Sealing materials for post-extraction site: a systematic review and network meta-analysis

Area of Science:

• Dental Implantology
• Periodontology
• Regenerative Medicine

Background:

• Alveolar bone dimensional changes after tooth extraction can compromise dental implant outcomes.
• Biomaterials are used to preserve alveolar bone dimensions and promote new bone formation.
• Evidence comparing different biomaterials for socket preservation is varied.

Purpose of the Study:

• To systematically review and network meta-analyze randomized controlled trials (RCTs) on biomaterial use for extraction socket preservation.
• To compare outcomes of socket coverage versus no coverage regarding horizontal/vertical bone changes and new bone formation.
• To identify which biomaterials offer superior outcomes for alveolar ridge preservation.

Main Methods:

• Systematic review and network meta-analysis of parallel and split-mouth RCTs (≥10 patients).
• Inclusion of studies from major databases (PubMed, Embase, Cochrane, Scopus).
• Primary outcomes: alveolar dimension preservation and new bone formation; statistical analysis using pairwise and network meta-analysis, SUCRA ranking.

Main Results:

• Twelve trials (312 sites) analyzed; socket coverage superior to no coverage.
• Autologous soft tissue grafts showed better horizontal bone preservation than resorbable membranes.
• Non-crosslinked membranes outperformed crosslinked membranes in hard tissue regeneration.

Conclusions:

• Socket coverage with biomaterials is beneficial for preserving alveolar bone dimensions.
• Non-crosslinked membranes demonstrate superior hard tissue regeneration compared to crosslinked ones.
• Further large-scale RCTs are needed to refine understanding of optimal biomaterial selection.