Clinical, Radiographic, Ultrasonographic and Histologic Outcomes of Alveolar Ridge Preservation using a Xenogeneic Collagen Plug with and without a Membrane: A Randomized Controlled Trial

Abstract

Background: Conventional bone augmentation for dental implants typically involves grafting materials, with or without barrier membranes, to preserve ridge dimensions. This study compares the changes in horizontal ridge width in patients undergoing alveolar ridge preservation (ARP) with a xenogenic (bovine) collagen plug, with and without a collagen membrane. Methods: A 6-month randomized clinical trial was conducted with 20 participants requiring ARP after tooth extraction. Participants were randomly assigned to two groups: Group I, which received a xenogenic plug alone, and Group II, which received a xenogeneic plug with a non-crosslinked collagen membrane. Both groups were allowed to heal by secondary intention. The outcomes of interest included clinical, radiographic, and ultrasonographic changes in hard and soft tissues, as well as histologic and histomorphometric evidence of new bone formation. Results: All enrolled participants completed the study, with a mean age of 54.25 ± 17.08 years, including 17 premolars and 3 . Baseline buccal bone thickness was similar between the groups (Group 1: 1.02 ± 0.44 mm; Group 2: 0.93 ± 0.45 mm; p = 0.662). At 6 months, no significant differences were observed between groups for keratinized tissue width (Group 1: 4.80 ± 1.48 mm; Group 2: 4.80 ± 1.14 mm; p = 0.999), gingival thickness (Group 1: 1.22 ± 0.25 mm; Group 2: 1.20 ± 0.35 mm; p = 0.650), horizontal bone width at 3 mm from the crest (Group 1: 9.02 ± 2.09 mm; Group 2: 8.41 ± 1.45 mm; p = 0.464), and change in vertical bone at the buccal aspect (Group 1: -0.78 ± 0.59 mm; Group 2: -1.31 ± 1.20 mm; p = 0.244). Ultrasound evaluations were consistent with clinical measurements. Histologic analysis showed similar new bone formation between groups (Group 1: 25.80 ± 15.48%; Group 2: 27.89 ± 18.21%; p = 0.803). Conclusion: The xenogeneic collagen plug alone yielded comparable ARP outcomes to its combination with a collagen membrane, simplifying the treatment process by reducing costs, time, and the need for additional materials.