Alveolar Ridge Preservation Using Sticky Bone and Chitosan

Alveolar ridge preservation (ARP) is commonly performed following tooth extraction to minimize post-extraction dimensional changes and maintain the alveolar ridge for subsequent implant placement. This study aims to clinically compare two grafting approaches for alveolar ridge preservation: a sticky bone consisting of bone graft mixed with platelet-rich fibrin (PRF), and bone graft combined with chitosan. The study will evaluate the effectiveness of these two approaches in preserving the dimensions and quality of the alveolar ridge following tooth extraction.

Inclusion Criteria: 1. Adults aged 18 to 65 years. 2. Systemically healthy or with mild systemic disease classified as ASA physical status I-II. 3. Clinical indication for extraction of two contralateral, symmetrical single-rooted teeth in the maxilla or mandible, with extraction not indicated because of periodontal disease. 4. Intact alveolar socket walls following extraction, including the buccal, lingual/palatal, mesial, and distal walls, confirmed clinically after extraction and supported by preoperative CBCT assessment. 5. A minimum width of 2 mm of keratinized tissue at each planned extraction site. 6. Good oral hygiene, defined as an O'Leary Plaque Control Record of less than 25%. Exclusion Criteria: 1. Uncontrolled systemic diseases or conditions that may adversely affect bone metabolism or healing, including uncontrolled diabetes mellitus, hyperparathyroidism, or treatment with bisphosphonates, particularly intravenous administration. 2. Previous radiotherapy to the head and neck region. 3. Immunosuppression, including active chemotherapy or long-term treatment with high-dose systemic corticosteroids. 4. Pregnancy or breastfeeding. 5. Multirooted teeth, including molars or teeth with root furcation involvement. 6. Known allergy or hypersensitivity to bovine collagen, if a bovine-derived bone graft is used, or to chitosan or shellfish products such as shrimp. 7. Acute infection or a purulent abscess at the extraction site, or a large periapical lesion. 8. Presence of buccal bone dehiscence or fenestration at the planned extraction site. 9. Current smoking. 10. Untreated or inadequately controlled periodontal disease.