| Alloplast + PRF | Natural healing/blood clot | Horizontal ridge-width change | MD -0.29 [-0.97, 0.38] GRADE not reported 2 studies · 40 participants |
| Dentin graft component | Absence of component | Horizontal ridge-width change | MD -1.35 [-1.82, -0.87] GRADE not reported 16 studies |
| Dentin graft component | Absence of component | Buccal vertical ridge-height change | MD -1.99 [-2.64, -1.34] GRADE not reported 14 studies |
| Barrier membrane component | Absence of component | Buccal vertical ridge-height change | MD -1.79 [-2.82, -0.76] GRADE not reported 14 studies |
| Barrier membrane component | Absence of component | Horizontal ridge-width change | MD -1.31 [-2.18, -0.44] GRADE not reported 16 studies |
| Barrier membrane component | Absence of component | Horizontal ridge-width change Excluding preliminary high-risk-of-bias studies | MD -1.47 [-2.55, -0.39] GRADE not reported 15 studies |
| Barrier membrane component | Absence of component | Horizontal ridge-width change Fixed-effect additive CNMA | MD -1.37 [-1.99, -0.74] GRADE not reported 16 studies |
| Allograft component | Absence of component | Horizontal ridge-width change | MD -0.77 [-1.16, -0.38] GRADE not reported 16 studies |
| Allograft component | Absence of component | Buccal vertical ridge-height change | MD -0.75 [-1.22, -0.28] GRADE not reported 14 studies |
| Allograft component | Absence of component | Horizontal ridge-width change Excluding preliminary high-risk-of-bias studies | MD -0.758 [-1.17, -0.35] GRADE not reported 15 studies |
| Allograft component | Absence of component | Horizontal ridge-width change 4–6-month follow-up | MD -0.852 [-1.53, -0.17] GRADE not reported 8 studies |
| Allograft component | Absence of component | Horizontal ridge-width change Fixed-effect additive CNMA | MD -0.778 [-0.96, -0.6] GRADE not reported 16 studies |
| Xenograft component | Absence of component | Buccal vertical ridge-height change | MD -0.23 [-0.93, 0.48] GRADE not reported 14 studies |
| Xenograft component | Absence of component | Horizontal ridge-width change | MD -0.57 [-1.2, 0.06] GRADE not reported 16 studies |
| Collagen scaffold component | Absence of component | Horizontal ridge-width change | MD -0.42 [-1.07, 0.23] GRADE not reported 16 studies |
| Collagen scaffold component | Absence of component | Buccal vertical ridge-height change | MD -0.76 [-1.48, -0.03] GRADE not reported 14 studies |
| PRF component | Absence of component | Horizontal ridge-width change 4–6-month follow-up | MD -0.478 [-0.88, -0.08] GRADE not reported 8 studies |
| PRF component | Absence of component | Horizontal ridge-width change Fixed-effect additive CNMA | MD -0.501 [-0.66, -0.35] GRADE not reported 16 studies |
| PRF component | Absence of component | Buccal vertical ridge-height change | MD -0.44 [-0.73, -0.14] GRADE not reported 14 studies |
| PRF component | Absence of component | Horizontal ridge-width change Excluding preliminary high-risk-of-bias studies | MD -0.382 [-0.66, -0.1] GRADE not reported 15 studies |
| PRF component | Absence of component | Horizontal ridge-width change | MD -0.4 [-0.66, -0.14] GRADE not reported 16 studies |
| Alloplast component | Absence of component | Buccal vertical ridge-height change | MD 0.04 [-0.52, 0.6] GRADE not reported 14 studies |
| Alloplast component | Absence of component | Horizontal ridge-width change | MD 0.01 [-0.51, 0.53] GRADE not reported 16 studies |
| Xenograft × PRF interaction | Additive component effects | Horizontal ridge-width change | MD 0.28 [-1.21, 1.76] GRADE not reported 16 studies |
| Alloplast × PRF interaction | Additive component effects | Horizontal ridge-width change | MD 0.6 [-0.97, 2.18] GRADE not reported 16 studies |
| Allograft + PRF | Allograft | Horizontal ridge-width change | MD -0.61 [-0.98, -0.24] GRADE not reported 2 studies |
| Allograft + PRF | Allograft | Buccal vertical ridge-height change | MD -0.33 [-0.63, -0.03] GRADE not reported 2 studies |
| PRF | Allograft | Horizontal ridge-width change | MD 0.2 [0.05, 0.36] GRADE not reported 3 studies |
| PRF | Allograft | Buccal vertical ridge-height change | MD 0.04 [-0.08, 0.17] GRADE not reported 3 studies |
Included primary studies 62
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Castro 2021 Effect of different platelet-rich fibrin matrices for ridge preservation in multiple tooth extractions: A split-mouth randomized… PMID:33847018 | 2021 | 3 other reviews | not stated | not extracted yet |
| Abad 2023 Efficacy of the application of leukocyte and platelet-rich fibrin (L-PRF) on alveolar ridge preservation. A randomized controlled clinical… PMID:37088697 | 2023 | 2 other reviews | not stated | not extracted yet |
| Clark 2018 Advanced platelet-rich fibrin and freeze-dried bone allograft for ridge preservation: A randomized controlled clinical trial. PMID:29683498 | 2018 | 2 other reviews | not stated | not extracted yet |
| Elfana 2021 Alveolar ridge preservation using autogenous whole-tooth versus demineralized dentin grafts: A randomized controlled clinical trial. PMID:33565656 | 2021 | 2 other reviews | not stated | not extracted yet |
| Girish Kumar 2018 To assess the efficacy of socket plug technique using platelet rich fibrin with or without the use of bone substitute in alveolar ridge… PMID:29411166 | 2018 | 2 other reviews | not stated | not extracted yet |
| Hussain 2023 Efficacy of Autogenous Dentin Biomaterial on Alveolar Ridge Preservation: A Randomized Controlled Clinical Trial. PMID:38179035 | 2023 | 2 other reviews | not stated | not extracted yet |
| Castro 2021 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Choi 2025 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Clark 2018 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Dhamija 2020 Socket preservation with demineralized freeze-dried bone allograft and platelet-rich fibrin for implant site development: A randomized… PMID:33223701 | 2020 | 1 other review | not stated | not extracted yet |
| Gowda 2023 Autologous tooth bone graft block compared with advanced platelet-rich fibrin in alveolar ridge preservation: A clinico-radiographic study. PMID:38434501 | 2023 | 1 other review | not stated | not extracted yet |
| Zampara 2022 A Histologic and Histomorphometric Evaluation of an Allograft, Xenograft, and Alloplast Graft for Alveolar Ridge Preservation in Humans: A… PMID:35446950 | 2022 | 1 other review | not stated | not extracted yet |
| Abad 2023 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Aladmawy 2022 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Aladmawy 2022 Histological and histomorphometric evaluation of alveolar ridge preservation using an allograft and nonresorbable membrane with and… PMID:35777057 | 2022 | this review only | not stated | not extracted yet |
| Alrayyes 2023 Extraction and Socket Preservation before Implant Placement Using Freeze-Dried Allograft (FDBA) and Platelet-Rich Fibrin in Smokers:… DOI:10.3390/app13127076 | 2023 | this review only | not stated | not extracted yet |
| Alrayyes 2023 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Azangookhiavi 2020 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Azangookhiavi 2020 Comparison of the Efficacy of Platelet-Rich Fibrin and Bone Allograft for Alveolar Ridge Preservation after Tooth Extraction: A Clinical… PMID:33615286 | 2020 | this review only | not stated | not extracted yet |
| Bajaj 2025 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Bajaj 2025 Evaluation of Effectiveness of Nanocrystalline Hydroxyapatite and Demineralized Bone Matrix Combined with Titanium-platelet Rich Fibrin… PMID:39905614 | 2024 | this review only | not stated | not extracted yet |
| Barone 2008 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Barone 2008 Xenograft versus extraction alone for ridge preservation after tooth removal: a clinical and histomorphometric study. PMID:18672985 | 2008 | this review only | not stated | not extracted yet |
| Barone 2016 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Barone 2016 Volumetric analysis of remodelling pattern after ridge preservation comparing use of two types of xenografts. A multicentre randomized… PMID:25727443 | 2016 | this review only | not stated | not extracted yet |
| Choi 2025 Moldable and Particulate Bone Material in Alveolar Ridge Preservation: A Multicenter Randomized Controlled Trial. PMID:40070028 | 2025 | this review only | not stated | not extracted yet |
| Corning 2019 Ridge preservation following tooth extraction using mineralized freeze-dried bone allograft compared to mineralized solvent-dehydrated… PMID:30161278 | 2019 | this review only | not stated | not extracted yet |
| Corning and Mealey 2019 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Demetter 2017 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Demetter 2017 Histologic Evaluation of Wound Healing After Ridge Preservation With Cortical, Cancellous, and Combined Cortico-Cancellous Freeze-Dried… PMID:28452622 | 2017 | this review only | not stated | not extracted yet |
| Dhamija 2020 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Elfana 2021 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Estrin 2026 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Estrin 2026 The Evolution of Extended Platelet-Rich Fibrin Membranes for Socket Grafting: Part Two: A Randomized Clinical Trial Comparing These… PMID:41590169 | 2026 | this review only | not stated | not extracted yet |
| Girish Kumar 2018 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Gowda 2023 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Hussain 2023 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Ivanova 2019 DIMENSIONAL RIDGE ALTERATIONS AND HISTOMORPHOMETRIC ANALYSIS FOLLOWING SOCKET PRESERVATION WITH PRF OR ALLOGRAFT. RANDOMIZED CONTROLLED… DOI:10.5272/jimab.2019254.2853 | 2019 | this review only | not stated | not extracted yet |
| Ivanova 2019 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Mopati 2025 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Mopati 2025 A comparative evaluation of eggshell derived hydroxyapatite and demineralized freeze-dried bone allograft in alveolar ridge preservation -… PMID:41409125 | 2025 | this review only | not stated | not extracted yet |
| Nainoor 2026 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Nainoor 2026 Comparison of Clinical and Radiographic Assessment of Efficacy of Eggshell-Derived Nanohydroxyapatite (EnHA) and Demineralized… PMID:41648709 | 2026 | this review only | not stated | not extracted yet |
| Nunes 2018 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Nunes 2018 Evaluation of a bone substitute covered with a collagen membrane for ridge preservation after tooth extraction. Clinical and tomographic… PMID:29569754 | 2018 | this review only | not stated | not extracted yet |
| Ouyyamwongs 2019 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Ouyyamwongs 2019 Alveolar Ridge Preservation Using Autologous Demineralized Tooth Matrix and Platelet-Rich Fibrin Versus Platelet-Rich Fibrin Alone: A… PMID:31188170 | 2019 | this review only | not stated | not extracted yet |
| Saito 2021 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Saito 2021 Evaluation of poly lactic-co-glycolic acid-coated β-tricalcium phosphate for alveolar ridge preservation: A multicenter randomized… PMID:32996128 | 2021 | this review only | not stated | not extracted yet |
| Schnutenhaus 2018 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Schnutenhaus 2018 Alveolar ridge preservation with a collagen material: a randomized controlled trial. PMID:30202607 | 2018 | this review only | not stated | not extracted yet |
| Schnutenhaus 2020 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Schnutenhaus 2020 Associations among Primary Stability, Histomorphometric Findings, and Bone Density: A Prospective Randomized Study after Alveolar Ridge… PMID:33023224 | 2020 | this review only | not stated | not extracted yet |
| Shahdad 2020 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Shahdad 2020 Randomized clinical trial comparing PEG-based synthetic to porcine-derived collagen membrane in the preservation of alveolar bone… PMID:32799365 | 2020 | this review only | not stated | not extracted yet |
| Talebi Ardakani 2024 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Talebi Ardakani 2024 Comparison of Histological, Clinical, and Radiographic Outcomes of Postextraction Ridge Preservation by Allogenic Bone Grafting With and… PMID:39483789 | 2024 | this review only | not stated | not extracted yet |
| Thakkar 2016 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Thakkar 2016 A comparative evaluation of extraction socket preservation with demineralized freeze-dried bone allograft alone and along with… PMID:27630503 | 2016 | this review only | not stated | not extracted yet |
| Wróbel 2026 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Wróbel 2026 Evaluation of the Effectiveness of the Socket Preservation Technique Using Allogeneic and Xenogeneic Materials: A Randomized Controlled… PMID:42346653 | 2026 | this review only | not stated | not extracted yet |
| Zampara 2022 matched by author and year (probable) | NR | 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 question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adults (≥18 years) requiring extraction of permanent teeth and subsequent alveolar ridge preservation (third-molar-only studies excluded unless relevant to implant-site preservation) | 31 RCTs, 932 participants and 853 extraction sites in 17 countries or regions (n=31) |
| Intervention | ARP strategies with scaffold materials (xenograft, allograft, alloplast, collagen-based, tooth/dentin-derived), PRF-based adjuncts, barrier membranes, or combinations | 17 complete treatment nodes and 8 predefined components; horizontal network 12 nodes, vertical network 10 nodes (n=31) |
| Comparison | Spontaneous/blood clot healing, PRF alone, scaffold-based approaches, membrane-assisted approaches, or other ARP protocols | Natural healing/blood clot as network reference (n=31) |
| Outcomes | Primary: horizontal ridge-width change and buccal vertical ridge-height change (mm); secondary: lingual/palatal vertical height, histomorphometry, need for additional augmentation, implant placement feasibility, patient-reported outcomes, adverse events | Horizontal ridge-width change (n=16 RCTs: NMA, additive and interaction CNMA); buccal vertical ridge-height change (n=14 RCTs: NMA and additive CNMA); histomorphometric (n=16), patient-reported and safety outcomes summarized descriptively without pooling |
| Study designs | RCTs (parallel-group, split-mouth, multi-arm) | RCTs; 7 split-mouth and 5 with three or more arms (n=31) |
| Timing | Single prespecified time point closest to implant-site evaluation; 4–6-month window prespecified for sensitivity analysis | Follow-up about 8 weeks to 7 months, mostly 3–6 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 | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | Partial Yes | no |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | NRSI: N/A · RCT: Yes | NRSI: N/A · RCT: Yes | yes |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | NRSI: N/A · RCT: Yes | NRSI: N/A · RCT: Yes | yes |
| 12Impact of risk of bias on the pooled results | Yes | Yes | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Low | Moderate | no |