Aim: To evaluate the efficacy of different techniques to seal the alveolus (flap advancement [FA], open healing with barrier [OHB], and open healing without barrier [OHNB]) during alveolar ridge preservation (ARP) in terms of horizontal ridge width resorption. Materials and Methods: Randomized trials of at least 2 months duration comparing at least two techniques to seal the alveolus against each other or against spontaneous healing (SH) were eligible. Searches were conducted in MEDLINE via PubMed, EMBASE, Scopus, and Cochrane Central. Conventional meta-analysis, meta-regression, and network meta-analysis (NMA) were conducted, with clinical and tomographic ridge width changes as outcomes. Predictive intervals (95% PI) were reported.Results: Twenty-two studies were included, accounting for 52 study arms. Meta-regression identified that the socket sealing technique and publication year explained the observed heterogeneity. NMA showed that FA and OHB led to significantly lower ridge resorption than SH, resulting in 1.18 mm (95% PI 0.21-2.13) and 1.10 mm (95% PI 0.49-1.69) wide alveolar ridges, respectively. No significant difference between OHNB and SH was found (0.46 mm, 95% PI -0.70 to 1.64). The treatment with the largest probability for ARP was FA (52.7%), followed by OHB (39.1%) and OHNB (8.2%).Conclusions: FA and OHB are efficacious techniques to seal the alveolus during ARP.

Tooth loss has a negative impact on individuals' life and well-being (Emami et al. 2013). Globally, total tooth loss is estimated to affect 267 million individuals and account for 7.3 million years lived with disability (Collaborators et al. 2020). Although estimates of severe tooth loss generally have decreased (Kassebaum et al. 2014), population-based studies still demonstrate high number of lost teeth over time in various countries (Dye et al. 2019; Muller et al. 2007). Caries and periodontitis are recognized as the main causes for tooth loss, but other factors have also been associated with its occurrence

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