An interventional study of Sticky Bone (PRF Combined with Bone Graft) and Chitosan Combined with Bone Graft in Alveolar Ridge Preservation, sponsored by Damascus University. Not yet recruiting. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2026-09-17.
Sponsored by Damascus University · Not applicable, Interventional, and Treatment
Alveolar ridge preservation (ARP) is commonly performed following tooth extraction to minimize post-extraction dimensional changes and maintain the alveolar ridge for subsequent implant placement. This study aims to clinically compare two grafting approaches for alveolar ridge preservation: a sticky bone consisting of bone graft mixed with platelet-rich fibrin (PRF), and bone graft combined with chitosan. The study will evaluate the effectiveness of these two approaches in preserving the dimensions and quality of the alveolar ridge following tooth extraction.
The present study is designed to clinically compare two approaches for alveolar ridge preservation following tooth extraction: a particulate bone graft combined with autologous advanced platelet-rich fibrin, forming a sticky bone graft, and the same particulate bone graft combined with chitosan. The study will use a split-mouth design, in which eligible patients requiring extraction of comparable teeth on both sides of the oral cavity will receive the two different interventions, with each side serving as a treatment site.
Following atraumatic tooth extraction and standardized socket debridement, the extraction sockets will undergo alveolar ridge preservation using one of the two assigned grafting approaches. In the PRF site, autologous PRF will be prepared from venous blood and combined with the particulate bone graft. In the chitosan site, the same type of particulate bone graft will be combined with chitosan to obtain a homogeneous grafting mixture. The graft materials will then be placed within the extraction sockets according to the standardized surgical protocol, followed by wound closure and routine postoperative care.
Damascus University is the lead sponsor of 212 studies on the registry; 11 are open to participants now.
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Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.
A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.
Read whether the line is about a condition or about medicines, and which medicines and doses it means.
Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.
Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.
An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.
ASA physical status
The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Immunosuppression
A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.
Read whether the line is about a condition or about medicines, and which medicines and doses it means.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Corticosteroids (steroids)
Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.
Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Hypersensitivity
An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
This arm will receive a particulate bone graft combined with autologous advanced platelet-rich fibrin, forming a cohesive sticky bone graft, for alveolar ridge preservation following tooth extraction. This intervention will be applied to one eligible extraction site in each participant.
Procedure: Sticky Bone (PRF Combined with Bone Graft)
This arm will receive the same particulate bone graft combined with chitosan for alveolar ridge preservation following tooth extraction. This intervention will be applied to the contralateral eligible extraction site in each participant
Procedure: Chitosan Combined with Bone Graft
Following atraumatic tooth extraction and standard socket preparation, autologous PRF will be prepared from the participant's venous blood and combined with the particulate bone graft to produce a cohesive sticky bone graft. The prepared graft mixture will then be placed into the designated extraction socket to provide alveolar ridge preservation during the healing period. Wound closure and postoperative management will be performed according to the standardized study protocol.
Following atraumatic tooth extraction and standard socket preparation, chitosan will be combined with the particulate bone graft to produce a homogeneous grafting material. The prepared mixture will then be placed into the designated extraction socket for alveolar ridge preservation during the healing period. Wound closure and postoperative management will be performed according to the standardized study protocol
Change in Alveolar Ridge Width
The change in alveolar ridge width will be assessed by comparing cone-beam computed tomography (CBCT) measurements obtained immediately after the surgical procedure (T1) with those obtained at 4 months postoperatively (T2). The corresponding CBCT images from T1 and T2 will be spatially matched using the OnDemand 3D imaging software to ensure standardized identification and measurement of the same anatomical levels at both time points. Alveolar ridge width will be measured at three standardized levels located 3 mm, 7 mm, and 10 mm apical to the cementoenamel junction (CEJ) of the tooth indicated for extraction. For each level, the change in ridge width will be calculated as the difference between the measurement at T1 and the corresponding measurement at T2. Alveolar ridge width and its change will be recorded in millimeters (mm).
Time frame: Immediately after the surgical procedure (T1) and at 4 months postoperatively (T2)
Change in Alveolar Ridge Height
The change in alveolar ridge height will be assessed using CBCT images obtained at T1 and T2. The corresponding images will be spatially matched using OnDemand 3D imaging software. Ridge height will be measured in millimeters (mm) at standardized reference locations, including the buccal plate and the midpoint of the extraction socket. The change in ridge height will be calculated as the difference between the T1 and T2 measurements.
Time frame: Immediately after the alveolar ridge preservation procedure (T1) and 4 months postoperatively (T2)
Change in Bone Graft Volume
The volume of the grafted material within the extraction socket will be assessed using CBCT images acquired at T1 and T2. Three-dimensional volumetric measurements will be performed using OnDemand 3D imaging software by delineating the grafted area within the extraction socket. The change in graft volume will be calculated from the difference between the T1 and T2 measurements. Volume will be expressed in cubic millimeters (mm³).
Time frame: Immediately after graft placement (T1) and 4 months postoperatively (T2)
Change in Bone Density at the Grafted Site
Bone density within the grafted extraction socket will be evaluated using CBCT images. A standardized region of interest within the grafted site will be assessed at both time points using OnDemand 3D imaging software. Bone density will be recorded in Hounsfield units (HU), and the change in bone density will be calculated as the difference between the T1 and T2 measurements.
Time frame: Immediately after graft placement (T1) and 4 months postoperatively (T2).
Early Wound Healing
Early soft-tissue wound healing will be assessed clinically using the Landry Wound Healing Index. The index will be determined by clinical examination and standardized clinical photographs. The Landry index evaluates wound healing according to predefined clinical characteristics, with higher scores indicating better healing.
Time frame: Postoperative days 7,14,21,30 days
Postoperative Complications
Postoperative complications will be assessed clinically during scheduled follow-up visits. The presence or absence of the following complications will be recorded for each treatment site: infection, graft exposure, flap necrosis, wound dehiscence, and severe edema. Each complication will be recorded as a binary outcome (Yes/No) based on clinical examination. The occurrence of any complication will also be documented in the study record.
Time frame: Postoperative days 3, 7, and 14
Postoperative Pain
Postoperative pain will be assessed using a Visual Analog Scale (VAS). Participants will record their pain level during the first postoperative week using a 100-mm VAS, where 0 = no pain and 100 = worst imaginable pain. Pain scores will be recorded for each treatment site according to the study assessment schedule.
Time frame: During the first 7 postoperative days
Postoperative Analgesic Consumption
Analgesic consumption will be assessed by recording the number of analgesic tablets taken by each participant during the first postoperative week. Participants will record analgesic use in a postoperative diary, and the total number of tablets consumed during the 7-day period will be recorded as a count (number of tablets).
Time frame: During the first 7 postoperative days
Postoperative Bleeding
Postoperative bleeding will be assessed based on participant-reported bleeding during the first postoperative week and documented in the postoperative follow-up record. Bleeding will be recorded as present or absent (Yes/No) for each treatment site. Any clinically significant bleeding episode requiring additional intervention will also be documented.
Time frame: During the first 7 postoperative days
Postoperative Edema
Postoperative facial edema will be assessed clinically during follow-up visits. The presence and severity of edema will be recorded using a standardized clinical assessment. Edema will be categorized as absent, mild, moderate, or severe based on clinical examination and comparison with the preoperative condition.
Time frame: Postoperative days 3, 5, and 7
Duration of Impairment of Daily Activities
The duration for which postoperative symptoms affect the participant's normal daily activities will be assessed using a postoperative patient diary. Participants will record the number of days during which their daily activities were partially or completely impaired because of the surgical procedure. The outcome will be expressed as the number of affected days
Time frame: During the first 14 postoperative days
Patient Satisfaction with Treatment at Each Extraction Site
Patient satisfaction with the treatment received at each extraction site will be assessed using a Visual Analog Scale (VAS) at 4 months after the procedure. Participants will rate their satisfaction on a 100-ةm VAS ranging from 0 = completely dissatisfied to 100 = completely satisfied. Satisfaction will be recorded separately for each treatment site.
Time frame: 4 months postoperatively
Change in Oral Health-Related Quality of Life
Oral health-related quality of life will be assessed using the Oral Health Impact Profile-14 (OHIP-14) questionnaire. The OHIP-14 consists of 14 items evaluating the impact of oral conditions on daily life. Each item is scored on a five-point response scale from 0 = never to 4 = very often, with total scores ranging from 0 to 56. A lower total score indicates better oral health-related quality of life. The change in OHIP-14 score from baseline to 4 months will be assessed.
Time frame: Baseline and 4 months postoperatively
Feasibility of Dental Implant Placement
The feasibility of dental implant placement at each preserved extraction site will be assessed clinically and radiographically at the 4-month follow-up. The site will be considered suitable for implant placement when the available ridge width is sufficient to accommodate a dental implant with a diameter of at least 3.5 mm, according to the predefined surgical criteria. The outcome will be recorded as feasible or not feasible (Yes/No).
Time frame: 4 months postoperatively
Need for Additional Bone Augmentation Before Implant Placement
The need for additional bone augmentation before dental implant placement will be assessed clinically and radiographically at the 4-month follow-up. Each treatment site will be classified according to whether additional augmentation is required to achieve adequate hard-tissue dimensions for implant placement. The outcome will be recorded as Yes/No, indicating whether additional bone augmentation is required.
Time frame: 4 months postoperatively, before implant placement
Width of Keratinized Tissue
The width of keratinized tissue at each treated extraction site will be measured clinically using a periodontal probe. The measurement will be taken from the gingival margin to the mucogingival junction at the designated treatment site. The width of keratinized tissue will be recorded in millimeters (mm).
Time frame: 4 months postoperatively
Willingness to Undergo a Second Surgical Procedure
The participant's willingness to undergo a second surgical procedure at each treatment site will be assessed by direct questioning during the follow-up visit before the planned implant-related procedure. The response will be recorded separately for each treatment site as Yes or No
Time frame: 4 months postoperatively
No study locations are listed for this record.
Plan to share: Undecided
Start is estimated for Oct 2026; primary completion for May 2027, 6 months later.
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