Purpose: The aim of this randomized controlled clinical trial was to radiographically evaluate hard tissue changes (bone height, width and density) in periodontally involved teeth after socket augmentation using xenograft with platelet rich fibrin compared to xenograft alone and the natural spontaneous healing. Subjects and Methods: A total of thirty extraction sockets in 18 patients were randomly divided into three groups; group I, treated by combined regenerative periodontal therapy (bone grafting using xenograft combined with platelet rich fibrin membrane).group II, treated by bone grafting using xenograft alone and group III, left untreated without bone graft or membrane placement (Control group). Radiographic parameters including linear and densometric radiographic measurements were measured at baseline then 6 months post-operatively in all studied groups. Results: Radiographic results showed statistically significant differences post operatively in all the groups. As group I (xenograft with PRF) showed statistically significant higher mean bone density, width and height post-operatively than the two other groups. Conclusion: Extraction Sockets treated with PRF combined with xenograft showed least reduction in alveolar ridge width and height and greatest increase in bone density than the other studied groups.