Expert consensus on orthodontic-associated alveolar ridge augmentation for adult patients

Runzhi Guo; Xiaotong Li; Jianxia Hou; Yiping Huang; Bing Fang; Hong He; Zuolin Jin; Fuhua Yan; Lin Wang; Yuxing Bai; Wenjie Hu; Lili Chen; Jinlin Song; Xianglong Han; Fang Jin; Jun Wang; Min Hu; Yang Cao; Yuehua Liu; Haiping Lu; Bin Yan; Yan Xu; Wensheng Ma; Yifan Lin; Xiao Xu; Li Xu; Weiran Li

doi:10.1038/s41368-026-00430-x

International Journal of Oral Science ›› 2026, Vol. 18 ›› Issue (1) :29 DOI: 10.1038/s41368-026-00430-x

Review Article

review-article

Expert consensus on orthodontic-associated alveolar ridge augmentation for adult patients

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¹Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing, China

²Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing, China

³Department of Orthodontics, Shanghai Key Laboratory of Stomatology, Shanghai Ninth People’s Hospital, College of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China

⁴State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration & Key Laboratory of Oral Biomedicine Ministry of Education & Hubei Key Laboratory of Stomatology & Department of Orthodontics & Center for Dentofacial Development and Sleep Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, China

⁵Department of Orthodontics, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, School of Stomatology, Air Force Medical University, Xi’an, China

⁶Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University, Nanjing, China

⁷Department of Orthodontics, Jiangsu Province Key Laboratory of Oral Diseases, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China

⁸Department of Orthodontics, Capital Medical University School of Stomatology, Beijing, China

⁹Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China

¹⁰Department of Orthodontics, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, China

¹¹State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China

¹²Department of Orthodontics, Hospital of Stomatology, Jilin University, Changchun, China

¹³Department of Orthodontics, Shanghai Stomatological Hospital, Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China

¹⁴Department of Stomatology, Zhejiang Chinese Medical University, Hangzhou, China

¹⁵Department of Orthodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China

¹⁶Department of Periodontology, The Affiliated Stomatological Hospital of Nanjing Medical University, Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China

¹⁷Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, China

¹⁸Division of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong, China

^a xulihome@263.net

^b weiranli@bjmu.edu.cn

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Abstract

Alveolar bone defects, including dehiscence and fenestration, are commonly encountered in adult patients seeking orthodontic treatment. These anatomical deficiencies increase the risk of periodontal complications and may significantly compromise orthodontic tooth movement. Alveolar bone defects can also develop during orthodontic treatment, particularly in adult patients with narrow alveolar ridges requiring excessive tooth movement. Orthodontic-associated alveolar ridge augmentation (OARA) is an effective treatment approach that provides additional bone support and facilitates tooth movement, thereby reducing the incidence of periodontal complications and accelerating and broadening the scope of movement. At present, standardized diagnostic and treatment protocols for OARA in adult patients are lacking. This expert consensus aims to provide evidence-based recommendations for OARA in adult patients. A multidisciplinary panel of 27 experts conducted a Delphi-style process incorporating a targeted literature review and three voting rounds, achieving ≥70% agreement. Twenty-nine consensus statements across seven clinical domains, including pre-OARA examination, indications, bone graft material selection, timing, surgical protocols, standard operating procedures and considerations, were established with recommendations graded according to adapted GRADE criteria. This report presents a structured clinical framework for OARA and identifies future research priorities.

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Runzhi Guo, Xiaotong Li, Jianxia Hou, Yiping Huang, Bing Fang, Hong He, Zuolin Jin, Fuhua Yan, Lin Wang, Yuxing Bai, Wenjie Hu, Lili Chen, Jinlin Song, Xianglong Han, Fang Jin, Jun Wang, Min Hu, Yang Cao, Yuehua Liu, Haiping Lu, Bin Yan, Yan Xu, Wensheng Ma, Yifan Lin, Xiao Xu, Li Xu, Weiran Li. Expert consensus on orthodontic-associated alveolar ridge augmentation for adult patients. International Journal of Oral Science, 2026, 18(1): 29 DOI:10.1038/s41368-026-00430-x

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