Biologically-Oriented Alveolar Ridge Preservation (BARP) in Intact and Compromised Extraction Sockets

Area of Science:

• Dentistry
• Oral Surgery
• Regenerative Medicine

Background:

• Alveolar ridge preservation (ARP) is crucial after tooth extraction to prevent bone loss.
• Buccal bone dehiscence presents significant challenges for traditional ARP methods.
• Post-extraction remodeling primarily impacts the coronal portion of the alveolar ridge.

Purpose of the Study:

• To evaluate the efficacy of the Biologically-oriented Alveolar Ridge Preservation (BARP) concept and its modified application (mBARP) for compromised sockets.
• To assess the ability of BARP/mBARP to preserve ridge dimensions and promote new bone formation.
• To investigate the clinical, radiographic, and histological outcomes of selective compartmentalized grafting.

Main Methods:

• Implementation of the BARP/mBARP protocols involving selective compartmentalized grafting in 30 extraction sites.
• Utilizing a collagen sponge in the apical socket for spontaneous healing and xenograft particles with a collagen sponge in the coronal portion for reinforcement.
• In compromised sockets, an additional collagen sponge was used for enhanced graft containment and soft tissue support.

Main Results:

• Effective preservation of ridge dimensions with minimal vertical loss (+0.3 mm) and limited horizontal reduction (0.7-1.0 mm) after 4-6 months.
• Controlled buccal soft tissue contraction (2.0-2.2 mm) and substantial new bone formation (38%-40%).
• Residual graft particles remained primarily confined to the coronal compartment, indicating successful compartmentalization.

Conclusions:

• The BARP concept and its modified application (mBARP) demonstrate favorable clinical, radiographic, and histological outcomes.
• Selective coronal grafting is an effective strategy for preserving alveolar ridge dimensions.
• This approach successfully maintains physiological healing in the deeper socket portion while reinforcing the coronal area.