Vitamin C Enters a Dental Ridge-Preservation Trial Built Around Autologous Tooth Graft Material
A randomized clinical trial in adults will test whether ascorbic acid-loaded injectable platelet-rich fibrin can improve alveolar ridge preservation after tooth extraction and before delayed implant placement. The study centers on a practical problem in oral surgery: once a tooth is removed, the surrounding socket begins to remodel, and the jawbone can narrow and lose height before an implant is ready to be placed. For patients who are expected to return later for implant therapy, preserving the shape and volume of the extraction site is often the difference between straightforward rehabilitation and a more complex reconstructive pathway.
Investigators will compare three approaches in a prospective, three-arm randomized design. One group will receive partially demineralized dentin graft alone, another will receive the same dentin graft combined with injectable platelet-rich fibrin or I-PRF, and a third will receive dentin graft combined with I-PRF enriched with vitamin C. The work is designed to probe a biologically plausible question: whether adding ascorbic acid to a blood-derived scaffold can improve healing enough to better preserve the ridge and support bone formation at the implant site.
One detail gives the study unusual clinical interest. The grafting material comes from the patient’s own extracted tooth.
Autologous Dentin, Blood-Derived Fibrin, and the Biology of Socket Healing
The trial uses a partially demineralized dentin graft prepared from the participant’s extracted tooth. Autogenous dentin is attractive because it is already biologically familiar to the body and may behave as a local mineralized scaffold during healing. In this protocol, the dentin is not being used in isolation. It is paired either with I-PRF or with I-PRF loaded with ascorbic acid, creating a family of interventions that all start with the patient’s own tissues and blood components.
I-PRF is a platelet-rich product prepared from peripheral blood. In oral surgery, platelet concentrates are used to support early healing through a fibrin matrix and biologically active factors released from platelets. The addition of vitamin C is the more mechanistic twist here. Ascorbic acid is central to collagen synthesis and connective tissue repair, and its role in osteoblast function makes it a sensible candidate when the endpoint is new bone formation rather than only soft-tissue closure. In theory, enriching the fibrin scaffold with vitamin C may create a more favorable microenvironment for mineralized tissue repair inside the socket.
The comparison is therefore not merely about which graft material fills the space. It is about which biologic environment most effectively supports the transition from extraction wound to implant-ready ridge.
Three Parallel Arms Will Be Measured With CBCT and Bone Biopsy
The study is set up as a randomized controlled trial with parallel assignment. Participants will undergo atraumatic extraction, then receive one of the three ridge-preservation protocols. The protocol also makes a clear methodological choice: the surgical operator will not be blinded, because the materials differ in their preparation and application, but outcome assessors will be masked. The examiner evaluating cone beam computed tomography, or CBCT, will be blinded to treatment assignment, and the histopathologist and histomorphometric examiner will also remain blinded during analysis.
This matters because ridge preservation trials can be vulnerable to subjective interpretation when imaging and tissue assessment are not masked. Here, the masking strategy is aimed at keeping the measurements of ridge width, ridge height, and tissue composition as objective as possible.
Follow-up will include clinical examination during healing and three-dimensional dental scans taken before treatment and four months later. Those scans will be used to measure changes in jawbone dimensions. At the time of delayed implant placement, a small bone sample will be collected for histological and histomorphometric evaluation. That biopsy will allow investigators to look beyond the external contour of the ridge and examine the interior repair process: how much new bone formed, how much graft material remains, and how much connective tissue persists inside the healing socket.
Eligibility Criteria Narrow the Cohort to Healthy Adults With Extraction Sites Suited to Preservation
The planned enrollment is 48 participants, all adults between 18 and 60 years of age. The population is intentionally narrow. Eligible participants must be medically healthy, classified as ASA type I, and have non-restorable teeth that are being removed with delayed implant placement planned afterward. The protocol also requires a site suitable for ridge preservation, periodontally healthy neighboring teeth, good oral hygiene, and willingness to comply with the four-month follow-up period.
Several common clinical variables are excluded. Patients with uncontrolled systemic disease affecting bone healing, prior radiotherapy or chemotherapy involving the head and neck, medications that alter bone metabolism, tobacco use, pregnancy, lactation, active infection at the extraction site, poor oral hygiene, untreated periodontal disease, or inability to consent are not eligible. The restrictions keep the study focused on a biologically cleaner healing model, where differences in ridge preservation are less likely to be blurred by systemic disease or major healing impairment.
The design is sensible for an early comparative study, but it also limits how broadly the findings can be applied. Healthy, compliant adults with controlled extraction sites are not the same as the mixed implant population seen in everyday practice, where diabetes, smoking, periodontal disease, and urgent extractions are common.
Ridge Width, Ridge Height, and Histology Will Decide Whether Vitamin C Adds Value
The trial’s primary clinical logic is straightforward: if the vitamin C-loaded arm preserves ridge dimensions better than dentin graft alone or dentin graft plus standard I-PRF, it could offer a more refined socket-preservation method for delayed implant cases. If the histologic sample also shows more mature bone formation and a more favorable balance between new bone, residual graft, and connective tissue, the biologic argument becomes stronger still.
What makes this trial interesting is the way it combines everyday oral surgery with a targeted biochemical hypothesis. Dentin grafting addresses the scaffold. I-PRF contributes a patient-derived fibrin matrix. Vitamin C targets the cellular machinery of repair. In a healing socket, those elements act on different levels of the same process: structure, signaling, and collagen-dependent tissue organization.
The estimated study start is October 30, 2026, with primary completion expected in March 2027 and full completion in June 2027. Until then, the question remains tightly focused on whether vitamin C can improve the performance of an already biologically appealing grafting strategy. The real test will be whether the added complexity of loading I-PRF with ascorbic acid translates into a measurable advantage in ridge preservation and bone quality at implant placement.