Effect of Pre-Prosthetic Surgical Alveoloplasty on Post-Prosthetic Mucosal Pathologies, Denture Retention, and Stability in Complete Denture Patients: A Systematic Review and Meta-Analysis

Abstract

Background: Pre-prosthetic surgical alveoloplasty is widely taught and practised as a means of optimising the alveolar ridge before complete denture fabrication, yet the degree to which it measurably improves post-prosthetic mucosal health, retention, and stability compared with denture fabrication without alveoloplasty has not been systematically established.

Objectives: This systematic review aimed to evaluate the effect of pre-prosthetic surgical alveoloplasty, relative to no alveoloplasty, on post-prosthetic mucosal pathology, denture retention, and denture stability in adult complete denture patients.

Methods: PubMed, Embase, the Cochrane Library, Web of Science, and Scopus were searched from January 2010 to June 2026 for randomised controlled trials and comparative cohort studies. Two reviewers independently screened records, extracted data, and assessed methodological quality using RoB 2 and ROBINS-I. A random-effects meta-analysis was planned a priori, with heterogeneity to be quantified using the I² statistic and publication bias to be assessed via funnel plot and Egger's test where a sufficient number of studies permitted.

Results: The search identified 118 records, of which 9 underwent full-text review. No randomised controlled trial or comparative cohort study directly comparing alveoloplasty with no alveoloplasty for mucosal pathology, retention, or stability outcomes met inclusion criteria; all excluded full texts lacked a concurrent non-surgical comparator or did not measure the outcomes of interest. Consequently, quantitative meta-analysis could not be performed for any outcome domain. A narrative synthesis of indirect and descriptive evidence, including single-arm case series and cross-sectional prevalence data, is presented in place of pooled effect estimates, following Synthesis Without Meta-analysis (SWiM) reporting guidance.

Conclusions: No controlled comparative evidence currently exists to confirm or refute the clinical benefit of pre-prosthetic alveoloplasty for post-prosthetic mucosal health, retention, or stability. Current practice rests on biomechanical rationale and uncontrolled case series rather than comparative trial evidence, representing a substantial evidence gap that adequately powered comparative studies should address.