Extraction Socket Management
Scientific background
Bone and soft-tissue remodeling after tooth extraction has been investigated thoroughly.
Clinical studies show that:
- after tooth extraction, severe volume loss occurs because of bone and soft-tissue resorption1–5
- two-thirds of resorption take place within the first three months1
Therefore, at the time of implant placement and if no Ridge Preservation is performed,
- the need for Guided Bone Regeneration is ten times higher6
- the need for Sinus Floor Elevation is two times higher and the number of more invasive procedures four times higher7
References
- Schropp L, et al.: Int J Periodontics Restorative Dent 2003; 23(4): 313-23. (Clinical study)
- Van der Weijden F, et al.: J Clin Periodontol 2009; 36(12): 1048-58. (Systematic review)
- Sanz M, et al.: Clin Oral Implants Res 2010; 21(1): 13-21. (Clinical study)
- Hammerle CH, et al.: Clin Oral Implants Res 2012; 23 Suppl 5: 80-82. (Systematic review)
- Jung RE, et al.: J Clin Periodontol 2013; 40(1) :90-98. (Clinical study)
- Weng D, et al.: Eur J Oral Implantol 2011; 4 Suppl: 59-66. (Systematic review)
- Cha JK, et al.: Clin Oral Implants Res 2019; 30: 515-23. (Clinical study)
- Nevins M, et al.: Int J Periodontics Restorative Dent 2006; 26(1): 19-29. (Clinical study)
- Vignoletti F, et al.: Clin Oral Implants Res 2012; 23 Suppl 5: 22-38. (Systematic review)
- Avila-Ortiz G, et al.: J Dent Res 2014; 93(10): 950-58. (Systematic review)
- Cardaropoli D, et al.: Int J Periodontics Restorative Dent 2012; 32(4): 421-30. (Clinical study)
- Cardaropoli D, et al.: Int J Periodontics Restorative Dent 2014; 34(2): 211-17. (Clinical study)
- Morjaria KR, et al.: Clin Implant Dent Relat Res 2014; 16(1): 1-20. (Systematic review)
- Horvath A, et al.: Clin Oral Investig. 2013; 17(2): 341-63. (Systematic review)
- Vittorini Orgeas G, et al.: Int J Oral Maxillofac Implants 2013; 28(4): 1049-61. (Systematic review)
- Ackermann KL: Int J Periodontics Restorative Dent 2009; 29(5): 489-97. (Clinical study)
- Schlee M, Esposito M: Eur J Oral Implantol 2009; 2(3):209-17. (Clinical study)
Fig. 1: Spontaneous healing. A: After tooth extraction. B: 2 months after tooth extraction
On the other hand, several studies, including randomized controlled clinical trials and meta-analyses, show that Ridge Preservation with Geistlich biomaterials can:
- prevent horizontal and vertical volume loss even in sites with thin buccal bone walls8
- optimize the bone and soft-tissue situation irrespective of the chosen time for implantation5,9-16
- improve the esthetic outcome by preserving the alveolar ridge volume and contour under pontics17
References
- Schropp L, et al.: Int J Periodontics Restorative Dent 2003; 23(4): 313-23. (Clinical study)
- Van der Weijden F, et al.: J Clin Periodontol 2009; 36(12): 1048-58. (Systematic review)
- Sanz M, et al.: Clin Oral Implants Res 2010; 21(1): 13-21. (Clinical study)
- Hammerle CH, et al.: Clin Oral Implants Res 2012; 23 Suppl 5: 80-82. (Systematic review)
- Jung RE, et al.: J Clin Periodontol 2013; 40(1) :90-98. (Clinical study)
- Weng D, et al.: Eur J Oral Implantol 2011; 4 Suppl: 59-66. (Systematic review)
- Cha JK, et al.: Clin Oral Implants Res 2019; 30: 515-23. (Clinical study)
- Nevins M, et al.: Int J Periodontics Restorative Dent 2006; 26(1): 19-29. (Clinical study)
- Vignoletti F, et al.: Clin Oral Implants Res 2012; 23 Suppl 5: 22-38. (Systematic review)
- Avila-Ortiz G, et al.: J Dent Res 2014; 93(10): 950-58. (Systematic review)
- Cardaropoli D, et al.: Int J Periodontics Restorative Dent 2012; 32(4): 421-30. (Clinical study)
- Cardaropoli D, et al.: Int J Periodontics Restorative Dent 2014; 34(2): 211-17. (Clinical study)
- Morjaria KR, et al.: Clin Implant Dent Relat Res 2014; 16(1): 1-20. (Systematic review)
- Horvath A, et al.: Clin Oral Investig. 2013; 17(2): 341-63. (Systematic review)
- Vittorini Orgeas G, et al.: Int J Oral Maxillofac Implants 2013; 28(4): 1049-61. (Systematic review)
- Ackermann KL: Int J Periodontics Restorative Dent 2009; 29(5): 489-97. (Clinical study)
- Schlee M, Esposito M: Eur J Oral Implantol 2009; 2(3):209-17. (Clinical study)
Fig 2: Volume preservation with Ridge Preservation technique: A: After tooth extraction. B: 3 months after tooth extraction.
Spontaneous healing vs. Ridge Preservation
Spontaneous healing vs. Ridge Preservation
Fig 3: Spontaneous healing vs. Ridge Preservation
Teaser Clinical Cases Extraction Socket