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

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.