ORIGINAL RESEARCH article
Front. Surg.
Sec. Reconstructive and Plastic Surgery
Randomized Controlled Trial of Immediate Alveolar Ridge Preservation for Bone and Soft Tissue Aesthetics After Tooth Extraction
Yi-Ye Zhou
Nan Li
Yan Gao
Hui Chen
Jinshan Hospital, Fudan University, Shanghai, China
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Abstract
Objective: This study aimed to evaluate the long-term outcomes of alveolar ridge preservation (ARP) on soft tissue morphology, correlate them with underlying bone changes, and assess its clinical value. It directly compared alveolar bone preservation and soft tissue aesthetics between ARP and conventional tooth extraction. Methods: In this prospective randomized controlled trial, sixty patients were randomly assigned (1:1) via sealed envelopes to a control group (conventional extraction) or an ARP group (immediate grafting with β-TCP and a collagen membrane). Over a 12-month follow-up, alveolar bone height and width changes were measured using CBCT. Soft tissue morphology was examined via plaster models, and aesthetics were evaluated using a 10-point scoring system for color and morphology. Results: Baseline characteristics were comparable between groups. After 12 months, the control group showed significantly greater bone resorption in height (1.3 mm) and width (1.7 mm) compared to the ARP group (0.7 mm and 1.1 mm, respectively; P<0.001). Soft tissue contours were significantly better in the ARP group (50.0% smooth, 50.0% mild abnormalities) than in the control group (33.3% margin disruption, 60.0% moderate irregularities; P<0.001). A strong negative correlation was found between aesthetic scores and bone resorption (P<0.001). The ARP group also achieved significantly higher soft tissue color (7.8±0.5) and morphological scores (7.7±0.6) than the control group (6.1±0.6 and 5.9±0.7; P<0.001). Conclusions: Immediate ARP using β-TCP and a collagen membrane significantly reduces alveolar bone resorption, better maintains soft tissue morphology and aesthetics, and provides a superior foundation for future implant rehabilitation, demonstrating substantial clinical value.
Summary
Keywords
After tooth extraction, Alveolar bone resorption, Alveolar ridge preservation, Collagen barrier membrane, randomized controlled trial, Soft tissueaesthetics, β-tricalciumphosphate (β-TCP)
Received
19 December 2025
Accepted
17 February 2026
Copyright
© 2026 Zhou, Li, Gao and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Hui Chen
Disclaimer
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