A comparative study of techniques for alveolar ridge preservation after tooth extraction

ISRCTN ISRCTN92729767
DOI https://doi.org/10.1186/ISRCTN92729767
Submission date
17/09/2025
Registration date
19/09/2025
Last edited
19/09/2025
Recruitment status
Recruiting
Overall study status
Ongoing
Condition category
Oral Health
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
Tooth extraction often leads to bone loss in the alveolar ridge, which can affect future implant placement. This study compares two techniques for preserving the ridge using different bone graft materials.

Who can participate?
Adults aged 20–50 with two similar teeth requiring extraction.

What Does the Study Involve?
Participants will receive two different treatments on each side of the mouth. One side will be treated with Sticky Bone, and the other with a calcium sulfate/tricalcium phosphate mixture.

What are the possible benefits and risks of participating?
No benefits and risks provided at registration

Where is the study run from?
Faculty of Dentistry, Idlib University, Syria

When is the study starting and how long is it expected to run for?
December 2024 to May 2027

Who is funding the study?
Investigator initiated and funded

Who is the main contact?
Dr Hussamdin Ismail, hussamdin_ismail@idlib.edu.sy

Contact information

Dr Hussam Ismail
Scientific, Principal Investigator

University Street
Idlib
+963
Syria

ORCiD logoORCID ID 0000-0001-7811-8648
Phone +963 987733550
Email dr.hussam.d.i@gmail.com
Prof Gohar Mushtaq
Public

Idlib University
Shoaib Street
Idlib
+44
Syria

ORCiD logoORCID ID 0000-0003-4880-4035
Phone +963 7949825419
Email gohar_mushtaq@idlib.edu.sy

Study information

Study designInterventional randomized split-mouth single-centre non-blinded clinical trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Dental clinic, University/medical school/dental school
Study typePrevention, Treatment
Participant information sheet 48017_PIS.pdf
Scientific titleEffect of a mixture of calcium sulfate and tricalcium phosphate versus sticky bone technique on alveolar ridge preservation: a clinical, radiographic, and histological split-mouth study
Study acronymARP reserve
Study objectivesEvaluation of the efficacy of sticky bone graft and calcium sulfate in:
Alveolar edge dimensions change
Bone Density
Osteogenesis (histological study)
Ethics approval(s)

Approved 15/05/2025, Ethics Committee of Idlib University (University Street, Idlib, -, Syria; +963936179302; fouad_aldaoud@idlib.edu.sy), ref: -

Health condition(s) or problem(s) studied Alveolar ridge resorption following tooth extraction
InterventionThe method of randomization used in this study is allocation by the draw-a-card method.

Group A (Sticky Bone):
Atraumatic extraction followed by application of tricalcium phosphate mixed with PRF using the Sticky Bone technique.

- Group B (CaSO₄ + TCP):
Atraumatic extraction followed by application of a 40:60 mixture of calcium sulfate and tricalcium phosphate.

- Follow-up Duration:
6 months

- Measurements:
Clinically: Measuring the dimensional changes of soft tissues and the thickness of the soft tissue covering the alveolar ridge crest.
Radiographically: Evaluating the radiographic bone density of the newly formed bone and assessing the dimensional changes in the buccal and lingual walls of the socket.
After standardizing the imaging parameters for cone-beam computed tomography (CBCT), radiographic scans will be taken using a Vatech X-ray device with the following settings:
• 120 kVp, 5 mA
• Voxel Size: 0.2 mm
Two CBCT images will be taken:
• First scan: Immediately after tooth extraction.
• Second scan: Six months post-extraction.
Both images will be loaded into the OnDemand3D software, where they will be aligned along the sagittal, coronal, and axial planes. The most relevant section of the image corresponding to the surgical intervention site will be selected.
Histologically: Determining the quality of the newly formed bone six months after the surgical procedure.

1. Pain score using VAS at 1 and 7 days post-operative.
2. Healing index using the Landry scale at 1 week.
3. Soft tissue height at 6 months • Local anesthesia (2% lidocaine 1:100,000) administered to the alveolar ridge crest. A periodontal probe (UNC-15) will be inserted at the center of the soft tissue covering the alveolar ridge crest. A small drop of flowable composite will be placed on the soft tissue surface around the probe and then light-cured. The distance from the tip of the probe to the composite marker will be measured using a digital calliper.
Intervention typeProcedure/Surgery
Primary outcome measure1. Dimensional changes of soft tissues and the thickness of the soft tissue covering the alveolar ridge crest measured clinically after tooth extraction and six months post-extraction
2. Bone density of the newly formed bone and assessing the dimensional changes in the buccal and lingual walls of the socket, measured using cone-beam computed tomography (CBCT) with a Vatech X-ray device immediately after tooth extraction and six months post-extraction
3. Quality of the newly formed bone measured using histology six months after the surgical procedure
Secondary outcome measures1. Pain measured using a Visual Analog Score (VAS) at 1 and 7 days post-operative
2. Healing measured using the Healing Index Landry scale at 7 days post-operative
3. Soft tissue height measured using the periodontal probe (UNC-15) method at 6 months
Overall study start date08/12/2024
Completion date20/05/2027

Eligibility

Participant type(s)Patient, Service user
Age groupAdult
Lower age limit20 Years
Upper age limit50 Years
SexBoth
Target number of participants12 participants (24 extraction sites)
Total final enrolment14
Key inclusion criteria1. Age 20–50 years
2. Good oral hygiene
3. Presence of two similar teeth requiring extraction in the same jaw (both upper and lower jaw)
4. The patient has two symmetrical teeth indicated for extraction
5. Type 1 socket classification (Elian) (indicating that the buccal bone plate is intact and undamaged following tooth extraction)
Key exclusion criteria1. Smokers or alcohol users
2. Systemic diseases or medications affecting bone healing
3. Pregnant or lactating women
4. Presence of infection or fistula at the extraction site
Date of first enrolment16/06/2025
Date of final enrolment21/12/2026

Locations

Countries of recruitment

  • Syria

Study participating centre

Faculty of Dentistry – Idlib University
University Street
Idlib
-
Syria

Sponsor information

Funders

Funder type

Other

Investigator initiated and funded

No information available

Results and Publications

Intention to publish date20/01/2027
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planPlanned publication in a peer-reviewed journal
IPD sharing planThe datasets generated during and/or analysed during the current study are/will be available upon request from Dr Hussamdin Ismail, hussamdin_ismail@idlib.edu.sy. The shared dataset will include anonymized variables such as pain scores, healing indices, soft tissue measurements, radiographic bone density, and histological findings.

Data will be made available via an open-access repository such as Zenodo or Dryad, or upon reasonable request to the principal investigator. Access will be granted to qualified researchers who provide a clear research purpose, obtain ethical approval, and sign a data use agreement ensuring responsible and confidential use.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Participant information sheet 19/09/2025 No Yes
Protocol file 19/09/2025 No No

Additional files

48017_Protocol.pdf
48017_PIS.pdf

Editorial Notes

19/09/2025: Study's existence confirmed by the Idlib University, University Council.