The effect of immediate implant placement on alveolar ridge preservation compared to spontaneous healing after tooth extraction: Radiographic results of a randomized controlled clinical trial

Aim To radiographically evaluate the effect of immediate implant placement plus alveolar ridge preservation (ARP) with a deproteneized bovine bone mineral and a collagen matrix (IMPL/DBBM/CM) as compared to ARP (DBBM/CM) or spontaneous healing (SH) on vertical and horizontal bone dimensional changes after 4 months of healing. Materials and methods Thirty patients requiring extraction of one single-rooted tooth or premolar were randomly assigned to IMPL/DBBM/CM, ARP DBBM/CM or SH. Cone-beam computed tomography (CBCT) scans, performed before tooth extraction and after 4 months, were superimposed in order to assess changes in ridge height at the buccal and lingual aspect and in ridge width at 1 mm, 3 mm and 5 mm apical to the bone crest. Kruskal-Wallis test was applied for comparison of differences between groups. Results No statistically significant differences between the groups were observed for the vertical bone resorption of the buccal and the lingual side, while significant differences were found between SH group (-3.37 +/- 1.55 mm; -43.2 +/- 25.1%) and both DBBM/CM (-1.56 +/- 0.76 mm; -19.2 +/- 9.1%) and IMPL/DBBM/CM (-1.29 +/- 0.38 mm; -14.9 +/- 4.9%) groups in the horizontal dimension at the most coronal aspect. Conclusion Ridge preservation techniques using DBBM and CM reduce the horizontal bone morphological changes that occur, mostly in the coronal portion of the buccal bone plate following tooth extraction, when compared to spontaneous healing. This is true regardless of whether immediate implant placement is performed or not.