Histomorphometric results in ridge preservation procedures comparing various graft materials in extraction sockets with nongrafted sockets in humans: a systematic review.

INTRODUCTION: The aim of this systematic review was to evaluate, from a histological point of view, the amount of newly formed bone in ridge preservation procedures using various graft materials in comparison with natural healing (NH) and to determine which is the ideal type of graft to be used. MATERIALS AND METHODS: A search strategy was developed to find articles in a human model published between 1990 and January 2013 in English language using MEDLINE database. RESULTS: Thirty-four articles were included in this systematic review. When comparing the percentage of newly formed bone using various grafting materials with NH, calcium sulfate, magnesium enriched hydroxyapatite, and porcine-derived bone grafts offered the best outcomes. However, due to the heterogeneity of the included studies, the search was extended to determine which type of graft resulted in greatest bone formation. CONCLUSION: When comparing ridge preservation with NH, only 3 studies encountered a greater amount of newly formed bone in the ridge preservation group, whereas the rest did not find statistically significant differences or even observed a greater percentage of newly formed bone in the control group. Therefore, more studies are needed to determine whether the use of graft materials enhances new bone formation in contrast to NH alone and to determine the most effective bone grafting material.