Identification and Efficacy Ranking of Allograft and Xenograft for Extraction and Ridge Preservation Procedures

The objective of this network meta-analysis was to identify and rank different ridge preservation procedures using allograft, xenograft, or extraction only by dimensional changes in ridge width and height after tooth extraction. Electronic and hand searches of several databases were performed in September 2016 to identify randomized controlled trials on extraction and ridge preservation with 3 to 7 months of follow-up. Eight studies were included in the network meta-analysis. The total number of teeth included in these trials was 466, which were randomly assigned to treatment groups. The effect sizes of ridge width ranged from -2.01 (credibility interval [CrI]: -2.92 to -1.04) for the least efficacious treatment (extraction only) to -0.21 (CrI: -2.09 to 1.67) for the most efficacious treatment (xenograft with barrier). For height, they ranged from -0.35 (CrI: -3.82 to 3.17) for the most efficacious treatment (freeze-dried bone allograft with barrier) to -1.11 (CrI: -6.21 to 3.88) for the least efficacious treatment (extraction). No significant difference was detected between treatments nor inconsistency between the direct and indirect estimates. None of the selected interventions were statistically significant compared with any other treatment. All treatment options resulted in minimal bone loss in alveolar ridge width and height.