Aim The aim of the current systematic review was to critically appraise evidence from randomized and prospective non‐randomized comparative clinical trials about the efficacy of lateral bone augmentation prior to implant placement and their outcome regarding bone width gain. Materials and Methods Eight databases were searched until May 2018 for randomized and prospective non‐randomized comparative trials on lateral bone augmentation prior to implant placement. After elimination of duplicate studies, data extraction and risk‐of‐bias assessment according to the Cochrane guidelines, random‐effects meta‐analyses of mean differences (MD) or relative risks (RR) and their 95% CIs were performed, followed by subgroup, meta‐regression and sensitivity analyses. Results Overall, 25 trials (16 randomized/9 non‐randomized) were identified, which included a total of 553 patients (42.2% male; mean age of 43.9 years). In these included studies and populations, various modalities for primary lateral bone augmentation rendered implant placement feasible. Small discrepancies were found between overall clinical and radiographic gain (pooled gains of 3.45 ± 1.18 mm versus 2.90 ± 0.83 mm, respectively), but were not statistically significant. Bone width gain was significantly inversely associated with baseline bone width (pooled effect: −0.35 mm/mm; 95% CI: −0.63 to −0.07 mm; p = 0.01). Additionally, % graft resorption was associated with patient age (36%/year, 95% CI: −0.62 to −0.11 mm; p = 0.01). The presence of xenograft added to autologous graft led to less resorption compared to autologous graft alone (MD: 1.06 mm; 95% CI: 0.21 to 1.92 mm; p = 0.01). Barrier membrane did not yield significant difference in terms of bone width gain (MD: −0.33 mm; 95% CI: −2.24 to 1.58 mm; p > 0.05) and graft resorption (MD: 0.84 mm; 95% CI: −1.42 to 3.09 mm; p > 0.05). However, the quality of evidence ranged from very low to moderate due to bias and imprecision. Conclusions Initially smaller bone dimensions are associated with favours larger bone width gain, which indicates that a severe lateral bone deficiency can be effectively augmented applying primary lateral bone augmentation. Both Patients’ age and recipient site (maxilla or mandible) seem to influence graft resorption. The addition of a xenograft can be helpful in reducing graft resorption. Existing evidence from randomized and prospective non‐randomized trials on humans indicates that lateral bone augmentation prior to implant placement can successfully increase bone width. There are some indications that patient‐related, site‐related, and technique‐related characteristics might influence the amount of gained bone width, but the quality of evidence is for the most part hampered by the small number of existing studies and methodological limitations that might lead to bias.

Aim To determine the effect of alveolar ridge preservation (ARP) in molar sites without primary flap closure. Materials and Methods Three groups were established: extraction sockets grafted with deproteinized bovine bone mineral containing 10% collagen (DBBM‐C) and covered by a native bilayer collagen membrane (NBCM) (test group 1), sockets grafted with DBBM‐C only (test group 2), and sockets that healed naturally (control group). Primary flap closure was not attempted. Conebeam computed tomography scans were obtained immediately and then 4 months after ARP. A biopsy was performed. The change of the marginal bone level was measured. Results There was significantly less horizontal resorption in test group 1 than in the control group at levels 1 mm (−1.02 ± 0.88 [mean ± SD] vs. −4.44 ± 3.71 mm) and 3 mm (−0.31 ± 1.51 vs. −2.27 ± 1.15 mm) below the crest, and significantly less vertical reduction in the midcrestal area in test group 1 than in test group 2 (−0.25 ± 0.95 vs. −1.15 ± 1.63 mm) (p < .05). There were no significant differences between test groups in clinical and histomorphometric measurements. All groups exhibited stable marginal bone levels after 1 year of loading. Conclusion Alveolar ridge preservation without primary flap closure in molar areas was effective in minimizing ridge resorption and facilitated implant treatment.

Aim To compare late implant placement following alveolar ridge preservation (LP/ARP) and early implantation (EP) in periodontally compromised non‐molar extraction sites with respect to soft tissue levels, aesthetics, and patient‐reported outcomes. Materials and methods Sixteen patients were randomly allocated to groups LP/ARP (n = 9) or EP (n = 7). Group LP/ARP received ARP using deproteinized bovine bone mineral containing 10% collagen and a native bilayer collagen membrane, and group EP received only extraction. Implant placement was performed 4–8 weeks post‐extraction in group EP and 4 months post‐alveolar ridge preservation in group LP/ARP. The soft tissue levels, pink/white esthetic scores, and periodontal parameters were evaluated at 1 year post‐loading. Patient's discomfort level was evaluated in terms of extraction/ARP and implant placement. Results No implant failure or biologic complications occurred. There was no statistically significant difference in the median change of the midfacial mucosal margin (0.03 for group LP/ARP, −0.19 mm for group EP) and the mesial/distal papilla (0.62/0.25 mm for group LP/ARP, 0.29/−0.5 mm for group EP), pink/white esthetic scores, periodontal parameters, and patient's discomfort between the two groups. Conclusion Both implant placement protocols led to comparable outcomes in soft tissue levels, periodontal parameters, and patient's discomfort level.

Objectives To compare two ridge preservation techniques and spontaneous healing in terms of soft tissue thickness, contour changes, and soft tissue handling two months after tooth extraction. Methods Thirty‐six patients were included with buccal bone plate dehiscences of up to 50% after single‐tooth extraction in the esthetic zone. They were randomly assigned to receive one of three procedures: a deproteinized bovine bone mineral with 10% collagen (DBBM‐C) covered with a collagen matrix (DBBM‐C/CM), DBBM‐C alone, or spontaneous healing (SH). Two months later, the status of soft tissue healing was assessed, and the thickness of the mucosa was measured at the center of the site. Thereafter, implants were placed and the need for further guided bone regeneration (GBR) to cover exposed implant surfaces was assessed. Results Thirty‐six patients were evaluated at the day of implant placement. An invagination of the soft tissues was recorded in 41.7% (n = 12), 53.8% (n = 13), and 90.9% (n = 11) of the sites in groups DBBM‐C/CM, DBBM‐C, and SH, respectively. The median thickness of the mucosa measured was 3.0 mm in group DBBM‐C/CM, 2.1 mm in group DBBM‐C, and 1.5 mm in group SH. Additional GBR was necessary in 66.7% (n = 12), 53.8% (n = 13), and 90.9% (n = 11) of the sites in groups DBBM‐C/CM, DBBM‐C, and SH, respectively. Conclusions The present explorative study revealed slight tendencies for more favorable soft tissue conditions with less invaginations as well as increased soft tissue volume and thickness in groups having received an alveolar ridge preservation procedure compared to spontaneously healed sites at 8 weeks of healing.