Ovate Pontic Versus Essix Provisional After Tooth Extraction and Alveolar Ridge Preservation (Pontic-Essix)

This randomized controlled trial compares two provisional socket-sealing concepts following single non-molar tooth extraction and alveolar ridge preservation: a fixed, tooth-supported, 3D-printed ovate pontic provisional restoration providing active soft tissue support (test) versus a removable Essix-type provisional restoration without intentional soft tissue contact combined with a porcine collagen matrix seal (control). Both groups receive alveolar ridge preservation using a deproteinized bovine bone mineral with 10% collagen. The primary endpoint is interproximal soft tissue height at 5 months, adjusted for baseline, assessed by digital superimposition of intraoral surface scans. Up to 40 participants will be enrolled at the University of Bern School of Dental Medicine.

Inclusion Criteria: * Adults aged 18 years or older * ASA physical status I or II * Requiring a single non-molar tooth extraction (incisor, canine, or premolar) in the maxilla or mandible, with planned tooth replacement * Extraction site bounded by natural, periodontally stable adjacent teeth * Intact alveolar socket upon extraction, or no more than one bony wall (facial, palatal, or lingual) presenting a dehiscence extending less than 50% of the total bony wall height * Willingness and ability to comply with the follow-up protocol * Ability to give informed consent, as documented by signature Exclusion Criteria: * Current smokers, or former smokers who quit less than 6 months before extraction * Uncontrolled diabetes mellitus (HbA1c \> 7.0%) * Clinical attachment loss ≥ 2 mm at the extraction site * Active or recent chemotherapy, or history of head and neck radiotherapy * Current or previous bisphosphonate therapy within the past 10 years * Immunosuppressive medication * Active oral or systemic acute infection * Severe hematologic disorder, hepatic or renal failure, or any clinically relevant bleeding disorder or anticoagulant medication that cannot be safely managed for the planned surgical procedure * Pregnancy or lactation * Known allergy or hypersensitivity to any of the study materials, including bovine-derived bone substitute, porcine-derived collagen matrix, or collagen-containing biomaterials * Any other disease or medication that may compromise normal wound healing * Inability to follow the study procedures (e.g., insufficient language comprehension, cognitive impairment, psychological disorder, or dementia) * Known or suspected non-compliance * Participation in another clinical trial that may interfere with the present study