Bone Substitutes Graft for Regeneration of the Anterior Maxillary Alveolar Process: A Systematic Review
The objective of this systematic review was to identify the available scientific evidence on bone substitutes (BSs) compared with autogenous bone grafts (ABGs) for regeneration of horizontal bone resorption in the anterior maxillary alveolar process, aiming at rehabilitation with endosseous implants. This review was performed according to the PRISMA guidelines (2020) and registered in the database PROSPERO (CRD: 42017070574). The databases searched were PUBMED/MEDLINE, EMBASE, SCOPUS, SCIENCE DIRECT, WEB OF SCIENCE, and CENTRAL COCHRANE, in the English language. The Australian National Health and Medical Research Council (NHMRC) and Cochrane Risk of Bias Tool were used to assess the study's quality and risk of bias. A total of 524 papers were found. After the selection process, 6 studies were selected for review. A total of 182 patients were followed for a period of 6 to 48 months. The mean age of patients was 46.46 years, and 152 implants were installed in the anterior region. Two studies achieved a reduced graft and implant failure rate, whereas the remaining 4 studies had no losses. It may be concluded that the use of ABGs and some BSs is a viable alternative for the rehabilitation with implants in individuals with anterior horizontal bone loss. However, additional randomized controlled trials are warranted due to the limited number of papers.

Flowchart describing the search and selection strategies.

Evaluation of risks of bias in the included studies based on the Cochrane Risk of Bias Tools.

Meta-analysis for the outcome graft failure: biomaterial vs autogenous bone.

Meta-analysis for the outcome complications in graft groups: biomaterial vs autogenous bone.

Meta-analysis for the outcome implant failure in the graft groups: biomaterial vs autogenous bone.

Meta-analysis for the outcome clinical gain for the graft groups: biomaterial vs autogenous bone. Final period: 6 months.

Meta-analysis for the outcome clinical gain in the graft groups: biomaterial vs autogenous bone. Initial time.

Meta-analysis of the comparison of the initial and final periods of the autogenous bone grafts and of the initial and final periods of the biomaterials.
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