Biologically-oriented Alveolar Ridge Preservation

BACKGROUND: A recent systematic review failed to identify one approach for alveolar ridge preservation with superior outcomes. The present case series aimed to evaluate the dimensional changes of sites undergoing Biologically-oriented Alveolar Ridge Preservation (BARP).METHODS: The sockets were filled with a collagen sponge up to 4-5 mm from the most coronal extensions of the crest. Xenograft particles were placed to fill the coronal part. In cases with a compromised buccal/lingual bone, an additional collagen sponge was interposed between the residual cortical bone plate and the mucoperiosteal flap. A collagen sponge was placed to cover the graft. RESULTS: The study population consisted in 10 extraction sites. Mean change in bone width and vertical ridge position as observed from BARP to re-entry for implant placement were 1.3 mm (14.4%) and 0.6 mm, respectively. The mean distance between buccal and lingual flap healing by secondary intention shifted from 4.9 mm immediately after BARP to 1.8 mm at 2 weeks. No marked differences in the dimensional changes of alveolar ridge were observed between sites with intact or deficient buccal bone plate. All implants were successfully loaded at 2-3 months after placement. In one case, bone augmentation was required.CONCLUSIONS: The stratification of materials proposed in BARP-technique and the additional use of a resorbable device to stabilize graft particles at the buccal aspect provided the conditions for maintaining the ridge dimensions fol-lowing tooth extraction comparable to the other technique of ARP, restricting the use of graft material to the most coronal portion of the socket.