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    Socket Preservation

    Uploaded by

    Manu Gupta
    The document discusses healing after tooth extraction and socket preservation techniques. It notes that extraction sockets typically experience 5-7 mm of horizontal ridge reduction and 2-4.5 mm of vertical ridge reduction over 6-12 months, with most changes in the first 3 months as the socket heals. Extraction sockets are classified as Type I-III based on the degree of soft and hard tissue loss, with Type III sockets being the most difficult to treat requiring grafting. Socket preservation techniques include atraumatic extraction, grafting the socket, using a membrane to protect grafts and prevent buccal plate collapse, and preventing socket wall collapse during healing.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Socket Preservation

    Uploaded by

    Manu Gupta
    227 views8 pages
    The document discusses healing after tooth extraction and socket preservation techniques. It notes that extraction sockets typically experience 5-7 mm of horizontal ridge reduction and 2-4.5 mm of vertical ridge reduction over 6-12 months, with most changes in the first 3 months as the socket heals. Extraction sockets are classified as Type I-III based on the degree of soft and hard tissue loss, with Type III sockets being the most difficult to treat requiring grafting. Socket preservation techniques include atraumatic extraction, grafting the socket, using a membrane to protect grafts and prevent buccal plate collapse, and preventing socket wall collapse during healing.

    Original Title

    SOCKET PRESERVATION

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    The document discusses healing after tooth extraction and socket preservation techniques. It notes that extraction sockets typically experience 5-7 mm of horizontal ridge reduction and 2-4.5 mm of vertical ridge reduction over 6-12 months, with most changes in the first 3 months as the socket heals. Extraction sockets are classified as Type I-III based on the degree of soft and hard tissue loss, with Type III sockets being the most difficult to treat requiring grafting. Socket preservation techniques include atraumatic extraction, grafting the socket, using a membrane to protect grafts and prevent buccal plate collapse, and preventing socket wall collapse during healing.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    227 views8 pages

    Socket Preservation

    Uploaded by

    Manu Gupta
    The document discusses healing after tooth extraction and socket preservation techniques. It notes that extraction sockets typically experience 5-7 mm of horizontal ridge reduction and 2-4.5 mm of vertical ridge reduction over 6-12 months, with most changes in the first 3 months as the socket heals. Extraction sockets are classified as Type I-III based on the degree of soft and hard tissue loss, with Type III sockets being the most difficult to treat requiring grafting. Socket preservation techniques include atraumatic extraction, grafting the socket, using a membrane to protect grafts and prevent buccal plate collapse, and preventing socket wall collapse during healing.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 8

    27/10/2017

    Healing of Extraction socket


    1.External dimensional
    changes at the
    extraction socket,
    •
    2. Internal dimensional

    SOCKET PRESERVATION changes within the


    extraction socket,

    3.dimensional changes
    in a damaged extraction
    socket,

    4 . dimensional changes
    in the mucosa1

    Al sabbagh - Immediate implant placement- Dent Clin N Am 59 (2015) 73–95

    Healing of Extraction socket Healing of Extraction socket


    •
    Dimensional changes
    • Horizontal ridge reduction  5 – 7
    mm
    • Vertical ridge reduction  2 – 4.5
    mm
    • This reduction occurs over a period
    of 6 to 12 months, although most
    of the changes occur during the
    first 3 months.

    Al sabbagh - Immediate implant placement- Dent Clin N Am 59 (2015) 73–95


    Al sabbagh - Immediate implant placement- Dent Clin N Am 59 (2015) 73–95

    1
    27/10/2017

    Reasons????? Bone Remodelling after Extraction


    • loss of blood supply secondary to loss of the periodontal • It has been well documented that the ridge follows a predictable
    ligament pattern of resorption following the extraction of a tooth.
    • Bone resorption usually is greater in the horizontal plane than in the
    vertical plane
    • disuse atrophy

    • Infections, preexisting root fractures and traumatic


    extractions can be additional contributing factors.

    Block et al - Dental Extractions and Preservation of Space for Implant Placement in Molar Block et al - Dental Extractions and Preservation of Space for Implant Placement in Molar
    Sites. DCNA -2015 Sites. DCNA -2015

    Remodeling of ridge after Extraction CLASSIFICATION OF EXTRACTION SOCKET


    •

    Stephen T. Chen, Immediate or Early Placement of Implants Following Tooth Extraction.


    IJOMI 2004 Elian et al , A simplified socket classification and repair technique, Pract Proced Aesthet
    Dent 2007;

    2
    27/10/2017

    CLASSIFICATION OF EXTRACTION SOCKET CLASSIFICATION OF EXTRACTION SOCKET


    • Type I sockets are the easiest and most predictable to treat. Most of • Type II sockets are often times the most difficult to diagnose. These
    the cases seen demonstrating excellent aesthetics with implants are sockets can be very deceptive, as the inexperienced clinician may
    Type I sockets. make the mistake of treating it as a Type I socket.
    • This often leads to a less than ideal aesthetic result. The largest group
    • This is particularly true if the soft tissue profile is thick and flat as of aesthetic problems comes from improper treatment of Type II
    opposed to a highly scalloped, thin profile. sockets because of the posttreatment soft tissue recession that may
    occur.

    Elian et al , A simplified socket classification and repair technique, Pract Proced Aesthet Elian et al , A simplified socket classification and repair technique, Pract Proced Aesthet
    Dent 2007; Dent 2007;

    Socket preservation
    CLASSIFICATION OF EXTRACTION SOCKET
    Technique
    • Type III sockets, however, are very difficult to treat and require soft • Atraumatic extraction
    tissue augmentation with additional grafts of connective tissue, or • Graft the socket
    connective tissue and bone, in a staged approach to rebuild lost
    tissue • Protect with a membrane
    • These cases are associated with soft tissue recession and loss of the • Prevent collapse of buccal plate
    buccal plate on the tooth prior to extraction.

    • Sockets in this classification require very high dental experience, skill,


    and time commitment for success.

    Elian et al , A simplified socket classification and repair technique, Pract Proced Aesthet
    Dent 2007;

    3
    27/10/2017

    ATRAUMATIC EXTRACTION ATRAUMATIC EXTRACTION

    careful inspection of the


    extraction socket

    walls are thoroughly curetted to


    Periotomes Tooth Sectioning remove all remnants of the
    periodontal ligament

    Irrigated with normal saline

    4
    27/10/2017

    EXTRACTION SOCKET EVALUATION


    Atraumatic extraction
    Visual
    Examination

    Probing
    of the
    socket

    Caplanis et al , Extraction defect Assessment, classification, and management, CDA


    2005

    Xenograft & collagen membrane Graft the socket

    Overfill the socket

    5
    27/10/2017

    Protect graft with barrier membrane Provisionals for soft tissue contouring

    Socket preservation for posteriors Atraumatic extraction

    6
    27/10/2017

    Graft and membrane Post extraction defects in buccal plate

    Graft and barrier membrane Socket preservation


    • Unaugmented sockets decreased in width by an average of 1.7 mm,
    while grafted sites decreased by 1.2 mm (a difference of 0.5 mm).
    • The quantity of bone observed on histological analysis was slightly
    greater in preservation sites, although these sites included both vital
    and nonvital bone.

    Becker et al - Immediate implant placement: treatment planning and surgical steps


    for successful outcome. Periodontology 2000

    7
    27/10/2017

    Socket preservation Technique Is it a valuable technique


    • Overall the socket intervention therapies did reduce alveolar ridge • Important to preserve the buccal bone volume for esthetic reasons in
    dimensional changes postextraction, but were unable to prevent anteriors
    resorption. • Suitable for type 1 and 2 extraction sockets
    • Histology did demonstrate a large proportion of residual graft • Less critical in posterior sockets with thick buccal plates
    material that may account for some of the difference in alveolar ridge
    dimensions at follow up. • Helps in building up the soft tissue thickness crestally

    Morjaria et al, Bone Healing after Tooth Extraction with or


    without an Intervention - Clinical Implant Dentistry and Related Research 2014

    Any other alternative?


    • Immediate implant placement

    • Socket shielding technique

    • Guided bone regeneration

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