Clinical Outcomes of Autogenous Tooth Bone Graft for Immediate Implant Placement: A Systematic Review and Meta-Analysis

The aim of this systematic review and meta-analysis was to evaluate the clinical and radiographic outcomes of autogenous tooth bone grafts (ATBGs) used in immediate implant placement and, where direct comparative evidence was available, to compare ATBGs with xenografts in terms of marginal bone loss, peri-implant bone dimensional changes, implant stability, bone density, implant survival, complications, and esthetic outcomes. PubMed, Web of Science, and the Cochrane Library were systematically searched for clinical studies evaluating ATBG in immediate implant placement. Risk of bias was assessed according to study design using RoB 2 for randomized controlled trials, ROBINS-I for non-randomized comparative studies, and the JBI Critical Appraisal Checklist for Case Series for case series. Marginal bone loss was synthesized using a random-effects meta-analysis, whereas outcomes unsuitable for quantitative synthesis were summarized narratively. The certainty of evidence for each outcome was assessed using the GRADE approach. Seven studies involving 311 participants were included, comprising 4 randomized controlled trials, 2 non-randomized comparative studies, and one case series. Among these, 3 direct comparative studies contributed to the meta-analysis of marginal bone loss (MBL). Mean MBL was 0.22 mm lower with ATBG than with xenografts, although the between-group difference was not statistically significant (MD = −0.22 mm; 95% CI, −0.64 to 0.19; P = .29). The available evidence showed no consistent between-group differences in horizontal bone preservation, implant stability, implant survival, complication rates, or aesthetic outcomes. Bone-density findings were inconsistent, and evidence concerning vertical bone changes was limited. Within the limitations of this review, ATBG appears to be a feasible autogenous graft material for immediate implant placement, with short-term clinical outcomes broadly similar to those of xenografts. The pooled analysis showed a trend toward lower marginal bone loss with ATBG than with xenografts, although the difference was not statistically significant.