Abstract
Bone resorption after tooth extraction can compromise alveolar ridge volume and limit implant-supported rehabilitation. Alveolar ridge preservation (ARP) using xenografts and resorbable collagen membranes has been proposed to reduce post-extraction dimensional changes; however, outcomes may vary depending on site characteristics and clinical conditions. The objective of this clinical case was to evaluate multidimensional ridge changes following alveolar preservation using a porcine pericardium collagen membrane and bovine bone xenograft prior to implant placement, assessed by cone beam computed tomography (CBCT). A 61-year-old male patient with Stage IV periodontitis and severe mobility underwent multiple extractions followed by alveolar preservation. CBCT analysis was performed at predefined extraction sites in the maxilla (#11, #12, #13, #21, #22, and #23) and mandible (#33, #34, #43, and #44). The measurement levels used were: coronal width (CW), the horizontal distance between the buccal and palatal/lingual bone crests at the coronal level; apical width (AW), the horizontal distance at the apical level; buccal apicoronal height (BH/AC), the distance from the apex to the buccal crest; and palatal/lingual apicoronal height (PLH/PAC-LAC), the distance from the apex to the palatal or lingual crest. CBCT scans were obtained under standardized acquisition parameters and recorded using voxel-based rigid alignment across sagittal slices. At 12 months, ridge dimensions remained stable within sub-millimeter ranges. In the maxilla, coronal width changed from 8.2 to 8.4 mm and apical width from 8.8 to 9.9 mm. In the mandible, coronal width changed from 9.2 to 9.6 mm and apical width from 9.9 to 10.1 mm. Vertical dimensional changes (buccal and palatal/lingual) were less than 1 mm. Eight implants were placed without additional augmentation procedures, and a control CBCT performed three months later confirmed dimensional stability at implant sites. In this patient, the combined regenerative approach was associated with favorable ridge stability prior to implant placement. Further studies are required to confirm the predictability of this approach.