ARP vs GBR: no single technique wins across all defects

Alveolar bone loss after tooth extraction is one of the persistent obstacles in implant dentistry, prompting the development of alveolar ridge preservation (ARP) and guided bone regeneration (GBR) techniques using graft materials and barrier membranes. This systematic review set out to critically compare the two approaches across membrane type, graft material, surgical timing, and soft tissue management.

The authors selected fourteen high-quality randomized controlled trials, extracting data on vertical and horizontal bone gain, implant survival, soft tissue stability, postoperative complications, and patient-reported satisfaction.

Modern resorbable membranes performed comparably to nonresorbable membranes in terms of bone regeneration, while causing less surgical invasiveness. Titanium mesh produced superior bone gain in complex defects, but at the cost of a higher complication rate. Earlier intervention timing tended to improve outcomes, and the choice of graft material influenced both osteogenic potential and structural stability of the regenerated site.

Clinical relevance: no single technique combination emerged as universally superior — the review's central message is that the choice between resorbable membranes, titanium mesh, and graft materials should be tailored to defect morphology and patient-specific factors rather than applied as a default protocol. The authors also flag an important limitation for practice: the included trials had small sample sizes, short follow-up, and generally excluded patients with systemic comorbidities — exactly the population where regenerative decisions are often most consequential — so extrapolating these results to medically complex patients should be done cautiously.