Evidence-Based Selection of Hard Tissue Grafts in Implantology: An Umbrella Review.
Keywords:
Implant dentistry; bone grafts;, xenografts; autografts; dentin-derived grafts;, guided bone regeneration; socket preservation; sinus augmentation.Abstract
This umbrella review, conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO
(CRD420261325454), synthesized high-level evidence to evaluate the clinical effectiveness of hard tissue graft materials in
implant dentistry. To gather relevant data, the authors executed a targeted electronic search strategy across the PubMed and
Scopus databases, specifically filtering for systematic reviews and meta-analyses published between January 2015 and
December 2025. Out of all the literature screened, 18 specific studies were ultimately included.
The findings revealed that no single graft material holds universal superiority across all clinical indications. Instead,
effectiveness is highly procedure-dependent: xenografts and alloplastic substitutes demonstrated favorable long-term
volumetric stability, particularly in socket preservation and maxillary sinus augmentation procedures. Furthermore, composite
grafts that combine autogenous bone with xenogeneic or synthetic substitutes consistently yielded superior regenerative
outcomes compared to single-material grafts. Autogenous dentin-derived grafts emerged as a promising alternative,
demonstrating favorable dimensional stability alongside strong osteogenic and osteoconductive potential. Additionally, the use
of membrane-assisted guided bone regeneration significantly enhanced clinical outcomes in both buccal dehiscence defects
and peri-implant regenerative procedures.
Ultimately, the review concludes that current evidence strongly supports an individualized, procedure-oriented approach to
graft selection. Utilizing composite grafting strategies and biologically enhanced regenerative approaches appears to optimize
clinical predictability and structural stability. While dentin-derived autografts represent a highly promising and innovative
alternative for alveolar reconstruction, further long-term clinical evidence is still required to fully validate their regular use.
