Effectiveness of three different alveolar ridge preservation techniques: a pilot randomized controlled trial

The aim of this pilot study was to obtain preliminary data regarding the effectiveness of three different alveolar ridge preservation modalities as compared with a control. Subjects in need of single-rooted tooth extraction were recruited and randomly allocated to one of four treatment groups: group 1 (control)--collagen plug; group 2--socket grafting and polytetrafluoroethylene (PTFE) barrier; group 3--socket grafting, buccal overbuilding, and PTFE barrier; group 4--socket grafting, collagen barrier, and PTFE barrier. The grafting material used in all groups was an allograft. At 16 weeks, surgical reentry was performed, and a bone core biopsy was harvested for histomorphometric analysis. A cone beam computed tomography scan was obtained at baseline and before surgical reentry. Clinical (keratinized mucosa [KM] and buccolingual ridge width [RW] changes) and volumetric outcomes were statistically analyzed. A total of 20 patients were recruited (5 patients per group). KM and buccolingual RW changes were minimal during the 16-week healing period for all groups, with no statistically significant differences. Volumetric analyses revealed comparable alveolar ridge resorption values for groups 1, 2, and 4 (3%, 7%, and 5%, respectively), while group 3 exhibited more reduction (16%). Histomorphometric analysis revealed the presence of adequate average values of mineralized tissue (group 1, 46.4%; group 2, 28.88%; group 3, 48.81%; group 4, 41.13%). Based on the clinical and volumetric outcomes, none of the ridge preservation modalities was superior to the control. The combination allograft (freeze-dried bone allograft and demineralized freeze-dried bone allograft) employed in this study appears to be a safe and adequate biomaterial for intraoral grafting.