Single‐rooted extraction socket classification: A systematic review and proposal of a new classification system based on morphologic and patient‐related factors

Abstract

Taxonomy and classification of a disease contributes to facilitating the diagnosis and treatment planning process and simplifies communication between clinicians. The aim of this study was to provide a critical appraisal based on a systematic review of the single-rooted extraction socket (ES) classifications and subsequently, introduce a new classification system combining the cornerstones of the previously proposed systems and based on the latest consensus in implant dentistry. Following the systematic search process in PubMed, EMBASE, and SCOPUS databases 13 ES classifications were detected. The most repeated hard and soft tissue factors in the previous classifications were buccal bone dehiscence, interproximal bone, gingival recession, and soft tissue phenotype. However, there was minimal attention to patient-related factors such as systemic conditions and smoking. Therefore, a new classification system based on the combination of patient-related factors, clinical and radiographical parameters was proposed. This divides an ES into three types. Class I and II sockets are candidates for receiving immediate implant placement and conversely, a class III socket includes a compromised condition that requires multiplestage reconstruction mostly suitable for standard delayed implant placement with alveolar ridge preservation. Within the limitations of this study, the new classification system not only provides comprehensive inclusion of various crucial parameters in implant placement (such as prediction of future implant position and osteotomy difficulty, etc.) but also, in contrast to the previously introduced systems, is able to classify the ES prior to extraction and also, takes into the account the patient-related factors as the class modifiers following the extraction.

Efficacy of alveolar ridge preservation with xenografts and resorbable socket sealing materials in the esthetic region: A systematic review with meta‐analyses

“…While the included studies described the general condition of the extraction socket, crucial in-situ site characteristics pertaining to the soft tissue (such as phenotype, level or loss, quality, and blood supply) and/or hard tissue (including buccal bone thickness or dehiscence, defect walls, apical topography, and root position) were not reported. 51 Furthermore, this systematic review did not consider outcomes such as implant survival, patient-reported outcome measures, incidence of peri-implant diseases, costs, and esthetics, despite their potential influence on decision-making. 52 Finally, it is important to note that the evaluation of bone reconstructions in severely resorbed sockets fell beyond the scope of the present review.…”

Assessment of the content and quality of YouTube videos related zygomatic implants: A content–quality analysis

“…The rehabilitation of an extremely atrophic maxilla is difficult for dentists because of insufficient bone that precludes placement of conventional‐length dental implants 1 . After tooth extraction, alveolar bone resorption is usually inevitable, and may compromise implant placement 2 . Various bone augmentation procedures have been suggested which increase the bone level and allow rehabilitation with implant‐supported prostheses in cases of atrophic maxilla.…”

“…1 After tooth extraction, alveolar bone resorption is usually inevitable, and may compromise implant placement. 2 Various bone augmentation procedures have been suggested which increase the bone level and allow rehabilitation with implant-supported prostheses in cases of atrophic maxilla. These include grafting procedures, apposition graft with or without Le Fort I osteotomy, and sinus lift.…”

Effect of alveolar ridge preservation on peri‐implant mucositis and peri‐implantitis prevalence: A multicenter, cross‐sectional study

“…9 Many authors classified the alveolar sockets according to the characteristics of both hard and soft tissues [10][11][12][13] and to patient-related factors. 14 The aim of the bone graft is to acts like a scaffold to promote bone formation and to maintain the ridge volume stable during the healing period. 6,15 Therefore, ARP procedures can be considered a treatment to minimize dimensional bone changes, which physiologically occurs after tooth extraction, 3,8 and to facilitate the following implant insertion.…”

“…After a tooth extraction performed in the least traumatic way, the alveolar socket is grafted with a bone substitute with or without a membrane 9 . Many authors classified the alveolar sockets according to the characteristics of both hard and soft tissues 10–13 and to patient‐related factors 14 …”