Is ridge preservation effective in the extraction sockets of periodontally compromised teeth? A randomized controlled trial

Objective: To verify whether ridge preservation is effective in the reduction of dimensional loss and in bone formation compared to spontaneous healing in extraction sockets of periodontally compromised teeth. Methods: Twenty-six subjects requiring tooth extraction for stage III/IV periodontitis were randomly assigned to one of two interventions: alveolar ridge preservation using collagenated bovine bone mineral and a resorbable collagen membrane (test, RP) or spontaneous healing (control, SH). Six months later, postoperative cone-beam computed tomography (CBCT) was performed to measure the linear and volumetric changes of the sockets compared to baseline scans. Biopsies were retrieved at the implant site for histomorphometric calculations. Nonparametric tests were applied for statistical analysis. Results; Significantly less shrinkage occurred in RP compared to SH, mainly in the crestal zone. The width loss difference between groups was 3.3 mm and 2.2 mm at 1 mm and 3 mm below the crest, respectively (p < .05). RP yielded a gain in socket height of 0.25 mm, whereas a loss of -0.39 mm was observed in SH (p < .05). The percentage of volume loss recorded in RP was also less than that recorded in SH (-26.53% vs -50.34, p < .05). Significantly less bone proportion was detected in biopsies from RP (30.1%) compared with SH (53.9%). A positive association between baseline bone loss and ridge shrinkage was found in SH but not in RP. Conclusion: Ridge preservation in extraction sockets of periodontally compromised teeth was effective in reducing the amount of ridge resorption.

Automated summary

The study demonstrated that ridge preservation was more effective in reducing dimensional loss and bone formation compared to spontaneous healing in extraction sockets of periodontally compromised teeth. The ridge preservation group showed significantly less ridge resorption, less loss in socket height and volume, and lower bone proportion in biopsies compared to the spontaneous healing group.