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Socket Preservation As a Precursor For Future Implant Placement – A case presentation

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INTRODUCTION

Tooth extraction whether traumatic or atraumatic, results in alveolar bone loss both in height and width. An average of 40-60% of original height and width is expected to be lost after extraction, most of which takes place within the first year. The rate of reduction of residual alveolar ridges is greater in mandibular (0.4mm/year) than in maxillary arches (0.1mm/year), 1mm in vertical bone 2-2.5 mm in horizontal bone resorption corresponding to 2mm soft tissue recession.
 This might negatively influence bone volume that is needed for future implant placement and also the ideal esthetic restoration and functional outcomes. Socket preservation allows preserving alveolar bone height, potentially regenerating new bone and thus maintaining the soft tissue height.

RATIONALE

According to Bays 1986, the rationale lies on the basis that the alveolar ridge resorption is an unavoidable sequelae to tooth loss. The most recent attempt to overcome the detrimental effects of deficient alveolar ridge is socket preservation, which maintains adequate dimensions of bone for implant placement as well as maintains a more esthetic gingival profile.

TECHNIQUES :-

1. Traditional socket preservation with or without collagen wound dressing material
2. LAYER’S TECHNIQUE
3.GUIDED BONE REGENERATION / Sandwich technique
4. IMMEDIATE IMPLANT PLACEMENT WITH GUIDED BONE REGENERATION

CASE PRESENTATION:-

1. PRE-OPERATIVE PHOTOGRAPH

2. ATRAUMATIC EXTRACTION irt 11

3. SITE GRAFTED

4. PROVISIONAL RPD GIVEN - for maintaining soft tissue profile.
Placement of PME after 4 months

Impression with analog in place

Prepared abutment

ABUTMENT IN PLACE

FINAL  CEMENT RETAINED PROSTHESIS
Final Radiograph

REFERENCES:-

  1. Ashman,A. 1995 Ridge Preservation The New Buzzword In Dentistry. Implant Soc, 6, pp1-7
  2. Ashman,A. 2000 Post Extraction Ridge Preservation Using A Synthetic Alloplast. Implant Dent ,9,pp.168-176
  3. Barboza,E.P. 1999 Localised Ridge Maintenance Using Bone Membrane. Implant Dent ,8 (2),pp.167-172
  4. Bartee,B.K..1995 A Simplified Technique For Ridge Preservation After Tooth Extraction. Dent Today,14,pp 62-67
  5. Iasella,J.M., H.Greenwell,R.L. Miller, M.Hill,C. Drisko,A.A.Bohra,et al. 2003 Ridge preservation with freeze- dried bone allograft and a collagen membrane compared to extraction socket alone for implant site development- a clinical and histologic study in humans. Journal of Periodontol,74,pp 990-999.
  6. Nevins,M. , J.T. Mellonig 1994. The advantages of localized ridge augmentation prior to implant placement: a staged event. International Journal Periodontics Restorative Dentistry, 14,pp.96-111

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