Alveolar ridge resorption following tooth extraction

Abstract

F ollowing tooth extraction, the fundic part of the bony socket fills in with connective tissue and bone, while the alveolar crest resorbs. After the wound heals and is covered with epithelium, the edentulous ridge remains.l-lo An important question is whether the center of the resulting residual ridge lies over the center of the original dentulous ridge or has shifted towards the original lingual or labial plate. This question is important to the prosthodontist who asks whether the artificial tooth should be placed over the center of the edentulous ridge or whether the artificial tooth should be placed more to the buccal or the lingual side of it in order to occupy more accurately the position of the natural tooth. On the basis of observations of dry skull specimens, Cryer’l stated that the edentulous lower jaw lies external to and is wider than the upper jaw after all teeth have been extracted. Rogers and Applebaum12 concluded from measurements made in cadavers with dentulous and edentulous jaws that in the maxillae the vertical height of the ridges had decreased, and the crest of the edentulous ridge had shifted palatally after tooth extraction. They felt that in the mandible the most extensive resorption of alveolar bone occurred on the superior surface of the ridge and on the lingual surface of at least the posterior part of the ridge. Thus they suggested that resorption of the labial plate in the maxillae results in a loss of edentulous arch length and width, while, in the mandible, resorption of the lingual plate increases the mandibular arch length and width so that the edentulous maxillary arch comes to lie within the edentulous mandibular arch. Tylman and Tylman13 wrote that, in the maxillae, the labial and buccal alveolar plates resorb much faster than the palatal plates, while, in the mandible, the amounts of bone resorbed at the lingual and labial plates are approximately the same. Swenson14 stated that after tooth extraction the alveolar process of the