Alveolar Ridge Resorption

Following tooth extraction, physiologic remodeling of the alveolar ridge results in significant horizontal and vertical bone resorption, often accompanied by soft tissue collapse. These dimensional changes may complicate future implant placement and compromise esthetic and functional outcomes. Alveolar ridge preservation techniques have been introduced to limit post-extraction tissue loss by supporting bone regeneration and stabilizing the soft tissues. A previously conducted study has shown optimal wound healing of a guided bone regeneration technique by employing a non-submerged barrier membrane versus a socket seal technique employing a free gingival graft versus unassisted healing. This prospective randomized controlled clinical trial aims to evaluate the effectiveness of alveolar ridge preservation using the combination of an allograft with either a platelet-rich fibrin (PRF) membrane, versus combination of an allograft with a barrier membrane versus spontaneous healing after tooth extraction. A total of fifty-one subjects will be randomly allocated into three treatment groups. Clinical and radiographic (periapical radiograph, CBCT) outcomes will be assessed at baseline, and 3 months post-extraction.

The goal of this clinical trial is to evaluate the clinical and radiographic effectiveness of the socket shield technique combined with concentrated growth factor (CGF) and alloplastic graft in promoting bone healing and achieving successful immediate implant placement in the esthetic zone. This prospective case series involves both male and female participants aged 18 years or older who require immediate implant placement in the maxillary anterior segments. The main questions it aims to answer are : Does the combined use of CGF and alloplastic grafting materials with the socket shield technique improve crestal bone levels as measured by CBCT? How does this intervention affect secondary outcomes such as primary implant stability measured via the Osstell implant stability quotient? Participants will: Undergo a socket shield procedure (partial extraction therapy) where the labial root fragment is retained to preserve the buccal bone. Provide a blood sample for the preparation of autologous CGF. Receive simultaneous immediate implant placement. Have a "sticky bone" mixture of CGF and alloplastic graft packed into the jumping gap around the implant. Attend follow-up appointments for clinical assessments and CBCT imaging at 2 weeks and 6 months post-operatively.