title: Alveolar ridge preservation after tooth extraction: a Bayesian Network meta-analysis of grafting materials efficacy on prevention of bone height and width reduction.
abstract: To conduct a traditional meta-analysis and a Bayesian Network meta-analysis to synthesize the information coming from randomized controlled trials on different socket grafting materials and combine the resulting indirect evidence in order to make inferences on treatments that have not been compared directly.
  
  
  
  RCTs were identified for inclusion in the systematic review and subsequent statistical analysis. Bone height and width remodelling were selected as the chosen summary measures for comparison. First, a series of pairwise meta-analyses were performed and overall mean difference (MD) in mm with 95% CI was calculated between grafted versus non-grafted sockets. Then, a Bayesian Network meta-analysis was performed to draw indirect conclusions on which grafting materials can be considered most likely the best compared to the others.
  
  
  
  From the six included studies, seven comparisons were obtained. Traditional meta-analysis showed statistically significant results in favour of grafting the socket compared to no-graft both for height (MD 1.02, 95% CI 0.44-1.59, p value < 0.001) than for width (MD 1.52 95% CI 1.18-1.86, p value <0.000001) remodelling. Bayesian Network meta-analysis allowed to obtain a rank of intervention efficacy.
  
  
  
  On the basis of the results of the present analysis, socket grafting seems to be more favourable than unassisted socket healing. Moreover, Bayesian Network meta-analysis indicates that freeze-dried bone graft plus membrane is the most likely effective in the reduction of bone height remodelling. Autologous bone marrow resulted the most likely effective when width remodelling was considered. Studies with larger samples and less risk of bias should be conducted in the future in order to further strengthen the results of this analysis.
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.|International Postgraduate Program in Oral Surgery, New York University College of Dentistry, New York, NY, USA.
authors.forename: Oreste
authors.initials: O
authors.lastname: Iocca
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Farcomeni
authors.affiliation: International Postgraduate Program in Oral Surgery, New York University College of Dentistry, New York, NY, USA.|Clínica Pardiñas, Private Practice, A Coruña, Spain.
authors.forename: Simon
authors.initials: S
authors.lastname: Pardiñas Lopez
authors.affiliation: Department of Oral and Maxillofacial Surgery, New York University College of Dentistry, New York, NY, USA.
authors.forename: Huzefa S
authors.initials: HS
authors.lastname: Talib
mesh_terms: D016301:Alveolar Bone Loss / Q000517:prevention & control*; D001499:Bayes Theorem; D018786:Bone Substitutes / Q000627:therapeutic use*; D006801:Humans; D014081:Tooth Extraction
chemical_list: D018786:Bone Substitutes
keywords: alveolar ridge preservation; bayesian; bayesian network meta-analysis; bone augmentation procedures; bone substitute materials; dental implants; meta-analysis; multiple treatment meta-analysis; oral implants; socket healing