Bone Loss After Extraction Seen
Socket preservation needed
Socket preservation is often overlooked by dentists and patients.
Can you see what is wrong in the images that you see on the right?
After the extraction of tooth #10 (upper left lateral incisor), a temporary bridge has been placed. In the area where the tooth is extracted, you can see a defect in the jaw bone (collapsed jaw bone ridge). This type of bone defect occurs often after extractions of front teeth. When the tooth was in place, the ridge was full just like it is on the adjacent teeth. Images are used with permission from lomalindaperio.com
Collapse of the jaw bone ridge after extraction happens when the bone covering the root is thin or absent. Thus it happens more often with the extraction of front teeth and in people with thin jaw bone. In the back teeth areas (molar areas), the bone is usually thick and ridge collapse is rare unless the bone in the area has been destroyed by inflammation. The resulting ridge collapse makes implant placement difficult and sometimes impossible.
Socekt Preservation for Future Implant Placement
When the dentist suspects thin bone or absence of bone over the root surface in the front area, he or she may recommend socket preservation (or ridge preservation), grafting the root socket with bone graft material right after the extraction of a tooth. By grafting the socket, the width of the bone ridge can be preserved up to about 80 or 90% of the original width of the ridge.
Socket preservation procedure is simple and painless (it does not add any more discomfort to the extraction of the tooth). After the tooth is removed, the socket is cleaned of any inflammation with instruments. Then, the cleaned socket is filled with bone graft material. The bone graft material placed within the socket is contained by using a membrane or collagen tape or plug. Then the area is sutured to stabilize the graft and the membrane. The sutures are removed 1 to 3 weeks later. If the membrane used does not dissolve (resorb) on its own, it is removed later through another procedure. The grafted socket is left to become mature with patient’s own bone for 6 to 9 months.
It is much easier to preserve the ridge shape than to recreate it later. With socket preservation, the extracted site will have plenty of bone for future implant placement (some variations in results do occur). Even with a conventional bridge, the ridge will look full under the pontic (fake tooth), giving the impression of having a natural tooth in the area.
One of the disadvantages with socket preservation is that the grafted socket requires 6 to 9 months of healing. Natural healing of sockets without grafting is completed in 2 to 4 months. Ridge expansion or bone expansion is an alternative way to deal with ridge collapse.
