Bone expansion as a horizontal alveolar ridge augmentation technique: a systematic review and meta-analysis

Bone expansion is one of the quickest, simplest, and most reliable methods of alveolar ridge augmentation for implant placement. This systematic review is designed to investigate the outcomes of the bone expansion technique for horizontal ridge augmentation.

The protocol of study has been prospectively registered into PROSPERO (CRD42023414686). Pubmed, Embase, Web of Science, and Scopus databases were searched. Human original articles utilizing different bone expansion procedures for horizontal ridge augmentation without the use of bone materials or combined with vertical ridge augmentation techniques were included in the study. Qualitative and quantitative synthesis have been conducted. I-squared was used to assess heterogeneity. Meta-regression, forest plots random-effect model, and weighted mean difference were used for analysis. Leave-one-out influence analysis for finding outliers. Egger's publication bias test and Funnel plots were used to address publication bias.

3291 records were identified. Ten articles were included in this study after screening. The survival and complication rates of implants placed simultaneously with bone expansion was 100% 100% (95% CI: 99-100%) and 0% (95% CI: 0-1%), respectively. The meta-regression revealed that by each month passing from the implant placement the survival probability would be decreased significantly by 0.08% (95% CI: 0.009-0.15%; P = 0.03). The weighted mean ridge width difference before and after the osseodensification was 1.55 mm (95% CI: 0.92-2.17 mm).

Based on the study's limitations it can be concluded that the bone expansion procedure can be considered an efficient and safe method regarding the survival and complication rates of placed implants.

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