Clinical, radiographic, and histological evaluation of autogenous demineralized dentin matrix versus xenograft in alveolar ridge preservation: a randomized controlled trial

Purpose This randomized controlled trial aimed to evaluate the clinical and histological efficacy of autogenous demineralized dentin matrix (DDM) compared with deproteinized bovine bone mineral (DBBM) for alveolar ridge preservation (ARP), with a specific focus on dimensional stability and remodeling dynamics over a 6-month follow-up period. Methods Fifty patients requiring single-tooth extraction were randomized to receive ARP with either DDM (test group, n = 25) or DBBM (control group, n = 25). Dimensional changes were assessed by CBCT at baseline, 3 months, and 6 months. Histomorphometric analysis was performed on bone core biopsies harvested at 6 months. Results Fifty patients were enrolled and randomly assigned to the test (DDM, n = 25) or control (DBBM, n = 25) group. At 3 months post-surgery, the test group exhibited significantly greater horizontal bone resorption at the mid-socket level (50%) compared with the control group ( p = 0.006). However, at 6 months, no statistically significant differences were observed between the two groups regarding horizontal width reduction at any level (coronal, middle, apical) or vertical height reduction ( p > 0.05). Histomorphometric analysis at 6 months revealed active new bone formation and good integration of graft particles in the DDM group, confirming its biodegradability and osteoconductive potential. Conclusions Although autogenous DDM exhibited a faster remodeling rate and dimensional contraction in the early healing phase (3 months), it achieved long-term (6-month) dimensional stability comparable with that of the gold-standard xenograft. Furthermore, histological evidence of superior tissue integration suggests that DDM is a biologically viable and cost-effective alternative for alveolar ridge preservation.