Preserving alveolar ridge after tooth extraction to promote tissue aesthetics and dental implants: a systematic review

Abstract

Introduction: In dental extractions, the preservation of bone and dental sockets should be the preferred option in patient treatment. In this regard, the width and height of the alveolar ridge after extraction can decrease by 3.87 mm and 1.67 mm, respectively, after three months, and by 63% and 22% after six months. Therefore, alveolar ridge preservation procedures have been introduced to prevent alveolar ridge atrophy and preserve sufficient bone dimensions to allow for the placement of implants. Objective: The aim was to address the primary clinical considerations for preserving dental sockets after tooth extraction, thereby promoting tissue aesthetics and facilitating the successful placement of dental implants. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from July to August 2025 in the Scopus, Embase, PubMed, Science Direct, Scielo, and Google Scholar 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 125 articles were found, and 30 articles were evaluated in full and 15 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 21 studies with a high risk of bias and 24 studies that did not meet GRADE and AMSTAR-2. According to the GRADE instrument, most studies presented homogeneity in their results, with X2=87.8%>50%. It was concluded that preserving bone volume after tooth extraction is a challenge in implant rehabilitation, aiming for functional and aesthetic results. An extraction socket filled with xenograft resulted in better preservation of alveolar bone dimensions, less ridge resorption, and provided better healing of both soft and hard tissues, yielding more satisfactory results. Furthermore, the use of photobiomodulation appeared to improve alveolar bone healing after tooth extraction and implant stability in cases of immediate extraction and implantation