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Alveolar ridge preservation after tooth extraction: a Bayesian Network meta‐analysis of grafting materials efficacy on prevention of bone height and width reduction
Author(s) -
Iocca Oreste,
Farcomeni Alessio,
Pardiñas Lopez Simon,
Talib Huzefa S.
Publication year - 2017
Publication title -
journal of clinical periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.456
H-Index - 151
eISSN - 1600-051X
pISSN - 0303-6979
DOI - 10.1111/jcpe.12633
Subject(s) - meta analysis , medicine , bone grafting , dentistry , bone remodeling , grafting , reduction (mathematics) , dental alveolus , randomized controlled trial , strictly standardized mean difference , orthodontics , mathematics , materials science , geometry , composite material , polymer
Aims 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. Materials and Methods RCT s 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. Results 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 <0.1) remodelling. Bayesian Network meta‐analysis allowed to obtain a rank of intervention efficacy. Conclusions 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.