Ridge Preservation Reduced Early Bone Loss, but Review Found Low Certainty

Edited by Dentaltown staff

Grafting an extraction socket preserved roughly 1.4 mm more ridge width than letting the site heal on its own, but the certainty of that evidence was low and the benefit may not hold in every clinical setting, according to a systematic review and meta-analysis published Sept. 24 in Oral and Maxillofacial Surgery.

Investigators screened 1,739 records from an initial 1,864, assessed 62 in full text, and identified 28 direct comparison reports. Twenty randomized studies contributed to the quantitative analysis, and eight reports were narrative only.

Alveolar ridge preservation was associated with 1.37 mm less horizontal ridge-width loss across 18 comparisons, with a 95% confidence interval of 1.80 mm to 0.94 mm. Buccal and facial vertical loss was 1.18 mm lower across 13 comparisons.

Both pooled estimates carried substantial heterogeneity, at 75.9% and 74.3%. The prediction intervals for both outcomes crossed zero, indicating that in some settings ridge preservation may produce no dimensional advantage. Certainty was rated low for both outcomes under GRADE.

An exploratory analysis combining broader vertical and buccal measurements across 16 comparisons also favored ridge preservation, at 1.26 mm, with very low certainty.

The authors concluded that ridge preservation may reduce early dimensional loss but that the evidence does not establish universal indications, superiority of any particular intervention, or long-term implant, aesthetic, or patient-reported benefit.

Researchers at Istanbul University-Cerrahpa?a and Bahçesehir University conducted the review, which was registered with PROSPERO. Searches of PubMed, Scopus, Web of Science, Embase, and ClinicalTrials.gov were run June 24, with supplementary verification through CENTRAL on July 1. Randomized comparisons were pooled using restricted maximum likelihood random-effects models with Hartung-Knapp inference, and risk of bias was assessed with RoB 2.

The review had two authors, and while both independently selected reports, data extraction was performed by one reviewer and verified by the second rather than conducted in duplicate. The pooled estimates describe early dimensional change and do not extend to later outcomes.

Sources:
Oral and Maxillofacial Surgery, “Alveolar ridge preservation versus unassisted socket healing following tooth extraction: a systematic review of controlled clinical studies and meta-analysis of randomised trials,” published Sept. 24, 2026: doi.org/10.1007/s10006-026-01642-5
PubMed record, PMID 42778696: pubmed.ncbi.nlm.nih.gov/42778696