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Background Many studies have addressed socket preservation, though fewer publications considering buccal wall loss can be found, since the literature typically considers sockets with four walls. A systematic review was made on the influence of type II buccal bone defects, according to Elian’s Classification, in socket grafting materials upon volumetric changes in width and height. Material and Methods An electronic and manual literature search was conducted in accordance to PRISMA statement. The search strategy was restricted to randomized controlled trials (RCTs) and controlled clinical trials (CCTs) describing post-extraction sockets with loss of buccal wall in which alveolar ridge preservation (ARP) was carried out in the test group and spontaneous healing of the socket (SH) was considered in the control group. Results The search strategy yielded 7 studies. The meta-analysis showed an additional bone loss of 2.37 mm in width ( p > 0.001) and of 1.10 mm in height ( p > 0.001) in the absence of ARP. The reconstruction of the vestibular wall was not evaluated in any study. The results also showed moderate to great heterogeneity among the included studies in terms of the changes in width and height. Conclusions Despite the heterogeneity of the included studies, the results indicate a benefit of ARP versus SH. Further studies are needed to determine the volumetric changes that occur when performing ARP in the presence of a buccal bone wall defect. Key words: Alveolar ridge preservation, buccal wall defect, volumetric changes, bone loss, meta-analysis.

The data analysis showed favorable results for treatment with 4 ZIs. The results showed no statistical differences in using 1 or another treatment, in terms of survival and failure rates. The reduction on treatment time and morbidity related to regenerative approaches may be its main advantage. In conclusion, the zygoma quad seems to be the treatment of choice for the rehabilitation of the severely atrophic maxilla.

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