Focused Clinical Question How should clinicians manage dental extraction sockets when immediate implant placement is contraindicated, and alveolar ridge preservation is expected to result in inadequate bone volume for implant placement? Summary Three fundamental options for extraction socket management form a hierarchical continuum in sites where dental implant placement is planned: place an immediate implant, perform ridge preservation, or perform ridge augmentation. The available volume and quality of bone and keratinized mucosa are the primary considerations driving the decision, and each tier in the continuum encompasses a variety of techniques with attendant advantages and disadvantages. Conclusions Some immediate implant protocols require no mucoperiosteal flap and possibly produce the most favorable clinical and patient‐centered outcomes compared with other extraction socket management approaches. Conversely, guided bone regeneration at dental extraction sites can result in substantial gains in alveolar ridge dimensions, although this treatment may adversely influence mucosal architecture and carry increased risk of postoperative morbidity. When favorable bone and mucosa are present at a dental extraction site, immediate implant placement may be the treatment of choice, barring unusual circumstances. Ridge preservation, typically associated with minimal postoperative morbidity, is a rational second choice when acceptable ridge dimensions are anticipated after healing.

Introduction: Numerous biomaterials are available for augmenting bone around dental implants. In contained extraction sockets, a demineralized freeze‐dried bone allograft (DFDBA) appears capable of maintaining dimensional stability of the alveolar ridge as well as mineralized alternatives but may yield a higher percentage of new vital bone. When DFDBA is used in large horizontal gap defects at molar immediate implant sites, graft containment and protection must occur through provisional restoration, an anatomic custom healing abutment, or by other means. Case Series: Two mandibular molar immediate implant sites received DFDBA covered by dense polytetrafluoroethylene membranes. Conclusion: The present report suggests a protocol for maintaining favorable dimensional stability of the alveolar ridge at molar immediate implant sites, while possibly minimizing residual peri‐implant biomaterial.

IntroductionPostoperative discomfort is a documented complication of the epithelialized palatal graft (EPG) procedure, and the expectation of an unpleasant patient experience may cause some practitioners to avoid EPG altogether. However, EPG affords distinct advantages in a variety of clinical situations, and the postoperative discomfort associated with the procedure can be minimized.Case SeriesThree generally and periodontally healthy patients with gingival recession defects and minimal zones of attached gingiva received mandibular anterior EPG procedures. In all cases, collagen membranes were trimmed to fit the palatal donor sites and sutured in place. Two patients reported minimal donor site discomfort at any time point. One patient with large bilateral donor sites reported moderate palatal discomfort limited to the first postoperative week. All patients reported overall positive treatment experiences.ConclusionsPlacement of a resorbable collagen membrane at large EPG harvest sites appears to limit topical irritation of the wound and may substantially improve patient comfort postoperatively. Combining local and systemic measures to minimize patient discomfort may render EPG procedures very tolerable for patients. Controlled clinical trials comparing patient‐centered outcomes following EPG harvest with and without collagen membrane placement appear warranted.