Socket Preservation Procedure after Tooth Extraction

Abstract

Jaw deformities from tooth removal can be prevented and repaired by a procedure called socket preservation. Socket preservation can greatly improve the smile’s appearance and increase the chances for successful dental implants for years to come. The procedure begins with atraumatic tooth extraction. Every attempt is made to preserve the surrounding bone and soft tissue, with an emphasis on being careful not to fracture the delicate buccal plate. There are a number of techniques and instruments that aid in this process. In general, one never wants to elevate so that force is directed toward the buccal plate. Once the tooth is extracted, all the granulation tissue is removed from the socket. It is important that good bleeding is established in the socket. Next, a bone graft material is placed into the socket.Various materials are used in modern dental and maxillofacial surgery for bone tissue substitution and reconstruction. All osteoplastic materials can be divided into four groups by origin: autogenic, allogenic, xenogenic and synthetic. The development of new medical technologies enables use of achievements in material science, biochemistry, molecular biology and genetic engineering while creating new combined synthetic materials for bone grafting. Mineralized cancellous bone is appropriate for most socket preservation cases.Synthetic resorbable materials were intended as an inexpensive substitute for natural hydroxyapatite. Synthetic graft materials include various types of calcium phosphate ceramics: tribasic calcium phosphate; bioglass; hydroxyapatite and its compositions with collagen, sulphated glycosaminoglycans such as keratan and chrondroitin sulphate as well as with sulphate and calcium phosphate.After the graft material is placed in the socket, it is then covered with a resorbable or non-resorbable membrane and sutured. Primary flap closure is not ideal. Most importantly, socket preservation helps to maintain the alveolar architecture. Socket preservation significantly reduces the loss of ridge width and height following tooth removal.

Efficacy of Sodium Carboxymethyl in Mandibular Extraction Sockets

“…2 Pain, infection, bone loss, or fracture of the tooth are the most common reasons for the extraction of teeth. 3 Once the tooth is extracted, the alveolar bone that holds the tooth in place (the socket) is often damaged or undergoes a three-dimensional bone resorption. And the resorption is lifelong, irreversible, chronic, and cumulative.…”

Benefits of mineralized bone cortical allograft for immediate implant placement in extraction sites: anin vivostudy in dogs

“…In a 30-patient clinical study, the use of biomaterials reduced horizontal loss, but not vertical loss, of the buccal wall [11]. Other studies have demonstrated that vertical bone loss was limited using an allograft covered with a resorbable collagen membrane [1012131415161718]. Clearly, biomaterials delay osseointegration during the time of reossification during new bone-implant contact.…”

“…Pure cortical allograft particles provide the density and strength of an autograft of cortical bone without the cost or invasiveness of that method. Therefore, the renewed interest of clinicians in allografts, with or without a collagenous membrane, justifies new in-depth studies of this material [131518]. Our study focused on cortical bone chips, which have not been previously studied.…”

Alveolar Bone Augmentation

“…Socket preservation helpsto maintain the alveolar architecture and significantly reduces the loss ofridge width and height following tooth removal [22].…”