Efficacy of autogenous tooth block for lateral ridge augmentation compared with autogenous bone block: A systematic review and meta-analysis.

Abstract

Autogenous tooth block (ATB) has been used as an alternative material for bone regeneration, but its efficacy compared with autogenous bone block (ABB) remains uncertain. The aim of this systematic review was to investigate and compare the clinical and histological performance of ATB and ABB grafts in lateral alveolar ridge augmentation (LARA). Electronic retrieval of MEDLINE, Embase, Cochrane Library (CENTRAL), Scopus, Web of Science, China national knowledge infrastructure, Wanfang data, SinoMed, and manual searching until July 2023 were used to identify controlled clinical trials employing ATB grafts in LARA. The identified reports included at least one of the following outcome variables: ridge width gain, graft resorption, postoperative complications, histology, and histomorphometry. Weighted or mean differences (MD), relative risk, and corresponding 95% confidence intervals (CI) were calculated. Descriptive analysis was applied to the qualitative statistics. The protocol followed the preferred reporting items for systematic reviews and meta-analyses statement and was prospectively registered in PROSPERO (CRD42023399611). Four controlled clinical trials with 77 participants each using ATB and ABB grafts were included. Meta-analysis indicated that ATB grafts resulted in greater bone width (MD = 1.31, 95% CI [0.92, 1.71], P < .00001) and less graft resorption (MD = -0.71, 95% CI [-1.22, -0.21], P = .005) than ABB grafts on LARA. There was no statistical difference in postoperative complications between ATB and ABB grafts (relative risk = 0.81, 95% CI [0.32, 2.04], P = .66). Furthermore, the ATB grafts exhibited positive replacement resorption with alveolar bone for favorable signs of new bone activity on histology and histomorphometry. Within the limitations of this study, ATB grafts could serve as an alternative material for ABB to support LARA. Further research with a longer follow-up period is required to verify these findings.