Effect of Alveolar Process and Basal Bone Features on Post‐Extraction Dimensional Changes

Aim To evaluate the effect of specific phenotypical and anatomical features of the alveolar process and basal bone on post‐extraction dimensional changes. Materials and Methods Patients requiring the extraction of a single maxillary non‐molar tooth were enrolled. A comprehensive panel of baseline anatomical characteristics, including sagittal root position (SRP) class, was recorded. Linear and volumetric bone changes and the need for ancillary bone augmentation (NBA) were assessed after a 14‐week healing period. Results Records from 65 patients were included. Facial bone thickness (FBT) ≤ 1 mm was associated with significantly greater dimensional changes and greater NBA compared to sites presenting FBT > 1 mm (88.46% vs. 35.13%; p < 0.002). Bone remodelling and NBA were highest in SRP Class IV (100%), with lower frequencies in Class I (60%) and Class II (43.5%). Sites with roots outside the bony housing showed significantly more remodelling and NBA (89.47% vs. 43.18%; p < 0.001). Sites with a basal bone width narrower than the alveolar processes exhibited significantly greater bone remodelling and a higher prevalence of NBA compared to sites where the basal bone was wider (88.89% vs. 50%; p = 0.09). Socket entrance dimensions, distance from the coronal aspect of the facial bone to adjacent boundaries and root volume showed a comparable trend towards increased dimensional changes and grafting. Conclusions Certain site‐specific features appear to significantly affect post‐extraction alveolar ridge remodelling and the subsequent NBA to facilitate implant therapy.