Alveolar Ridge Preservation: A Histomorphometric Analysis

Sigmar Schnutenhaus1, 2, *, Werner Götz3, Jens Dreyhaupt4, Heike Rudolph2, Ralph G. Luthardt2
1 Private practice, Hilzingen, Germany
2 Department of Prosthetic Dentistry, Center of Dentistry, Ulm University, Ulm, Germany
3 Department of Orthodontics, Oral Biology Laboratory, University of Bonn, Bonn, Germany
4 Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany

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Creative Commons License
© 2018 Schnutenhaus et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Private practice, Breiter Wasmen 10, 78247 Hilzingen, Germany, Tel: +49 7731 182755, Fax: + 49 7731 182766, E-mail:



This study presents the histomorphometric findings after tooth extraction with and without Alveolar Ridge Preservation (ARP) with a collagen cone filling the socket in combination with a collagen membrane covering the socket.

Materials and Methods:

In a controlled randomized clinical study, 10 patients were treated with the combination material after tooth extraction. In 10 patients, the extraction sockets were left to heal without further intervention. Soft tissue, new bone formation, bone quality and bone remodeling, blood flow vascularization, and inflammation were evaluated histomorphometrically. This was performed (semi-) quantitatively using a blinded protocol.


The statistical evaluation showed no significant difference for any parameter. When the combination material was used, more pronounced remodeling, increased osteoblast activity, and increased vascularization were demonstrated based on the histomorphometric findings. In contrast, there were reduced levels of osteogenesis and less mineralization. There was slightly more bundle bone in patients with ARP.


The histomorphometric analysis of ARP with a combination material consisting of a collagen cone and a collagen membrane showed no significant differences in terms of new bone formation and bone quality. Descriptively, however, different manifestations were seen that might benefit from being documented using larger samples and being tested for clinical relevance.

Keywords: Alveolar bone loss, Ridge preservation, Bone regeneration, Histomorphometric analysis, Extraction sockets, Collagen.