ABSTRACT Aim This pilot randomized controlled trial evaluated the efficacy of demineralized dentin graft (DDG) combined with injectable platelet‐rich fibrin (I‐PRF) and metronidazole (MTZ) versus DDG with I‐PRF and DDG alone in alveolar ridge preservation (ARP) of chronically infected extraction sockets. Methods Patients with non‐restorable teeth and chronic periapical infection in the maxillary anterior and premolar regions were randomly assigned to three groups ( n = 18/group): DDG alone, DDG + I‐PRF, and DDG + I‐PRF/MTZ. After extraction, graft materials were placed into sockets. Cone‐beam CT scans at baseline and 6 months assessed vertical and horizontal ridge dimensions. Virtual implant planning evaluated the need for further augmentation. Pain was recorded daily for 7 days using a visual analogue scale (VAS). Bone biopsies at 6 months were harvested during implant placement for histomorphometric analysis. Results Fifty‐four patients were analyzed. No significant differences were found in vertical and horizontal ridge dimensional changes ( p > 0.05). Minimal additional augmentation was needed. The DDG + I‐PRF/MTZ group showed significantly the highest mineralized bone percentage (55.02% ± 3.65%), followed by DDG + I‐PRF (41.14% ± 7.00%) and DDG alone (30.21% ± 3.72%) ( p < 0.05). Soft tissue proportion histologically was significantly lowest in the DDG + I‐PRF/MTZ group ( p < 0.05). Conclusion All protocols were effective for ARP. Addition of I‐PRF with MTZ enhanced bone mineralization. Trial Registration www.clinicaltrials.gov : NCT06374784
Elbehwashy et al. (Fri,) studied this question.