Soares Kaio Henrique, Aguirre Janelle, Vilela Nathalia, Gonçalves Patrícia F, Lazarin Rafael, Schey Karin C, Duarte Poliana M
Department of Periodontology, University of Florida College of Dentistry, Gainesville, Florida, USA.
Department of Dentistry, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil.
J Periodontol. 2025 Jul 29. doi: 10.1002/JPER.24-0852.
While several studies have compared the performance of alveolar ridge preservation (ARP) using different bone substitutes in terms of histological outcomes and maintenance of ridge dimensions, there is a lack of data comparing implant outcomes in ARP-treated sites with different grafts. The aim of this retrospective cohort study was to compare the performance of dental implants placed in areas that underwent ARP with either allograft or xenograft, focusing on marginal bone loss, implant failure, and peri-implantitis.
Patient records were examined for those who received at least one dental implant in ARP areas, using either allograft or xenograft, or non-grafted sockets. Implants were assessed for preloading crestal bone loss (PLCBL), post-loading crestal bone loss (PoLCBL), early and late failure, and peri-implantitis. Data were analyzed using bivariate methods and mixed-effects Cox regression.
A total of 509 implants in 390 subjects were analyzed. Implants in non-grafted sockets or those with allograft or xenograft did not differ in PoLCBL ≥ 0.5 mm, early failure, late failure, or peri-implantitis (p > 0.05). Implants placed in allograft-treated sites had a significantly lower risk of developing PLCBL ≥ 0.5 mm (Hazard ratio [HR] = 0.84, 95% CI = 0.22 to 1.46; p = 0.0078), PLCBL ≥ 1.5 mm (HR = -1.27, 95% CI = -2.08 to -0.46; p = 0.0024), and PoLCBL ≥ 1.5 mm (HR = -1.14, 95% CI = -2.00 to -0.28; p = 0.0097) than those placed in non-grafted sockets. Implants inserted in xenograft-treated sites presented a tendency toward a lower risk of PLCBL ≥ 0.5 mm than those placed in non-grafted sockets (HR = 1.03, 95% CI = 0.01 to 2.07; p = 0.052). No implants in xenograft-treated sites developed PLCBL or PoLCBL ≥1.5 mm.
Implants placed in ARP areas with allograft or xenograft showed no significant differences in PLCBL, PoLCBL, implant failure, or peri-implantitis, indicating both materials are reliable treatment options. ARP overall demonstrated a protective effect against crestal bone loss.
The present study evaluated the clinical outcomes of implants placed in sites following alveolar ridge preservation (ARP) using allogeneic or xenogeneic biomaterials, addressing a gap in the current literature. Analysis of 509 implants in 390 subjects demonstrated that both biomaterial options are reliable, yielding comparable outcomes with no significant differences in marginal bone loss, implant failure, or peri-implantitis. These findings suggest clinicians can choose allografts or xenografts for ARP based on individual preferences and clinical considerations. Furthermore, implants placed in grafted sites after ARP exhibited a lower incidence of peri-implant bone loss compared with those placed in non-grafted ridges, underscoring the protective effect of ARP on peri-implant outcomes.
