Comparison of the efficacy of different techniques to seal the alveolus during alveolar ridge preservation: meta-regression and network meta-analysis
J Clin Periodontol
Abstract
Aim: To evaluate the efficacy of different techniques to seal the alveolus [flap advancement (FA), open healing with barrier (OHB), and open healing without barrier (OHNB)] during alveolar ridge preservation (ARP) in terms of horizontal ridge width resorption.
Methods: Randomized trials of at least two months duration comparing at least two techniques to seal the alveolus against each other or against spontaneous healing (SH) were eligible. Searches were conducted in MEDLINE via Pubmed, EMBASE, Scopus and Cochrane Central. Conventional meta-analysis, meta-regression and network meta-analysis (NMA) were conducted, with clinical and tomographic ridge width changes as outcomes. Predictive intervals (95%PI) were reported.
Results: Twenty-two studies were included, accounting for 52 study arms. Meta-regression identified that SS technique and publication year explained the observed heterogeneity. NMA showed that FA and OHB led to significantly lower ridge resorption than SH, resulting in 1.18mm (95%PI 0.21 - 2.13) and 1.10mm (95%PI 0.49 - 1.69) wider alveolar ridges, respectively. No significant difference between OHNB and SH was found (0.46mm, 95%PI -0.70 - 1.64). The treatment with the largest probability for ARP was FA (52.7%), followed by OHB (39.1%) and OHNB (8.2%).
Conclusions: FA and OHB are efficacious techniques to seal the alveolus during ARP.
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