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.