Surgical Techniques for Alveolar Socket Preservation: A Systematic Review

Purpose: To evaluate, through a systematic review of the literature, the efficacy of different surgical techniques in maintaining residual bone in the alveolar process following tooth extractions. Materials and Methods: MEDLINE/PubMed was searched through January 2010 and papers were selected according to the CONSORT statement and an independent three-stage screening process. The selected outcome variables were clinical width and height changes of the socket, and means and standard deviations were calculated from the included studies. For those studies that were randomized controlled trials, six meta-analyses were performed by dividing studies into three groups with regard to the use of barriers and grafting (barriers alone, graft alone, or both). Results: Thirteen papers met the eligibility criteria and were included in the analyses. Statistically significant ridge preservation was found for studies that used barriers alone; the pooled weighted mean was 0.909 mm (95% confidence interval, 0.497554 to 1.320732 mm) for bone height, while the mean for bone width was 2.966 mm (95% confidence interval, 2.334770 to 3.598300 mm). Conclusions: Socket preservation procedures are effective in limiting horizontal and vertical ridge alterations in postextraction sites. The meta-analysis indicates that the use of barrier membranes alone might improve normal wound healing in extraction sites.