Biomaterial used to counteract ridge reduction following the removal of adjacent teeth: A randomized controlled multicenter study

Abstract

Background

Alveolar ridge resorption (ARP) is a well-recognized consequence of tooth extraction, and multiple adjacent extractions may lead to greater ridge reduction than single-tooth extractions. This multicenter randomized controlled trial aimed to assess ridge remodeling after removing 2 adjacent teeth and whether socket grafting with deproteinized bovine bone mineral with collagen (DBBM-C) plus a collagen membrane could counteract the ridge reduction.

Methods

Forty-two patients requiring 2 adjacent tooth extractions were randomly assigned to either Test (DBBM-C graft + collagen membrane) or Control (natural healing). Impressions were taken immediately after extraction and at 6 months, and models were analyzed to measure changes in horizontal ridge width (bucco-lingual at 3 mm below the crest) and vertical ridge height (buccal and lingual).

Results

At 6 months, grafted sites had significantly less ridge reduction than controls. Horizontal ridge width reduction averaged 57.7% in Control versus 23.0% in Test (p < 0.001). Vertical height loss was also greater in controls (buccal 3.0 mm vs. 1.5 mm; lingual 2.2 mm vs. 1.3 mm; p < 0.001). Both mesial and distal sockets benefited similarly from grafting, with comparable preservation at each site.

Conclusion

Filling adjacent extraction sockets with DBBM-C and covering with a collagen membrane significantly reduced horizontal and vertical alveolar ridge resorption compared to unassisted healing. This approach effectively preserves bone volume after multiple tooth extractions, which may facilitate later implant placement.

Plain language summary

When 2 neighboring teeth are removed, the area tends to shrink in width and height as it heals. This bone loss can make it more difficult to place dental implants later. In this study, we tested a method to help maintain the bone after removing 2 adjacent teeth. In the Test group, the empty tooth sockets were filled with a bone graft material (deproteinized bovine bone mineral and collagen) and covered with a collagen membrane. In the Control group, the sites were left to heal physiologically. A total of 42 patients participated, each needing 2 side-by-side teeth removed. After 6 months of healing, we compared models of the patients from right after the extractions to those taken 6 months later. The results showed that the group with the bone graft and membrane had much less bone shrinkage than the group without them. The 2 extraction sites in the graft group maintained their bone height and width similarly. In summary, using a bone substitute material and membrane immediately after multiple tooth extractions helped preserve the jawbone, which could make future treatments like dental implants more successful.