Alveolar Ridge Preservation Comparing Healing Outcomes of Two Different Putty Grafts: A Clinical and Histologic Study

This randomized clinical study compared the ridge dimensional changes following alveolar ridge preservation (ARP) with two different putty grafts in non-molar sites. The secondary outcomes included evaluation of histologic composition of the filled alveolus, changes in soft tissue thickness and clinical parameters and implant primary stability. Thirty subjects requiring a non-molar extraction and delayed implant placement were randomized into two groups receiving either a combination demineralized/mineralized putty allograft (DMP) or a synthetic calcium phosphosilicate putty alloplast (CPS) and covered with an acellular dermal matrix allograft (ADM) as a barrier membrane. Cone-beam computed tomography (CBCT) scans were used to measure ridge dimensional changes at two timepoints: before extraction and 4 months after ARP. At re-entry for implant placement, a trephine core sample was taken for histologic analysis. Implant stability quotient (ISQ) values were used to record implant stability. The CPS group showed a mean decrease from 8.60 ± 1.97 mm to 6.47 ± 2.11 mm (mean change: -2.13 mm [-25.2%], p < 0.001), while the DMP group decreased from 7.83 ± 1.49 mm to 6.55 ± 1.88 mm (mean change: -1.28 mm [-16.0%], p = 0.009). Histologic evaluation showed a statistically significant higher percentage of mineralized tissue (MT) in the DMP group (38.2%) compared to the CPS group (20.2%) (p = 0.004). Both putty grafts effectively preserved ridge dimensions and facilitated implant placement. However, significantly more MT was noted in the DMP group at 4 months compared to the CPS alloplast.