Clinical and Histologic Outcomes of Biologically Oriented Alveolar Ridge Preservation: A Prospective Observational Study

Introduction: This study aimed to evaluate the efficacy of Biologically oriented Alveolar Ridge Preservation (BARP) in minimizing post-extraction ridge modifications compared with unassisted socket healing. Methods: A prospective controlled observational study was conducted involving 30 patients requiring single-rooted upper premolar extractions. Patients were divided into two groups: the test (15 patients), which underwent a ridge preservation procedure combining absorbable collagen sponge in the middle and apical third of the socket and collagenated xenogeneic bone substitute in the most coronal part (BARP), and the control (15 patients), which healed spontaneously. Soft tissue contour changes after 6 months were analyzed using digital impressions. Moreover, histomorphometric analysis of the regenerated tissue was performed in the test group. Results: BARP significantly reduced post-extractive mucosal ridge modifications compared to the control group. Mean vertical shrinkage at the mid-buccal part of the edentulous site was 1.61 ± 0.61 mm (BARP) vs. 2.51 ± 0.64 mm (control; t-test, df = 28, p < 0.001), and mean horizontal reduction was 3.37 ± 0.63 mm (BARP) vs. 4.34 ± 0.48 mm (control; t-test, df = 28, p < 0.001). Histomorphometric analysis of the regenerated tissue showed 39.7% ± 9.1% newly formed bone with minimal residual graft material (5.0% ± 5.4%). Conclusion: BARP technique effectively minimizes post-extractive soft tissue contour modifications and supports natural bone regeneration, resulting in adequate bone dimensions for implant rehabilitation.