Alveolar ridge resorption after tooth extraction: A consequence of a fundamental principle of bone physiology

S Hansson,A Halldin

doi:10.1177/1758736012456543

Abstract

It is well established that tooth extraction is followed by a reduction of the buccolingual as well as the apicocoronal dimension of the alveolar ridge. Different measures have been taken to avoid this bone modelling process, such as immediate implant placement and bone grafting, but in most cases with disappointing results. One fundamental principle of bone physiology is the adaptation of bone mass and bone structure to the levels and frequencies of strain. In the present article, it is shown that the reduction of the alveolar ridge dimensions after tooth extraction is a natural consequence of this physiological principle.

Highlights

It is well established that tooth extraction is followed by a reduction of the buccolingual as well as apicocoronal dimension of the alveolar ridge at the edentulous site.[1,2]
It has been suggested that immediate implant placement into fresh extraction sockets might counteract this catabolic process and preserve the dimensions of the alveolar ridge.[3,4,5,6]
The application of freeze-dried bone allograft in combination with a membrane was found to improve the ridge dimensions in patients after 6 months compared to a control, both vertically and horizontally.[12]

Summary

Introduction

It is well established that tooth extraction is followed by a reduction of the buccolingual as well as the apicocoronal dimension of the alveolar ridge. It is well established that tooth extraction is followed by a reduction of the buccolingual as well as apicocoronal dimension of the alveolar ridge at the edentulous site.[1,2] It has been suggested that immediate implant placement into fresh extraction sockets might counteract this catabolic process and preserve the dimensions of the alveolar ridge.[3,4,5,6] studies in humans[7] and experiments in dogs[8,9] have belied this hypothesis In another dog study, it was found that the resorption of the buccal/lingual walls occurred in two overlapping phases. The lamellae of cancellous bone are preferentially aligned with the principal strains caused by the dominating loads.[16,18,19] This enables the most economical use of the bone material. Based on a compilation of animal experimental data, Qin et al.[23] proposed the following formula for a daily stress stimulus,

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