title: Bone healing after tooth extraction with or without an intervention: a systematic review of randomized controlled trials.
abstract: OBJECTIVE
  To assess whether the use of a graft and/or membrane post-tooth extraction improves healing of the site dimensionally, radiographically, and/or histologically.
  
  
  METHODS
  MEDLINE and EMBASE and the Cochrane Central register of controlled trials (CENTRAL) were searched up until August 2011. Randomized controlled trials that included and compared healing post-tooth extraction between a control (no intervention) and a graft and/or membrane (test) were selected.
  
  
  RESULTS
  Titles and abstracts of 2,861 papers were screened. A total of 42 papers were selected for full text reading. Nine papers met the eligibility criteria and were selected for further analysis. Because of the varying graft materials used and the different methods of investigation, as well as the variation in follow-up times, a meta-analysis was not possible. The present review found that clinically, there was a range in loss of width in the control sites of 2.46 mm (SD 0.4 mm) to 4.56 mm (SD 0.33 mm) compared to 1.14 mm (SD 0.87 mm) to 2.5 mm (SD 1.2 mm) in the test sites. The range in loss of height in control sites was 0.9 mm (SD 1.6 mm) to 3.6 mm (SD 1.5 mm) compared to a gain of 1.3 mm (SD 2 mm) to a loss of 0.62 mm (SD 0.51 mm) in test sites. Radiographically a range of change in bone height of between 0.51 mm (No SD) to 1.17 mm (SD 1.23 mm) was noted in control sites compared to a change of between 0.02 mm (SD 1.2 mm) and 1 mm (SD 1.4 mm) in test sites.
  
  
  CONCLUSIONS
  There is limited data regarding the effectiveness of alveolar ridge preservation therapies when compared to the control. Overall the socket intervention therapies did reduce alveolar ridge dimensional changes post-extraction, but were unable to prevent resorption. Histology did demonstrate a large proportion of residual graft material that may account for some of the difference in alveolar ridge dimensions at follow up.
authors.affiliation: Postgraduate student, Department of Restorative Dentistry, Kings' College London Dental Institute, Floor 25 Tower Wing, Guy's Hospital Campus, London, UK Senior lecturer, Department of Restorative Dentistry, Kings' College London Dental Institute, Floor 25 Tower Wing, Guy's Hospital Campus, London, UK Professor of Implant Dentistry and Periodontology, Department of Restorative Dentistry, Kings' College London Dental Institute, Floor 25 Tower Wing, Guy's Hospital Campus, London, UK.
authors.forename: Kushel R
authors.initials: KR
authors.lastname: Morjaria
authors.forename: Ron
authors.initials: R
authors.lastname: Wilson
authors.forename: Richard M
authors.initials: RM
authors.lastname: Palmer
mesh_terms: D000539:Alveolar Process / Q000601:surgery*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D014081:Tooth Extraction; D014945:Wound Healing