Influence of healing time on the outcomes of alveolar ridge preservation using a collagenated bovine bone xenograft: A randomized clinical trial

Emilio Couso-Queiruga, Holly A. Weber, Carlos Garaicoa-Pazmino, Christopher Barwacz, Marisa Kalleme, Pablo Galindo-Moreno, Gustavo Avila-Ortiz

Research output: Contribution to journalArticlepeer-review


Aim: To evaluate the healing outcomes in non-molar post-extraction sockets filled with deproteinized bovine bone mineral with collagen (DBBM-C) as a function of time. Materials and Methods: Patients in need of non-molar tooth extraction were randomly allocated into one of three groups according to the total healing time (A—3 months; B—6 months; C—9 months). The effect of alveolar ridge preservation (ARP) therapy via socket filling using DBBM-C and socket sealing with a porcine collagen matrix (CM) was assessed based on a panel of clinical, digital, histomorphometric, implant-related, and patient-reported outcomes. Results: A total of 42 patients completed the study (n = 14 in each group). Histomorphometric analysis of bone core biopsies obtained at the time of implant placement showed a continuous increase in the proportion of mineralized tissue with respect to non-mineralized tissue, and a decrease in the proportion of remaining xenograft material over time. All volumetric bone and soft tissue contour assessments revealed a dimensional reduction of the alveolar ridge overtime affecting mainly the facial aspect. Linear regression analyses indicated that baseline buccal bone thickness is a strong predictor of bone and soft tissue modelling. Ancillary bone augmentation at the time of implant placement was needed in 16.7% of the sites (A:2; B:1; C:4). Patient-reported discomfort and wound healing index scores progressively decreased over time and was similar across groups. Conclusions: Healing time influences the proportion of tissue compartments in non-molar post-extraction sites filled with DBBM-C and sealed with a CM. A variable degree of alveolar ridge atrophy, affecting mainly the facial aspect, occurs even after performing ARP therapy. These changes are more pronounced in sites exhibiting thin facial bone (≤1 mm) at baseline ( NCT03659617).

Original languageEnglish (US)
Pages (from-to)132-146
Number of pages15
JournalJournal of Clinical Periodontology
Issue number2
StateAccepted/In press - 2022
Externally publishedYes


  • alveolar ridge preservation
  • bone resorption
  • dental implants
  • digital image processing
  • tooth extraction

ASJC Scopus subject areas

  • Periodontics


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