Letter to the editor in response to "Microbial colonization in the partially exposed nonabsorbable membrane during alveolar ridge preservation" (Braz et al., clinical oral Investigations, https://doi.org/10.1007/s00784-024-05763-7.).

Objective: This letter addresses the recent study by Braz et al. published in Clinical Oral Investigations in 2024 ( https://doi.org/10.1007/s00784-024-05763-7 ), which reported that intentionally exposed d-PTFE membranes modulate microbial colonization in alveolar ridge preservation (ARP) sites, creating a more homogeneous and anaerobic community on both the inner and outer surfaces of the membrane.

Materials And Methods: We argue that the study's methodology may have skewed the results, particularly the inclusion of both intact and damaged extraction sockets (with loss of the buccal wall) and the absence of bone grafting.

Results: The absence of bone graft might have contributed to membrane dislodgement and increased microbial contamination rather than the membrane's inherent properties.

Conclusion: This critique is significant because it challenges the conclusion that the d-PTFE membrane itself is responsible for microbial colonization, highlighting the need to consider extrinsic factors and study design limitations.

Clinical Relevance: Our discussion aims to enhance the understanding of microbial dynamics in ARP procedures and emphasizes the need for caution when interpreting the study's findings, given the context of established clinical practices and existing evidence.