Comparative effectiveness of autologous particulate dentin graft for alveolar ridge preservation: a network meta-analysis of randomized controlled trials

Abstract

Objectives: This network meta-analysis (NMA) rigorously assessed the regenerative potential of autologous particulate dentin graft (ADG) in the context of alveolar ridge preservation (ARP), comparatively analyzing its performance against particulate xenogeneic (XG), allogeneic (ALG), alloplastic (APG) grafts, and blood clot healing (BCH). Materials and methods: A comprehensive review was undertaken utilizing recognized databases (PubMed, the Cochrane Central Library, Embase, Web of Science, CNKI, Wanfang, and VIP database) from 2015 to 2024, registered on PROSPERO (CRD42024572610). This NMA assessed radiographic parameters of alveolar ridges, measuring coronal width, buccal height, and lingual height, and evaluated new bone formation via histomorphometric analysis. Utilizing the random effects model to assess the efficacy of treatments, while the quality of the studies was evaluated using the ROB2 and GRADE criteria. Results: 25 randomized controlled trials involving 710 patients and 830 tooth extraction sites were conducted. Both ADG and XG significantly preserved alveolar ridge volume compared to BCH. Specifically, ADG (MD = 1.67; 95% CI: 0.81, 2.54, P < 0.001) and XG (MD = 0.93; 95% CI: 0.20, 1.65, P = 0.012) demonstrated superior preservation of coronal alveolar ridge width change, with ADG showing an advantage over XG (MD = -0.75; 95% CI: -1.45, -0.05, P = 0.035). Similarly, both ADG (MD = 0.64; 95% CI: 0.21, 1.08, P = 0.004) and XG (MD = 0.68; 95% CI: 0.31, 1.04, P < 0.001) significantly maintained and buccal and lingual alveolar ridge height change compared to BCH. Conclusions: ADG effectively preserves alveolar ridge volume while demonstrating comparable new bone formation profiles with conventional bone graft substitutes.