Early healing of soft tissue following alveolar ridge preservation according to the sealing material: a retrospective clinical study.

PURPOSE: This study compared early soft-tissue healing after open-healing alveolar ridge preservation (ARP) in periodontally compromised extraction sockets according to the type of resorbable sealing material used. METHODS: A total of 127 extraction sockets were categorized into 3 groups according to the sealing material used: (i) absorbable atelocollagen sponge, (ii) resorbable non-cross-linked collagen membrane (CM group), and (iii) acellular dermal matrix. Serial intraoral photographs were obtained at 4 time points: immediately after surgery (T0), at 1.0±0.3 weeks (T1), at 4±1 weeks (T2), and at 15±3 weeks (T3). The primary outcome was open wound percentage, which was used to characterize early soft-tissue healing. Secondary outcomes included the Modified Early Wound Healing Score (m-EHS), time to complete epithelialization, the need for additional bone grafting at implant placement, and marginal bone loss (MBL) after implantation. RESULTS: The CM group showed a distinct early healing pattern characterized by a transient increase in wound exposure at T1. This group also had a significantly higher frequency of additional bone grafting at implant placement (P=0.001). However, MBL after implantation did not differ significantly among the groups. A higher open wound percentage at 1 week postoperatively was positively correlated with greater distal MBL (P=0.006). The m-EHS and final epithelialization time did not differ significantly among the groups. CONCLUSIONS: Early soft-tissue healing after open-healing ARP varied according to the sealing material used. The CM group showed greater early wound exposure and more frequent additional grafting. Greater early wound exposure was also associated with greater distal bone loss. These findings suggest that sealing material characteristics may influence early healing and later clinical outcomes.