Background : This study compares Ceno bone biomaterial with demineralized bone matrix putty in preserving the alveolar ridge and soft tissue after tooth extraction.
Methods: We conducted a randomized controlled trial involving 36 single-rooted teeth designated as non-restorable (30 completed the 4-month follow-up). Extraction sites were randomly assigned to one of three groups: demineralized freeze-dried bone allograft (CenoBone, n = 10), demineralized bone matrix putty (DBM putty, n = 10), and a control group without grafts (n = 10). After extraction and 4 months post-extraction horizontal and vertical ridge dimensions were assessed using calipers and an acrylic stent. Before extraction and 4 months later, impressions were made and scanned using an intraoral scanner (CS3600, Carestream Dental) to generate STL files for volumetric analysis using exocad 3.0 software. Descriptive statistics, paired t-tests, and ANOVA Repeated Measures were conducted.
Results: Ridge width decreased in the CenoBone group from 7.06 ± 0.46 mm to 5.59 ± 0.53 mm (P < 0.001), in the DBM putty group from 6.98 ± 0.5 mm to 5.54 ± 0.51 mm, and in the control group from 7.22 ± .46 mm to 5.72 ± 0.46 mm (P < 0.001). All groups experienced width loss, but no significant difference was found between the two grafted groups (P=/0834). Vertical changes of buccal crest were -1.18 ± 0.36 mm (CenoBone), -1.21 ± 0.51 mm (DBM putty), and -2.04 ± 0.71 mm (control) (P < 0.05). Volumetric soft tissue changes at 4 months post-extraction in three dimensions were -0.58 mm (CenoBone), -0.54 mm (DBM putty), and -1.80 mm (control). Significant differences were observed between the grafted groups and the control, but not between the grafted groups.
Conclusion: Both demineralized freeze-dried bone allograft and demineralized bone matrix putty significantly enhanced ridge preservation compared to extraction alone, However, no statistically significant difference was observed between the two test groups. These preserved dimensions are more favorable for subsequent implant placement, particularly in areas where loss of ridge height may compromise the esthetic outcome. Although ridge preservation techniques were unable to completely compensate for the reduction in soft-tissue volume, contour shrinkage was significantly less pronounced than in sites undergoing natural healing following tooth extraction.