Surgical protocols for ridge preservation after tooth extraction. A systematic review. Ridge preservation with or without an osteoinductive allograft: a clinical, radiographic, micro-computed tomography, and histologic study evaluating dimensional changes and new bone formation of the alveolar ridge. Effectiveness of three different alveolar ridge preservation techniques: a pilot randomized controlled trial. Ridge Preservation for Implant Therapy: a Review of the Literature Ridge preservation using a composite bone graft and a bioabsorbable membrane with and without primary wound closure: a comparative clinical trial. The capture-mark-recapture technique can be used as a stopping rule when searching in systematic reviews. Ridge Preservation Comparing a Nonresorbable PTFE Membrane to a Resorbable Collagen Membrane: A Clinical and Histologic Study in Humans Restorations in abrasion/erosion cervical lesions: 8-year results of a triple blind randomized controlled trial. Xenograft versus extraction alone for ridge preservation after tooth removal: a clinical and histomorphometric study. Ridge Preservation Using Composite Alloplastic Materials: A Randomized Control Clinical and Histological Study in Humans. Clinical evaluation of two "packable" posterior composite resins Alveolar ridge preservation with guided bone regeneration and a synthetic bone substitute or a bovine-derived xenograft: a randomized, controlled clinical trial. Radiographic evaluation of different techniques for ridge preservation after tooth extraction: a randomized controlled clinical trial. Summarizing systematic reviews: methodological development, conduct and reporting of an umbrella review approach A systematic review of marginal soft tissue at implants subjected to immediate loading or immediate restoration. Two-year clinical comparison of a microfilled and a hybrid resin-based composite in non-carious Class V lesions. Radiographic and clinical outcomes of implants placed in ridge preserved sites: a 12-month post-loading follow-up.
OBJECTIVE This systematic review aims to evaluate the scientific evidence on the efficacy in the surgical protocol s design ed for preserving the alveolar ridge after tooth extraction and to evaluate how these techniques affect the placement of dental implants and the final implant supported restoration . MATERIAL AND METHODS A thorough search in MEDLINE - PubMed , Embase and the Cochrane Central Register of controlled trials ( CENTRAL ) was conducted up to February 2011 . R and omized clinical trials and prospect i ve cohort studies with a follow-up of at least 3 months reporting changes on both the hard and soft tissues ( height and /or width ) of the alveolar process ( mm or % ) after tooth extraction were considered for inclusion . RESULTS The screening of titles and abstract s result ed in 14 publications meeting the eligibility criteria . Data from nine of these 14 studies could be grouped in the meta-analyses . Results from the meta-analyses showed a statistically significant greater ridge reduction in bone height for control groups as compared to test groups ( weighted mean differences , WMD = -1.47 mm ; 95 % CI [ -1.982 , -0.953 ] ; P < 0.001 ; heterogeneity : I(2 ) = 13.1 % ; χ(2 ) P-value = 0.314 ) and a significant greater reduction in bone width for control groups compared to the test groups ( WMD = -1.830 mm ; 95 % CI [ -2.947 , -0.732 ] ; P = 0.001 ; heterogeneity : I(2 ) = 0 % ; χ(2 ) P-value = 0.837 ) . Subgroup analysis was based on the surgical protocol used for the socket preservation ( flapless/flapped , barrier membrane/no membrane , primary intention healing/no primary healing ) and on the measurement method utilized to evaluate morphological changes . Meta-regression analyses demonstrated a statistically significant difference favoring the flapped subgroup in terms of bone width ( meta-regression ; slope = 2.26 ; 95 % IC [ 1.01 ; 3.51 ] ; P = 0.003 ) . CONCLUSIONS The potential benefit of socket preservation therapies was demonstrated result ing in significantly less vertical and horizontal contraction of the alveolar bone crest . The scientific evidence does not provide clear guidelines in regards to the type of bio material , or surgical procedure , although a significant positive effect of the flapped surgery was observed . There are no data available to draw conclusions on the consequences of such benefits on the long-term outcomes of implant therapy BACKGROUND The aim of this r and omized , controlled clinical trial is to determine whether ridge preservation using an osteoinductive allograft ( test ) would prevent ridge resorption and promote bone maturation compared to extraction alone ( control ) . METHODS Seventeen patients ( 20 total sites ) , in need of a non-molar extraction and delayed implant placement were r and omly selected to receive either ridge preservation or extraction alone .  A cone-beam computed tomography was completed with a radiographic stent in place before extraction and 10 to 12 weeks postoperatively for dimensional and buccal plate analyses . Bone cores were taken for micro-computed tomography ( microCT ) and histologic analyses . RESULTS Resorption of the alveolar ridge occurred at all sites with no statistically significant differences found between test and control sites . A significant correlation was found between the initial buccal plate thickness and the loss of vertical ridge height . microCT and histologic analyses found a mean new bone volume of 44.9 % with microCT and 37.4 % with histology in test sites and 39 % and 35.5 % , respectively , in control sites . The residual graft volume was 2.4 % with microCT and 4.5 % with histology . CONCLUSIONS Test and control sites lost similar amounts of alveolar ridge , with the loss of buccolingual width occurring predominantly at the expense of the buccal bone . A thicker buccal plate was associated with less ridge loss in the vertical dimension . The percentage of new bone was not statistically significant between either the test or control sites , using either microCT or histologic analyses The aim of this pilot study was to obtain preliminary data regarding the effectiveness of three different alveolar ridge preservation modalities as compared with a control . Subjects in need of single-rooted tooth extraction were recruited and r and omly allocated to one of four treatment groups : group 1 (control)--collagen plug ; group 2 - -socket grafting and polytetrafluoroethylene ( PTFE ) barrier ; group 3 - -socket grafting , buccal overbuilding , and PTFE barrier ; group 4 - -socket grafting , collagen barrier , and PTFE barrier . The grafting material used in all groups was an allograft . At 16 weeks , surgical reentry was performed , and a bone core biopsy was harvested for histomorphometric analysis . A cone beam computed tomography scan was obtained at baseline and before surgical reentry . Clinical ( keratinized mucosa [ KM ] and buccolingual ridge width [ RW ] changes ) and volumetric outcomes were statistically analyzed . A total of 20 patients were recruited ( 5 patients per group ) .  KM and buccolingual RW changes were minimal during the 16-week healing period for all groups , with no statistically significant differences . Volumetric analyses revealed comparable alveolar ridge resorption values for groups 1 , 2 , and 4 ( 3 % , 7 % , and 5 % , respectively ) , while group 3 exhibited more reduction ( 16 % ) . Histomorphometric analysis revealed the presence of adequate average values of mineralized tissue ( group 1 , 46.4 % ; group 2 , 28.88 % ; group 3 , 48.81 % ; group 4 , 41.13 % ) . Based on the clinical and volumetric outcomes , none of the ridge preservation modalities was superior to the control . The combination allograft ( freeze-dried bone allograft and demineralized freeze-dried bone allograft ) employed in this study appears to be a safe and adequate bio material for intraoral grafting Healing of the extraction socket after tooth removal involves retention of the blood clot followed by a sequence of events that lead to changes in the alveolar process in a three dimensional fashion . This normal healing event results in a minimal loss of vertical height ( around 1 mm ) , but a substantial loss of width in the buccal-lingual plane ( 4 - 6 mm ) . During the first three months following extraction that loss has been shown to be significant and may result in both a hard tissue and soft tissue deformity affecting the ability to restore the site with acceptable esthetics . Procedures that reduce the resorptive process have been shown to be predictable and potentially capable of eliminating secondary surgery for site preparation when implant therapy is planned . The key element is prior planning by the dental therapist to act at the time of extraction to prevent the collapse of the ridge due to the loss of the alveolus . Several techniques have been employed as ridge preservation procedures involving the use of bone grafts , barrier membranes and biologics to provide a better restorative outcome . This review will explore the evidence behind each technique and their efficacy in accomplishing site preparation . The literature does not identify a single technique as superior to others ; however , all accepted therapeutic procedures for ridge preservation have been shown to be more effective than blood clot alone in r and omized controlled studies BACKGROUND The aim of this single-masked , r and omized controlled clinical trial is to compare hard and soft tissue changes after ridge preservation performed with ( control , RPc ) and without ( test , RPe ) primary soft tissue closure in a split-mouth design . METHODS Eleven patients completed this 6-month trial .  Extraction and ridge preservation were performed using a composite bone graft of inorganic bovine-derived hydroxyapatite matrix and cell binding peptide P-15 ( ABM/P-15 ) , demineralized freeze-dried bone allograft , and a copolymer bioabsorbable membrane .  Primary wound closure was achieved on the control sites ( RPc ) , whereas test sites ( RPe ) left the membrane exposed . Pocket probing depth on adjacent teeth , repositioning of the mucogingival junction , bone width , bone fill , and postoperative discomfort were assessed . Bone cores were obtained for histological examination . RESULTS Intragroup analyses for both groups demonstrated statistically significant mean reductions in probing depth ( RPc : 0.42 mm , P = 0.012 ; RPe : 0.25 mm , P = 0.012 ) and bone width ( RPc : 3 mm , P = 0.002 ; RPe : 3.42 mm , P < 0.001 ) . However , intergroup analysis did not find these parameters to be statistically different at 6 months . The test group showed statistically significant mean change in bone fill ( 7.21 mm ; P < 0.001 ) . Compared to the control group , the test group showed statistically significant lower mean postoperative discomfort ( RPc 4 versus RPe 2 ; P = 0.002 ) . Histomorphometric analysis showed presence of 0 % to 40 % of ABM/P-15 and 5 % to 20 % of new bone formation in both groups . Comparison of clinical variables between the two groups at 6 months revealed that the mucogingival junction was statistically significantly more coronally displaced in the control group than in the test group , with a mean of 3.83 mm versus 1.21 mm ( P = 0.002 ) . CONCLUSIONS Ridge preservation without flap advancement preserves more keratinized tissue and has less postoperative discomfort and swelling . Although ridge preservation is performed with either method , ≈27 % to 30 % of bone width is lost OBJECTIVE Research ers have no empirically based search stopping rule when looking for potentially relevant articles for inclusion in systematic review s. We tested a stopping strategy based on capture-mark-recapture ( CMR ; i.e. , the Horizon Estimate ) statistical modeling to estimate the total number of articles in the domain of clinical decision support tools for osteoporosis disease management using four large bibliographic data bases ( Medline , EMBASE , CINAHL , and EBM review s ) . STUDY DESIGN AND SETTING Retrospective evaluation of the Horizon Estimate using a systematic review of r and omized controlled trials ( RCTs ) at two levels of article screening : title and abstract ( 1,246 potentially relevant articles ) and full text ( 42 potentially relevant articles ) . RESULTS The CMR model suggests that the total number of potential articles was 1,838 for the first level of screening , and 49 for the full-text level . The four data bases provided 68 % of known articles for the first level of screening and 81 % for full-text screening . CONCLUSIONS The CMR technique can be used in systematic review s to estimate the closeness to capturing the total body of literature on a given topic . More studies are needed to objective ly determine the usefulness of Horizon Estimates as a stopping rule strategy for systematic review search ing Purpose : The primary aim of this r and omized , controlled , blinded clinical trial was to compare the effect of a resorbable collagen membrane ( CM group ) versus a nonresorbable high-density polytetrafluoroethylene membrane ( PTFE group ) on the clinical and histologic outcomes of a ridge preservation procedure . Material s and Methods : All 24 sites received an intrasocket cancellous allograft and a buccal overlay bovine derived xenograft . Results : The change in horizontal crestal ridge width was −1.4 ± 1.2 mm for the CM group , whereas the PTFE group lost −2.2 ± 1.5 mm , which was not statistically significant between groups ( P > 0.05 ) . Vertical ridge height change was −1.2 ± 1.5 for the CM group , whereas the PTFE group lost −0.5 ± 1.6 , which was not significantly different between groups ( P > 0.05 ) . The percent vital bone was similar and not significantly different between groups . Primary closure was not obtained and the exposed membrane portion over the socket opening healed with keratinized tissue . Conclusion : The choice of a resorbable versus a nonresorbable barrier membrane did not affect the clinical or the histologic outcome of ridge preservation treatment PURPOSE An equivalence r and omized controlled trial within the subject was organized to evaluate the clinical long-term success of a new 2-step etch & rinse adhesive and a new nano-filled ormocer . METHODS 50 subjects , 21 males and 29 females aged between 21 and 65 , were r and omized to receive 150 restorations , 100 with the new restorative material , 50 with the composite as control , placed in non-carious cervical lesions with the same bonding system . The main outcome measure was the cause of failure at 8 years . R and omization was number table-generated , with allocation concealment by opaque sequentially numbered sealed and stapled envelopes . Subjects , examiner , and analyst were blinded to group assignment . Two interim analyses were performed . Data were analyzed by ANOVA and Cox test ( P < 0.05 ) . RESULTS After 8 years , 40 subjects and 120 teeth were included in the analysis of the primary outcome . There were eight failures in the experimental group and four failures in the control group . The cumulative loss rate was 7 % for both restorative material s , with the annual failure lower than 1 % , without any statistically significant difference . There were two key elements of failure : the presence of sclerotic dentin and the relationship between lesion and gingival margin BACKGROUND The preservation of bone volume immediately after tooth removal might be necessary to optimize the success of implant placement in terms of esthetics and function . The objectives of this r and omized clinical trial were two-fold : 1 ) to compare the bone dimensional changes following tooth extraction with extraction plus ridge preservation using corticocancellous porcine bone and a collagen membrane ; and 2 ) to analyze and compare histologic and histomorphometric aspects of the extraction -alone sites to the grafted sites . METHODS Forty subjects who required tooth extraction and implant placement were enrolled in this study . Using a computer-generated r and omization list , the subjects were r and omly assigned to the control group ( EXT ; extraction alone ) or to the test group ( RP ; ridge-preservation procedure with corticocancellous porcine bone and collagen membrane ) . The following parameters were assessed immediately after extraction and 7 months prior to implant placement : plaque index , gingival index , bleeding on probing , horizontal ridge width , and vertical ridge changes . A bone biopsy was taken from the control and test sites 7 months after the surgical treatment . Histologic and histomorphometric analyses were also performed . RESULTS A significantly greater horizontal reabsorption was observed at EXT sites ( 4.3+/-0.8 mm ) compared to RP sites ( 2.5+/-1.2 mm ) . The ridge height reduction at the buccal side was 3.6+/-1.5 mm for the extraction -alone group , whereas it was 0.7+/-1.4 mm for the ridge-preservation group . Moreover , the vertical change at the lingual sites was 0.4 mm in the ridge-preservation group and 3 mm in the extraction -alone group . Forty biopsies were harvested from the experimental sites ( test and control sites ) . The biopsies harvested from the grafted sites revealed the presence of trabecular bone , which was highly mineralized and well structured . Particles of the grafted material could be identified in all sample s. The bone formed in the control sites was also well structured with a minor percentage of mineralized bone . The amount of connective tissue was significantly higher in the extraction -alone group than in the ridge-preservation group . CONCLUSIONS The ridge-preservation approach using porcine bone in combination with collagen membrane significantly limited the resorption of hard tissue ridge after tooth extraction compared to extraction alone . Furthermore , the histologic analysis showed a significantly higher percentage of trabecular bone and total mineralized tissue in ridge-preservation sites compared to extraction -alone sites 7 months after tooth removal AIM To evaluate ( clinical ly , histologically , and histo-morphometrically ) the use of composite material s ( Biphasic calcium sulphate [ BCS ] with β Tri-Calcium Phosphate ( β-TCP ) and Hydroxyapatite [ HA ] ) in extraction socket sites and compare it to un-disturbed natural healing . MATERIAL AND METHODS Prospect i ve clinical trial of 36 patients ( 40 extraction sockets ) were r and omly assigned to either test or control group . Alveolar ridge horizontal dimension was measured in the middle of the socket at crest and 3 and 6 mm subcrestally . Crestal vertical height was measured at baseline surgery and at 4 month re-entry , at which time bone core biopsies were harvested from the center of the edentulous ridge . Histo-morphometric evaluation of the sample s was performed using hematoxylin & eosin stains and morphometric software . RESULTS The change in horizontal ridge width was higher in the control compared to the experimental group : 2.28 ± 2.36 mm versus 0.03 ± 2.32 mm ( p = .007 ) at -3 mm and 2.28 ± 2.43 versus 0.035 ± 3.05 ( p = .02 ) at -6 mm , for the experimental and control sites , respectively . The vertical distance form bone crest to neighboring horizontal line interconnecting the neighboring teeth was minimal in both groups ( 0.307 ± 2.01 mm versus 0.14 ± 2.03 mm [ p = 0.41 ] ) . Residual scaffolds occupied 15.99 ± 11.4 % of the volume in the grafted ( test ) sites while bone area fraction was not statistically different among the groups ( 47.7 ± 10.6 % versus 52.6 ± 11.6 % , test versus control , respectively p = .39 ) . The percentage of connective tissue in the control group was significantly higher that test group ( 36.3 ± 19.4 % versus 46.7 ± 10.6 % test versus control , respectively , p = .013 ) . CONCLUSION Ridge preservation technique using a combination of two synthetic bone grafts β-TCP and HA with BCS result ed in greater stability in the horizontal dimension after 4 months Abstract .The purpose of this study was to evaluate the clinical performance of two " packable " posterior composites : Prodigy Condensable ( P ) ( Kerr ) and Definite ( D ) ( Degussa ) .  Thirty-six patients participated in the study . A total of 78 restorations were made , 40 with D and 38 with  P.  Each patient received at least two restorations  , one of each studied material . The material s were h and led according to the manufacturer 's instructions . The restorations were finished and polished after 1 week . They were evaluated at baseline and after 1 year by two independent evaluators using the United States Public Health Service ( USPHS ) criteria . Colored slides were made of all the restorations . After 1 year , 35 patients and 76 restorations ( 39 with D and 37 with P ) were available for evaluation . All restorations received A criteria except the following ones , which received B criteria : color P ( one restoration ) and D ( one restoration ) , marginal staining P ( three restorations ) and D ( two restorations ) , surface staining P ( nine restorations ) and D ( three restorations ) , anatomic form P ( one restoration ) and D ( three restorations ) , and marginal adaptation P ( one restoration ) and D ( eight restorations ) . The obtained data were tabulated and statistically analyzed using the Fisher and McNemar tests . After 1 year , P showed a significant increase in superficial staining . For D , the marginal adaptation became significantly worse than baseline and P. The studied material s can be considered acceptable during this evaluation period . Further evaluations are necessary for a better clinical performance analysis OBJECTIVES The aim of this r and omized , controlled clinical trial was to compare the potential of a synthetic bone substitute or a bovine-derived xenograft combined with a collagen membrane to preserve the alveolar ridge dimensions following tooth extraction . METHODS Twenty-seven patients were r and omized into two treatment groups following single tooth extraction in the incisor , canine and premolar area . In the test group , the alveolar socket was grafted with Straumann Bone Ceramic ( SBC ) , while in the control group , Bio-Oss deproteinized bovine bone mineral ( DBBM ) was applied . In both groups , a collagen barrier was used to cover the grafting material . Complete soft tissue coverage of the barriers was not achieved . After 8 months , during re-entry procedures and before implant placement , the horizontal and vertical dimensions of the residual ridge were re-evaluated and trephine biopsies were performed for histological analysis in all patients . RESULTS Twenty-six patients completed the study . The bucco-lingual dimension of the alveolar ridge decreased by 1.1+/-1 mm in the SBC group and by 2.1+/-1 in the DBBM group ( P<0.05 ) . Both material s preserved the mesio-distal bone height of the ridge . No differences in the width of buccal and palatal bone plate were observed between the two groups . The histological analysis showed new bone formation in the apical part of the biopsies , which , in some instances , was in direct contact with both SBC and DBBM particles . The coronal part of the biopsies was occupied by a dense fibrous connective tissue surrounding the SBC and DBBM particles . CONCLUSION Both bio material s partially preserved the width and the interproximal bone height of the alveolar ridge OBJECTIVE To evaluate the radiographic changes of the  alveolar ridge following application of different ridge preservation techniques  6 months after tooth extraction . MATERIAL S AND METHODS Four treatment modalities were r and omly assigned in 40 patients : β-tricalcium-phosphate-particles with polylactid coating ( β-TCP ) , demineralized bovine bone mineral with 10 % collagen covered with a collagen matrix ( DBBM-C/CM ) , DBBM-C covered with an autogenous soft-tissue graft ( DBBM-C/PG ) and spontaneous healing ( control ) . Cone-beam computed tomography scans were performed after treatment and 6 months later . RESULTS After 6 months , the vertical changes ranged between -0.6 mm ( -10.2 % ) for control and a gain of 0.3 mm ( 5.6 % ) for DBBM-C/PG on the lingual side , and between -2.0 mm ( -20.9 % ) for β-TCP and a gain of 1.2 mm ( 8.1 % ) for DBBM-C/PG on the buccal side . The most accentuated ridge width changes were recorded 1 mm below the crest : -3.3 mm ( -43.3 % , C ) , -6.1 mm ( -77.5 % , β-TCP ) , -1.2 mm ( -17.4 % , DBBM-C/CM ) and -1.4 mm ( -18.1 % , DBBM-C/PG ) . At all three levels , DBBM-C with either CM or PG was not significantly differing ( p > 0.05 ) , while most other differences between the groups reached statistical significance ( p < 0.05 ) . CONCLUSIONS Application of DBBM-C , covered with CM or PG , result ed in less vertical and horizontal changes of the alveolar ridge as compared with controls 6 months after extraction Aims : With the increase in the number of systematic review s available , a logical next step to provide decision makers in healthcare with the evidence they require has been the conduct of review s of existing systematic review s. Syntheses of existing systematic review s are referred to by many different names , one of which is an umbrella review . An umbrella review allows the findings of review s relevant to a review question to be compared and contrasted . An umbrella review 's most characteristic feature is that this type of evidence synthesis only considers for inclusion the highest level of evidence , namely other systematic review s and meta-analyses . A methodology working group was formed by the Joanna Briggs Institute to develop method ological guidance for the conduct of an umbrella review , including diverse types of evidence , both quantitative and qualitative . The aim of this study is to describe the development and guidance for the conduct of an umbrella review . Methods : Discussion and testing of the elements of methods for the conduct of an umbrella review were held over a 6-month period by members of a methodology working group . The working group comprised six participants who corresponded via teleconference , e-mail and face-to-face meeting during this development period . In October 2013 , the methodology was presented in a workshop at the Joanna Briggs Institute Convention . Workshop participants , review authors and method ologists provided further testing , critique and feedback on the proposed methodology . Results : This study describes the methodology and methods developed for the conduct of an umbrella review that includes published systematic review s and meta-analyses as the analytical unit of the review . Details are provided regarding the essential elements of an umbrella review , including presentation of the review question in a Population , Intervention , Comparator , Outcome format , nuances of the inclusion criteria and search strategy . A critical appraisal tool with 10 questions to help assess risk of bias in systematic review s and meta-analyses was also developed and tested . Relevant details to extract from included review s and how to best present the findings of both quantitative and qualitative systematic review s in a reader friendly format are provided . Conclusions : Umbrella review s provide a ready means for decision makers in healthcare to gain a clear underst and ing of a broad topic area . The umbrella review methodology described here is the first to consider review s that report other than quantitative evidence derived from r and omized controlled trials . The methodology includes an easy to use and informative summary of evidence table to readily provide decision makers with the available , highest level of evidence relevant to the question posed OBJECTIVES The objective of this systematic review was to critically evaluate marginal soft-tissue aspects at implants subjected to immediate loading or immediate restoration . METHODS An electronic Medline search from 1966 up to August 2005 was conducted to identify prospect i ve and retrospective studies on immediate implant loading . The search strategy was complemented by h and search ing in peer- review ed journals . Studies reporting on soft-tissue aspects at implants subjected to immediate loading or immediate restoration and with a follow-up time of at least 1 year were included . Assessment of identified studies and data extraction was performed independently by two review ers . An attempt was made to isolate and categorize studies with similar protocol s in order to identify trends and relevant factors . Variables that were considered included marginal and interproximal soft-tissue stability , marginal plaque accumulation , probing depth , bleeding on probing , peri-implant mucositis and peri-implantitis . RESULTS From an initial yield of 581 titles , 240 articles were selected for text analysis , finally result ing in 17 studies that met the inclusion criteria . Six studies on immediate implant loading or restoration were controlled studies , whereas the remainder was prospect i ve case series . Seven studies reported on a 1-year data , and the longest follow-up within the included studies was 4 years . The total number of patients treated within the 17 studies was 432 including a total 706 implants studied . Overall , the articles reported on many different procedures and follow-up times , time points and evaluated soft-tissue parameters varied considerably between the different articles . CONCLUSION Within the limits of the evaluated data it can be cautiously concluded that once immediately loaded or restored implants integrate successfully , they appear to show a soft-tissue reaction with regard to periodontal as well as morphologic aspects comparable with those of conventionally loaded implants . However , follow-up periods are generally short , number of patients and /or implants per study are few , and most studies present only limited data on peri-implant soft-tissue evaluation . More accurate long-term studies with a stronger study design ( i.e. , RCT ) reporting more detailed on treatment and follow-up protocol s are required to allow for proper comparisons and conclusions The purpose of this double-blind clinical trial was to compare the retention rate in noncarious Class V lesions of two resin-based composite restorative material s with contrasting stiffness . Isolation with retraction cord , pressed paper triangles , and cotton rolls was used to closely mimic the procedures generally used in a practice setting . Thirty pairs of restorations were placed , one using Silux Plus and one using Z100 . The assignment of material was r and omized , and the subjects were unaware of the material used . All restorations were placed with a fourth-generation adhesive liner , Scotchbond Multi- Purpose . Evaluations were performed at baseline , 6 , 12 , 18 , and 24 months by two independent examiners using criteria developed by Cvar and Ryge in a forced consensus model . Examiners were unaware of the restoration 's group identity . No difference between the retention rates for the two groups was found after 24 months , bringing into question the role that a material 's stiffness plays in determining retention in a noncarious Class V lesion OBJECTIVE The aim of this clinical study was to evaluate the interproximal radiographic bone levels and the survival/success rate of  dental implants  placed in alveolar ridges previously preserved with a synthetic bone substitute or a bovine xenograft . MATERIAL AND METHODS Alveolar ridge preservation was performed in 27 patients who were r and omly assigned in two groups . In the test group ( n = 14 ) , the extraction socket was treated with a synthetic bone graft Straumann Bone Ceramic ; SBC and a collagen barrier , whereas in the control group ( n = 13 ) a deproteinized bovine bone mineral ( DBBM ) and the same collagen barrier were used . After 8 months of healing , titanium dental implants with a hydrophilic surface were placed in the preserved ridges . During surgery , 9/13 implants in the SBC group and 8/12 implants in the DBBM group presented with either dehiscence or fenestration defects and required additional bone augmentation . The implants were loaded at 4 months following placement and were followed up for 1 year post-loading . Interproximal radiographic bone levels were evaluated in st and ardized periapical radiographs at loading and 1 year post-loading . Probing pocket depth , gingival recession and bleeding upon probing were recorded at implants and neighbouring teeth . The success rate of the implants was evaluated according to criteria set by Albrektsson et al. ( 1986 ) . RESULTS The survival rate of the implants in both groups was 100 % at 1-year post-loading . No statistically significant differences in any of the clinical and radiographic measurements were detected between the two groups ( P < 0.05 ) . The success rate of the implants was 84.6 % ( 11/13 ) in the SBC group and 83.3 % ( 10/12 ) in the DBBM group . CONCLUSION Equivalent success and survival rates ( as well as similar radiographic changes ) of dental implants placed in alveolar ridges previously preserved with SBC or DBBM should be anticipated
The use of DBB/CF reduced the magnitude of vertical bone resorption , yet the study showed high risk of bias .
Implication s of Key Findings Within the limitations of this systematic review , L-PRF reduced the magnitude of vertical and horizontal bone resorption , which places L-PRF as a potential material of choice for ridge preservation procedures .
Conclusions Within the limitations and weaknesses of both studies , the use of DBB/CF prevented the vertical crestal bone resorption while the L-PRF prevented both the horizontal and vertical crestal bone resorption .
Background The purpose of this systematic review was to accurately assess the procedural success of  ridge preservation technique  through the application of strict inclusion and exclusion criteria .