A randomized, controlled, multicentre clinical trial of post-extraction alveolar ridge preservation.
To compare the effectiveness of two-ridge preservation treatments.



Forty subjects with extraction sockets exhibiting substantial buccal dehiscences were enrolled and randomized across 10 standardized centres. Treatments were demineralized allograft plus reconstituted and cross-linked collagen membrane (DFDBA + RECXC) or deproteinized bovine bone mineral with collagen plus native, bilayer collagen membrane (DBBMC + NBCM). Socket dimensions were recorded at baseline and 6 months. Wound closure and soft tissue inflammation were followed post-operatively, and biopsies were retrieved for histomorphometric analysis at 6 months.



Primary endpoint: at 6 months, extraction socket horizontal measures were significantly greater for DBBMC + NBCM (average 1.76 mm greater, p = 0.0256). Secondary and Exploratory endpoints: (1) lingual and buccal vertical bone changes were not significantly different between the two treatment modalities, (2) histomorphometric % new bone and % new bone + graft were not significantly different, but significantly more graft remnants remained for DBBMC; (3) at 1 month, incision line gaps were significantly greater and more incision lines remained open for DFDBA + RECXC; (4) higher inflammation at 1 week tended to correlate with lower ridge preservation results; and (5) deeper socket morphologies with thinner bony walls correlated with better ridge preservation. Thirty-seven of 40 sites had sufficient ridge dimension for implant placement at 6 months; the remainder were DFDBA + RECXC sites.



DBBMC + NBCM provided better soft tissue healing and ridge preservation for implant placement. Deeper extraction sockets with higher and more intact bony walls responded more favourably to ridge preservation therapy.
The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.|Private Practice, Houston, TX, USA.
Eric Todd
ET
Scheyer
The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.|Private Practice, Victoria, TX, USA.
Rick
R
Heard
The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.|Private Practice, Tacoma, WA, USA.|Department of Periodontics, School of Dentistry, University of Washington, Seattle, WA, USA.
Jim
J
Janakievski
The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.|Private Practice, Oakbrook Terrace, IL, USA.|Department of Graduate Periodontics, College of Dentistry, University of Illinois, Chicago, IL, USA.
George
G
Mandelaris
The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.|Private Practice, Boston, MA, USA.|Department of Oral Medicine, Infection and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, MA, USA.
Marc L
ML
Nevins
The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.|Private Practice, San Mateo, CA, USA.
Stephen R
SR
Pickering
The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.|Private Practice, Richmond, VA, USA.|Department of Graduate Periodontics, Virginia Commonwealth School of Dentistry, Richmond, VA, USA.
Christopher R
CR
Richardson
The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.|Private Practice, San Mateo, CA, USA.
Bryan
B
Pope
The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.|Private Practice, New London, CT, USA.
Gregory
G
Toback
The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.|Private Practice, Fenton, MI, USA.|University of Michigan School of Dentistry, Ann Arbor, MI, USA.
Diego
D
Velásquez
Institute for Clinical Chemistry and Laboratory Medicine, Medical Center - University of Freiburg, Freiburg im Breisgau, Germany.
Heiner
H
Nagursky
D016301:Alveolar Bone Loss; D000539:Alveolar Process; D000540:Alveolar Ridge Augmentation; D000818:Animals; D016025:Bone Transplantation; D002417:Cattle; D003094:Collagen; D006801:Humans; D008567:Membranes, Artificial; D014081:Tooth Extraction; D020390:Tooth Socket
D008567:Membranes, Artificial; D003094:Collagen
collagen membrane; demineralized allograft; extraction; guided bone regeneration; private practice; randomized controlled trial; ridge preservation; xenogeneic graft