Component network meta-analysis of scaffold materials, platelet-rich fibrin and barrier membranes for alveolar ridge preservation

Background Alveolar ridge preservation (ARP) involves the use of multiple treatment components, including scaffold materials, platelet-rich fibrin (PRF) adjuncts, and barrier membranes. However, conventional meta-analyses generally evaluate complete treatment protocols and cannot determine the independent contribution of individual components. This study aimed to investigate the component-level effects of ARP interventions using component network meta-analysis (CNMA). Methods Randomized controlled trials evaluating ARP after tooth extraction in adults were identified from PubMed, Cochrane CENTRAL, Embase, and Web of Science from inception to July 2026. Complete treatment strategies were initially compared using random-effects network meta-analysis. Subsequently, interventions were decomposed into scaffold, PRF, and barrier membrane components for additive and interaction CNMA. The primary outcomes were horizontal ridge-width change and buccal vertical ridge-height change. Results Thirty-one randomized controlled trials were included. Standard network meta-analysis demonstrated that several scaffold- and membrane-containing strategies were associated with reduced ridge dimensional loss compared with natural healing. In additive CNMA for horizontal ridge-width change, barrier membrane showed the largest estimated component effect (MD, −1.31 mm; 95% CI, −2.18 to −0.44), followed by allograft (MD, −0.77 mm; 95% CI, −1.16 to −0.38) and PRF adjunct (MD, −0.40 mm; 95% CI, −0.66 to −0.14). Interaction analyses did not demonstrate convincing evidence that the effect of PRF varied according to scaffold type, although estimates were limited by imprecision. Conclusions This component network meta-analysis suggests that the effects of alveolar ridge preservation are associated with the combined contribution of individual treatment components rather than complete treatment packages alone. Barrier membranes and allograft components showed relatively favorable component-level estimates for horizontal ridge-width preservation, whereas PRF showed a smaller incremental effect. However, these findings should not be interpreted as definitive evidence of superiority over other regenerative components, given network inconsistency, sparse evidence for some components, and the low or very low certainty of several component-level estimates. Systematic Review Registration : identifier CRD420261459356.