The effectiveness of hydroxyapatite in alveolar ridge preservation: A systematic review

Abstract

Abstract Aim: This systematic review is aimed to evaluate the clinical, radiographical, and histologic/histomorphometric outcomes of using hydroxyapatite (HA), either alone or in combination with other biomaterials in alveolar ridge preservation (ARP). The effects of particle sizes were also investigated. Materials and Methods: This study followed the requirements outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and was duly registered with the International Prospective Register of Systematic Reviews. Studies published from 2015 to 2021 were included, focusing on patients aged 18 years or older requiring tooth extraction. Various interventions and comparators were assessed, including HA alone and HA combined with organic/inorganic materials. Primary outcomes were the dimensional alveolar bone changes measured clinically and radiographically, whereas secondary outcomes included histological and histomorphometric evaluations. Results: A total of 15 studies were included, comprising case series, cohorts, and randomized controlled trials. HA, both alone and in combination, demonstrated potential in reducing alveolar bone resorption. Clinical and radiographic measurements revealed reduced horizontal and vertical ridge changes when HA was used. Histological analysis demonstrated favorable outcomes with the presence of new bone formation around residual graft particles. Conclusions: Combining HA with organic or inorganic materials showed promise in preserving alveolar ridge dimensions, with less residual graft material observed during implant placement. The use of nanoscale HA also demonstrated positive outcomes in bone regeneration. However, due to the heterogeneity of study designs, further research with larger sample sizes and uniform methodologies is needed to provide more definitive conclusions. In summary, HA, especially in combination with other materials, holds the potential for effective ARP, but standardization of approaches is essential for more reliable results in future studies.