{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T07:08:08Z","timestamp":1789456088308,"version":"build-2803163510"},"reference-count":93,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Periodontology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Engineered scaffolds hold promise for personalizing surgical therapy and are being increasingly applied in clinical practice. Therefore, a comprehensive synthesis of existing data on ridge augmentation is warranted.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A systematic review and meta\u2010analysis were conducted following PRISMA guidelines (PROSPERO: CRD42024611887). Four databases (MEDLINE, EMBASE, Cochrane Central, Scopus) and the grey literature were searched. Eligible studies included randomized clinical trials and prospective case series. The primary outcomes were horizontal, vertical, and volumetric bone gains. A meta\u2010analysis was performed to obtain pooled estimates for vertical bone gain (mm), horizontal bone gain (mm), volumetric bone gain (mm\n 3<\/jats:sup>\n ), and early and late complication rates (%). The certainty of evidence was evaluated using the GRADE approach.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Thirteen studies (\n n<\/jats:italic>\n \u00a0=\u00a0241 patients, mean age 47.1\u00a0years) and 202 defects (12.4% horizontal, 27.2% vertical, and 60.4% combined) were included. Risk of bias was significant, with three of six randomized clinical trials showing low risk and all non\u2010randomized studies showing moderate\u2010to\u2010serious risk of bias. Nine studies used customized computer\u2010aided design and manufacturing (CAD\/CAM) titanium mesh devices, while the remaining studies used materials like polyether ether\u2010ketone scaffolds (two studies), three\u2010dimensional hydroxyapatite blocks (one study), or customized allogeneic bone blocks (one study). Pooled horizontal bone gain was 4.96\u00a0mm (95% CI: 4.48\u20135.44\u00a0mm), vertical gain 5.64\u00a0mm (95% CI: 5.26\u20136.02\u00a0mm), and volumetric gain 1307\u00a0mm\n 3<\/jats:sup>\n (95% CI: 1000\u20131700\u00a0mm\n 3<\/jats:sup>\n ) over a 6 to 9\u2010month follow\u2010up period. The overall complication rate, irrespective of timing and resorbable membrane use, was 21.7% [16.4\u201327.0]. The pooled early and late\u00a0(<4 or \u22654\u00a0weeks) complication rates were 24.3% and 16.5%, respectively. Based on six studies, the early complications were 25.6% without versus 21.4% with resorbable membranes. Meta\u2010regression identified smoking status, surgical experience of the operator, and the defect type as significant factors influencing bone gain.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Engineered scaffolds show promise in managing complex alveolar defects, achieving significant bone gains in all dimensions. However, a high complication rate makes the outcomes unpredictable and limits their use to selective cases.<\/jats:p>\n <\/jats:sec>\n \n Plain language summary<\/jats:title>\n This review investigated the usefulness of patient\u2010specific scaffolds in improving our ability to rebuild lost jawbone. Researchers included 13 studies using different scaffolds, such as custom\u2010made titanium meshes, polyether ether\u2010ketone scaffolds, three\u2010dimensionally printed bone\u2010like blocks, or customized donated bone blocks. On average, patients gained about 5\u00a0mm of new bone in both width and height, and a significant increase in overall bone volume after 6 to 9\u00a0months. However, complications were common, affecting about one in five patients. Using a resorbable membrane helped reduce early problems. Key factors such as the surgeon's experience, the type of bone defect (combined horizontal and vertical defects vs. purely vertical), and whether the patient smoked had a strong impact on both bone gain and complications. These findings demonstrated that engineered scaffolds can successfully rebuild missing jawbone, but because complications are relatively frequent, they should be used only in carefully selected patients by highly experienced surgeons.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jper.70103","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T06:19:35Z","timestamp":1789453175000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of engineered scaffolds for horizontal and vertical ridge augmentation: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5067-7317","authenticated-orcid":false,"given":"Muhammad H. A.","family":"Saleh","sequence":"first","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8781-1997","authenticated-orcid":false,"given":"Elena","family":"Calciolari","sequence":"additional","affiliation":[{"name":"Centre for Oral Clinical Research Institute of Dentistry Faculty of Medicine and Dentistry Queen Mary University of London (QMUL) London UK"},{"name":"Department of Medicine and Surgery Centre of Dentistry University of Parma Parma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7538-7866","authenticated-orcid":false,"given":"Ethan","family":"Ng","sequence":"additional","affiliation":[{"name":"Centre for Oral Clinical Research Institute of Dentistry Faculty of Medicine and Dentistry Queen Mary University of London (QMUL) London UK"},{"name":"Department of Restorative Dentistry National Dental Centre Singapore Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3473-2149","authenticated-orcid":false,"given":"Sandra","family":"Stuhr","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6581-2104","authenticated-orcid":false,"given":"Hamoun","family":"Sabri","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry Ann Arbor Michigan USA"},{"name":"Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION) Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4117-9073","authenticated-orcid":false,"given":"Nikolaos","family":"Donos","sequence":"additional","affiliation":[{"name":"Centre for Oral Clinical Research Institute of Dentistry Faculty of Medicine and Dentistry Queen Mary University of London (QMUL) London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5844-1341","authenticated-orcid":false,"given":"Purnima S.","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1563\/aaid-joi-D-21-00108","article-title":"Comparative efficacy of different flapless ridge preservation techniques: a systematic review and meta\u2010analysis","volume":"49","author":"Ng E","year":"2023","journal-title":"J Oral Implantol"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.11607\/jomi.11162","article-title":"Reconstructive peri\u2010implant site development throughout an implant life cycle. a retrospective study","volume":"0","author":"Kalani K","year":"2025","journal-title":"Int J Oral Maxillofac Implants"},{"issue":"1","key":"e_1_2_10_4_1","first-page":"S291","article-title":"The etiology of hard\u2010 and soft\u2010tissue deficiencies at dental implants: a narrative review","volume":"89","author":"Hammerle CHF","year":"2018","journal-title":"J Periodontol"},{"key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1111\/jcpe.13049","article-title":"Cell therapy for orofacial bone regeneration: A systematic review and meta\u2010analysis","volume":"46","author":"Shanbhag S","year":"2019","journal-title":"J Clin Periodontol"},{"issue":"21","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1111\/jcpe.13123","article-title":"Biomaterials and regenerative technologies used in bone regeneration in the craniomaxillofacial region: Consensus report of group 2 of the 15th European Workshop on Periodontology on Bone Regeneration","volume":"46","author":"Sanz M","year":"2019","journal-title":"J Clin Periodontol"},{"key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1111\/jcpe.13850","article-title":"Comparative evidence of different surgical techniques for the management of vertical alveolar ridge defects in terms of complications and efficacy: a systematic review and network meta\u2010analysis","volume":"50","author":"Alotaibi FF","year":"2023","journal-title":"J Clin Periodontol"},{"key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1111\/prd.12531","article-title":"Efficacy of biomaterials for lateral bone augmentation performed with guided bone regeneration. 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