Preservation of the alveolar ridge in exodontia: a systematic review of the major aesthetic aspects

Abstract

Introduction: In the work of implant placement in the post-extraction of single teeth, the esthetic zone has been a topic of great interest in the last 4 decades. Significant advances are being made in tissue biology knowledge in terms of post-extraction hard and soft tissue changes, helping to better understand the etiology of these esthetic complications. Objective: The present study carried out a concise systematic review of the tooth extraction process in light of minimally invasive extraction to preserve the esthetic area. Methods: The present study followed a concise systematic review model, following the rules of systematic review – PRISMA. The search strategy was carried out in the PubMed, Embase, Ovid, Cochrane Library, Web Of Science, and Scopus databases. The quality of the studies was based on the GRADE instrument, and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 104 studies were found and, after that, 36 studies of high to medium quality. As a result, it became evident that the extraction of a tooth initiates a series of reparative processes involving hard tissue (alveolar bone) and soft tissue (periodontal), gingiva). Alveolar bone changes after tooth extraction can compromise prosthetic rehabilitation. Alveolar ridge preservation has been proposed to limit these changes and improve prosthetic and esthetic results when implants are used. Alveolar ridge preservation techniques can minimize the overall changes in residual ridge height and width six months after extraction, but the evidence is very uncertain. There is no evidence of differences in the need for additional augmentation at the time of implant placement, implant failure, esthetic outcomes, or any other clinical parameters due to a lack of long-term information or data.