Facial Wall Research Articles

Impact of different cephalometric skeletal configurations on anatomic midface parameters in adults

ObjectivesSkull morphology and growth patterns are essential for orthodontic treatment, impacting clinical decision making. We aimed to determine the association of different cephalometric skeletal configurations on midface parameters as measured in 3D CT datasets.Materials and methodsAfter sample size calculation, a total of 240 fully dentulous patients between 20 and 79 years of age (mean age: 42 ± 15), who had received a CT of the skull within the scope of trauma diagnosis or intracranial bleeding, were retrospectively selected. On the basis of cephalometric analysis, using MPR reconstructions, patients were subdivided into three different vertical skull configurations (brachyfacial, mesofacial, dolichofacial) and the respective skeletal Class I, II, and III relationships. Anatomic parameters were measured using a three-dimensional post-processing console: the thickness of the maxillary and palatine bones as well as the alveolar crest, maxillary body and sutural length, width and height of the hard palate, maxillary facial wall thickness, and masseter muscle thickness and length.ResultsIndividuals with brachyfacial configurations had a significantly increased palatal and alveolar ridge thicknesses compared to those with dolichofacial- or mesofacial configurations. Brachyfacial configurations presented a significantly increased length and thickness of the masseter muscle (4.599 cm; 1.526 cm) than mesofacial (4.431 cm; 1.466 cm) and dolichofacial configurations (4.405 cm; 1.397 cm) (p < 0.001). Individuals with a skeletal Class III had a significantly shorter palatal length (5.313 cm) than those with Class I (5.406 cm) and Class II (5.404 cm) (p < 0.01). Sutural length was also significantly shorter in Class III (p < 0.05).ConclusionsSkeletal configurations have an impact on parameters of the bony skull. Also, measurable adaptations of the muscular phenotype could result.Clinical relevanceThe association between viscerocranial morphology and midface anatomy might be beneficial for tailoring orthodontic appliances to individual anatomy and planning cortically anchored orthodontic appliances.

Prominent osteolysis in the maxilla: case report of an odontogenic fibroma mimicking a cyst

BackgroundOdontogenic fibroma (OF) is a rare benign odontogenic tumor of ectomesenchymal origin, mostly affecting the tooth-bearing portions of the jaws in middle-aged patients. Whilst small lesions tend to be clinically asymptomatic, varying unspecific clinical symptoms occur with an increase in size and may mimic odontogenic or other maxillofacial bone tumors, cysts, or fibro-osseous lesions of the jaws.Case presentationA 31-year-old female patient presented with a hard, non-fluctuating protrusion in the vestibule of the upper right maxilla. It was visualized on cone beam computed tomography (CBCT) as space-occupying osteolysis with the displacement of the floor and facial wall of the maxillary sinus, mimicking a cyst-like lesion. The tissue was surgically removed and identified as an OF in the histopathological examination. One year after the surgery, restitution of regular sinus anatomy and physiological intraoral findings were observed.ConclusionsThis case report emphasizes that rare entities, like the maxillary OF presented, often demonstrate nonspecific clinical and radiological findings. Nevertheless, clinicians need to consider rare entities as possible differential diagnoses and plan the treatment accordingly. Histopathological examination is essential to conclude the diagnosis. OF rarely recur after proper enucleation.

Evaluation of the anterior maxillary bone for implant placement and its relationship with the final restoration using Cone Beam Computed Tomography (CBCT) images

Statement of the Problem: The thickness and height of the facial wall of the alveolar bone in anterior part of maxilla is a critical factor to achieving esthetic and success of implant insertion. Objectives:The aim of present study was evaluating the anterior maxillary bone by cone beam computed tomography (CBCT) images.Methods :In this in vitro study, 200 CBCT images of the anterior maxillary teeth were examined. Each tooth was classified according to the sagittal root position and the measurements were done by one practitioner. Results:The following variables were significantly associated with gender (male predilection): tooth-ridge angulation (TRA )in the right lateral teeth; concavity angulation (CA)in the right central and lateral teeth; concavity depth (CD ) in the right lateral teeth and both canines; concavity location (CL)in the right canine; buccal bone height (BH)and palatal bone height ( PH) in the left canine.Age was associated with CLand ridge angulation in none of the teeth; with TRA and CD in all anterior teeth; bone density in the right lateral teeth; with CA in both lateral teeth; with BH in both central teeth; with PHin the right central and left lateral teeth; and with TA in both lateral teeth and canines.

Influence of restorative materials on occlusal and internal adaptation of CAD-CAM inlays

Aim: To evaluate the occlusal and internal marginal adaptation of inlay restorations made of different materials, using CAD-CAM. Methods: Preparations were made for MOD inlays of one-third intercuspal width and 4 mm depth in 30 third human molars. The teeth were restored using CAD-CAM materials (n=10) of nanoceramic resin (Lava Ultimate), polymer-infiltrated ceramic network (VITA ENAMIC), or lithium disilicate glass-ceramic (IPS e.max CAD). The specimens were cemented with dual resin cement and sectioned at the center of the restoration, after which the two halves were evaluated, and photographed The occlusal and internal discrepancy (μm) was determined at five points: cavosurface angle of the occlusal-facial wall (CA-O); center of the facial wall (FW); faciopulpal angle (FPA); center of the pulpal wall (PW); and center of the lingual wall (LW). The data were submitted to the Kruskal-Wallis and the Dunn tests (α=0.05). Results: No difference was observed among the materials regarding the occlusal discrepancy at the CA-O, FPA, or PW internal points. The e.max CAD measurement at FW showed larger internal discrepancy than that of Lava (p=0.02). The internal discrepancy at LW was greater for e.max CAD than VITA ENAMIC (p=0.02). Conclusion: Lithium disilicate glass-ceramic presented greater internal discrepancy in relation to the surrounding walls of the inlay preparations.

“Cone Beam Imaging of Cochlear Implants “

Abstract Objectives to assess the role of Cone Beam CT (CBCT) in the postoperative cochlear implant (CI) imaging in determining details about the electrode position, insertion depth, angle and other fine anatomical details. Methods This retrospective study included 32 patients (34 ears) with post-CI CBCT imaging. All images were anonymized and reviewed by two experienced head and neck radiologists in consensus for the measurements of the implant insertion depth, facial canal (vertical part) diameter, wall thickness and distance between it and the electrode cable, then assessment of the quality of visualization of fine structures as the facial nerve canal, chorda tympani, separate electrode contacts and scalar position of electrodes were done using 4-point scale. Results The insertion angles for the electrodes were measured in all the ears with a mean ± SD = 430.24 ± 121.43, the facial canal diameters were measured in 97.1% (33 ears) with a mean ± SD = 1.54 ± 0.33, the facial wall thickness was measured in 79.4% (27 ears) with a mean ± SD = 0.62 ± 0.32, the facial canalelectrode cable distances were measured in 97.1% (33 ears) with a mean ± SD = 1.64 ± 0.50 and the chorda tympani was visualized in 88.2% (30 ears). Perfect visualization of the scalar position of electrodes were encountered in 76.5% (26 ears), separate electrode contacts in 20.6% (7 ears), facial canal in 35.3% (12 ears), facial canal wall in 26.5% (9 ears), and chorda tympani in 41.2% (14 ears). Conclusion CBCT is a valuable tool in the postoperative assessment of cochlear implants

Novel CAD-CAM zirconia coping design to enhance the aesthetics and strength for anterior PLZ crowns.

The aesthetics and strength of anterior porcelain layered zirconia (PLZ) crowns are mainly affected by the zirconia (Zr) coping design. There is a need for a modified design to enhance aesthetics with strength. The purpose of this study was to compare the fracture resistance of anterior PLZ crowns having modified CAD-CAM Zr coping designs (in terms of thickness and marginal collar designs) with standard Zr copings. Fifty PLZ crowns were fabricated and divided into two groups: Gr 1: Standard Zr Coping (SZC) (control gr) with 0.5 mm thickness (Facial-F, Mesial-M, Distal-D, incisal-I, and Palatal-P) without a collar; Gr 2: Collar Zr Coping (CZC) (test gr) with 2.5 mm collar height on M, D, P and 0.2 mm F and variable facial wall thickness. Subgroups: Gr 2a: (CZC-0.5 mm) facial wall thickness 0.5 mm; Gr 2b: (CZC-0.4 mm) facial wall thickness 0.4 mm; Gr 2c: (CZC-0.3 mm) facial wall thickness 0.3 mm; Gr 2d: (CZC-0.2 mm) facial wall thickness 0.2 mm. The fracture load was determined and analysed using One-way ANOVA and Dunnet test. The minimum fracture load was 927.36 ± 127.80 N observed for Gr 2c (CZC at 0.3 mm) while the maximum fracture load was 1373.61 ± 146.54 N observed for Gr 2a (CZC at 0.5 mm). A highly significant difference in mean fracture load among various Zr coping groups (p< 0.001) was determined. Novel Zr coping design for anterior PLZ crowns can provide better aesthetics with strength. Reducing the thickness of Zr coping in the aesthetic zone to 0.2 mm and providing a modified collar design (2.5 mm collar height on M, D, P, and 0.2 mm F) would provide strength without jeopardizing aesthetics.

РАЗВИТИЕ ИНТЕРЬЕРА ПОЛЕССКОГО ЖИЛИЩА: ЭВОЛЮЦИЯ «МЫСНЫКА» (ПОСУДНОГО ШКАФА)

In the article, separate stages of the evolution of the cupboard («mysnyk») in the Polissia dwelling are considered. It was established that at first its functions were performed by a system structurally connected with a log-house «hriad» (decks or beams), which were gradually transformed into «hriady»-shelfs. The shelves placed on the threshold and facial walls were one of the oldest, and the initial stage of the genesis of «myshynyk», which later took their place, is connected with them. At Polissia two types of «myshynyk» has been developed: stationary – structurally associated with a log-house or «lava» (older), and mobile, mostly hinged (of a new origin).

Socket shield technique for optimizing aesthetic results of immediate implants

Loss of alveolar bone may be attributed to various factors, such periodontal diseases, endodontic pathology, facial trauma, and traumatic tooth extraction. Different techniques such as ridge preservation procedures have been proposed to maintain the ridge dimension to a certain amount. However, applying these methods to extraction sockets could not completely preserve the coronal part of facial bone walls which were comprised almost entirely of bundle bone. The socket shield technique (SST) with immediate implant in esthetic zone provides a promising treatment to better manage these risks and preserve the post-extraction hard and soft tissues. This case report demonstrates the 3-year follow up of the treatment of non-restorable maxillary lateral incisor with the socket shield technique in conjunction with immediate implant placement. Keywords: Socket-shield technique, Dental implant, Ridge preservation, Immediate implant, Alveolar ridge resorption, Buccal bone, Esthetic zone.

Thickness of the buccal bone wall and root angulation in the maxilla and mandible: an approach to cone beam computed tomography

BackgroundThe objective of this paper is to anatomically describe the bone morphology in the maxillary and mandibular tooth areas, which might help in planning post-extraction implants.MethodsCBCT images (Planmeca ProMax 3D) of 403 teeth (208 upper teeth and 195 lower teeth) were obtained from 49 patients referred to the Dental School of Seville from January to December 2014. The thickness of the facial wall was measured at the crest, point A, 4 mm below, point B, and at the apex, point C. The second parameter was the angle formed between the dental axis and the axis of the basal bone.ResultsA total of 403 teeth were measured. In the maxilla, 89.4% of incisors, 93.94% of canines, 78% of premolars and 70.5% of molars had a buccal bone wall thickness less than the ideal 2 mm. In the mandible, 73.5% of incisors, 49% of canines, 64% of premolars and 53% of molars had < 1 mm buccal bone thickness as measured at point B. The mean angulation in the maxilla was 11.67 ± 6.37° for incisors, 16.88 ± 7.93° for canines, 13.93 ± 8.6° for premolars, and 9.89 ± 4.8° for molars. In the mandible, the mean values were 10.63 ± 8.76° for incisors, 10.98 ± 7.36° for canines, 10.54 ± 5.82° for premolars and 16.19 ± 11.22° for molars.ConclusionsThe high incidence of a buccal wall thickness of less than 2 mm in over 80% of the assessed sites indicates the need for additional regeneration procedures, and several locations may also require custom abutments to solve the angulation problems for screw-retained crowns.

Autogenous bone grafts in oral implantology\u2014is it still a \u201cgold standard\u201d? A consecutive review of 279 patients with 456 clinical procedures

BackgroundThis study assessed the clinical outcomes of graft success rate and early implant survival rate after preprosthetic alveolar ridge reconstruction with autologous bone grafts.MethodsA consecutive retrospective study was conducted on all patients who were treated at the military outpatient clinic of the Department of Oral and Plastic Maxillofacial Surgery at the military hospital in Ulm (Germany) in the years of 2009 until 2011 with autologous bone transplantation prior to secondary implant insertion. Intraoral donor sites (crista zygomatico-alveolaris, ramus mandible, symphysis mandible, and anterior sinus wall) and extraoral donor site (iliac crest) were used. A total of 279 patients underwent after a healing period of 3–5 months routinely computer tomography scans followed by virtual implant planning. The implants were inserted using guided oral implantation as described by Naziri et al. All records of all the consecutive patients were reviewed according to patient age, history of periodontitis, smoking status, jaw area and dental situation, augmentation method, intra- and postoperative surgical complications, and surgeon’s qualifications. Evaluated was the augmentation surgical outcome regarding bone graft loss and early implant loss postoperatively at the time of prosthodontic restauration as well a follow-up period of 2 years after loading.ResultsA total of 279 patients underwent 456 autologous augmentation procedures in 546 edentulous areas. One hundred thirteen crista zygomatico-alveolaris grafts, 104 ramus mandible grafts, 11 symphysis grafts, 116 grafts from the anterior superior iliac crest, and 112 sinus lift augmentations with bone scrapes from the anterior facial wall had been performed. There was no drop out or loss of follow-up of any case that had been treated in our clinical center in this 3-year period. Four hundred thirty-six (95.6%) of the bone grafts healed successfully, and 20 grafts (4.4%) in 20 patients had been lost. Fourteen out of 20 patients with total graft failure were secondarily re-augmented, and six patients wished no further harvesting procedure. In the six patients, a partial graft resorption was detected at the time of implantation and additional simultaneous augmentation during implant insertion was necessary. No long-term nerve injury occurred. Five hundred twenty-five out of 546 initially planned implants in 259 patients could be inserted into successfully augmented areas, whereas 21 implants in 20 patients due to graft loss could not be inserted. A final rehabilitation as preplanned with dental implants was possible in 273 of the 279 patients. The early implant failure rate was 0.38% concerning two out of the 525 inserted implants which had to be removed before the prosthodontic restoration. Two implants after iliac crest augmentation were lost within a period of 2 years after loading, concerning a total implant survival rate after 2 years of occlusal loading rate of 99.6% after autologous bone augmentation prior to implant insertion.ConclusionsThis review demonstrates the predictability of autologous bone material in alveolar ridge reconstructions prior to implant insertion, independent from donor and recipient site including even autologous bone chips for sinus elevation. Due to the low harvesting morbidity of autologous bone grafts, the clinical results of our study indicate that autologous bone grafts still remain the “gold standard” in alveolar ridge augmentation prior to oral implantation.

Selected Factors Determining Appearing of Efflorescences on Facial Walls

One of problems of facing walls is their aesthetics lowered by efflorescence. Besides workmanship, the main cause is using mortars. It is needed to say that aside from the set: wall element – mortar on most new objects during their first years of usage efflorescence appear of different intensity and chemical compound. Basing on observations of real objects it was found, that intensity of appearing efflorescence change depending on external climate. Detailed researches of influence of selected climatic factors i.e. air temperature and humidity run on field post of facing walls localized in area of University of Science and Technology in Bydgoszcz. The study takes into consideration the following test walls where three different mortar types have been used: Portland cement-based mortar: CEM I, CEM I with plasticizer, cement-lime mortar with CL 90 hydrated lime. The examination analyses performed imply that the critical month for Bydgoszcz is April of each year, when detailed parameters of climate create positive conditions for salt crystallization. In this month efflorescence is reaches the highest level. Arising dripstone and leaks persist for summer period until October and undergo further metamorphose – transferring from efflorescence to the wall interior.

Microstructure of Selected Mortars Undergoing Long-term Influence of External Environment

A facial wall is defined as an element used outside or inside which should have an attractive look. It is built from attractive wall elements using standard way of execution and joints filled with mortar appropriate for this type of wall element. From the point of view of durability, the mortar is a wall element which not only binds bricks but also takes part in humidity transport. It is associated with mortar microstructure which in comparison to clinker is characterized with high percentage of pores causing capillary flow and wall drying abilities. Mortars belong to the group of chemically active materials for which both internal as external factors are essential. The reason for internal corrosion are mortar components (binder, sand, water, additions). External corrosion includes all cases where mortar is threatened with external factors (CO2 gas, acid rain, temperature changes exceeding zero point, solution of soluble mineral salts originating from surrounding elements). The factors mentioned essentially influence mortar microstructure changes. This process is distributed in time. This work concerns the analysis of changes in quantity and distribution of pores resulting from many years of functioning of mortar in facial wall threatened with external factors. The researches were performed on a field test station localized in area of the University of Science and Technology in Bydgoszcz (Poland). Three facial walls with different mortars were chosen: Portland cement based mortar CEM I, Portland cement based mortar CEM I with plasticizer and cement-lime mortar. During construction of walls, standard beams were formed from mortars in order to perform basic tests and microstructure tests after 28 days of hardening.

Changes of Clinker Microstructure after Long-term Influence of External Environment

Contemporary clinker elements because of numerous colours and shapes give uncountable opportunities for architectural compositions. Apart from undeniable aesthetic values they are characterized with high resistance to environment influence. It is associated both with clinker microstructure as with adopted mortar types. By definition a facial wall has an attractive look which should be maintained during the whole period of the construction usage. However, it often occurs that the intended effect has not been reached. On majority of buildings during the first years of using there are efflorescence's appearing, covering mainly clinker surface. They are primary efflorescence's which should disappear during the first year of exploitation. The multi-year work led by the authors on real objects indicate that this period is definitely longer and efflorescence change according to seasons. The cyclic influence of salts changes the clinker microstructure. This work concerns the clinker microstructure and its changes resulting from ten years of exposition on external climate conditions. The researches were led on field station localized on area of the University of Science and Technology Bydgoszcz (Poland).

An open randomized controlled clinical trial to evaluate ridge preservation and repair using SocketKAP(™) and SocketKAGE(™) : part 2 - three-dimensional alveolar bone volumetric analysis of CBCT imaging.

The aims of this study were (i) to evaluate the efficacy of ridge preservation and repair procedures involving the application of SocketKAP(™) and SocketKAGE(™) devices following tooth removal and (ii) to evaluate alveolar bone volumetric changes at 6months post-extraction in intact sockets or those with facial wall dehiscence defects using 3-dimensional pre- and postoperative CBCT data. Thirty-six patients required 61 teeth extracted. Five cohorts were established: Group A: Intact Socket Negative Control Group B: Intact Socket + SocketKAP(™) Group C: Intact Socket Filled with Anorganic Bovine Bone Mineral (ABBM) + SocketKAP(™) Group D: Facial Dehiscence Socket Negative Control Group E: Facial Dehiscence Socket Filled with ABBM + SocketKAP(™) + SocketKAGE(™) . Preoperative CBCT scans were obtained followed by digital subtraction of the test teeth. At 6months post-extraction, another CBCT scan was obtained. The pre- and postoperative scans were then superimposed, allowing highly accurate quantitative determination of the 3D volumetric alveolar bone volume changes from baseline through 6months. Significant volumetric bone loss occurred in all sockets, localized mainly in the 0-3mm zone apical to the ridge crest. For intact sockets, SocketKAP(™) + ABBM treatment led to a statistically significant greater percentage of remaining mineralized tissue volume when compared to negative control group. A significant difference favoring SocketKAP(™) + SocketKAGE(™) + ABBM treatment was observed for sockets with facial dehiscence defects compared to the negative control group. SocketKAP(™) , with ABBM, appears effective in limiting post-extraction volumetric bone loss in intact sockets, while SocketKAP(™) + SocketKAGE + ABBM appears effective in limiting post-extraction bone loss in sockets with dehiscence defects.

Alveolar ridge dimensional changes following ridge preservation procedure: part-2 - CBCT 3D analysis in non-human primate model.

The aim of this study was to evaluate the efficacy of ridge preservation involving novel devices used for obturation of socket orifice (Socket cap; SocketKAP(™) ) and resorbable cage used for space maintenance in sites with facial wall dehiscence (Socket cage; SocketKAGE(™) ). Eight teeth were extracted in each of six Macaca fascicularis non-human primates. Six intervention groups consisted of the following: Group A: intact socket negative control. Group B: intact socket: socket cap. Group C: intact socket filled with anorganic bovine bone mineral (ABBM) + socket cap. Group D: dehiscence: negative control. Group E: dehiscence: socket cap + socket cage. Group F: dehiscence: filled with ABBM + socket cap + socket cage. CBCT scans were obtained preoperatively and at 6 and 12weeks following intervention. The pre- and postoperative scans were superimposed, to quantify 3D volumetric alveolar bone changes. Volumetric bone loss occurred in all sockets, not only within the cretal zone (0-3mm) to the ridge crest, as has been commonly reported by other investigators, but significant bone loss was also detected in the zone which was 3-6mm apical to the alveolar crest. For intact sockets, socket cap + ABBM led to significantly greater percentages of remaining bone volume when compared to groups A and B. A significant difference favoring socket cap + socket cage + ABBM treatment was observed for sockets with facial dehiscence defects compared to groups D and E. Socket cap in conjunction with ABBM appears effective in limiting post-extraction volumetric bone loss in intact sockets, while socket cap + socket cage + ABBM appears effective in limiting post-extraction bone loss in sockets with dehiscence defects.

Nasal meatus plasty: a contribution to plastic reconstruction of the nasal valve during midfacial degloving.

Midfacial degloving is a proven method for easily accessing the midface, the nasal pyramid, the maxillary and ethmoidal sinuses, the orbits, as well as the anterior skull base. Indications for this method of access mainly include tumour resections in the area of the midface, the septum, the maxillary sinus, the paranasal to the sphenoidal sinus as well as the clivus. In addition, this method of access allows for the exposure of the bony structures of the midface in the event of extensive fractures.In general, this method of access combines an incision in the oral vestibule and circular incisions in the nasal vestibule area in order to release the nasal pyramid.After removing the facial wall of the maxillary sinus, extensive exposure of the surgical site is possible.One disadvantage of this method of access is the difficult reconstruction of the nasal valve area, which often leads to cicatricial stenoses and difficulties with breathing through the nose. Furthermore, wound healing problems and osteoradionecrosis in the area of the lateral margin of the anterior nasal aperture after replantation of the facial wall of the maxillary sinus have been described, because in this area sufficient soft tissue coverage cannot be ensured when a conventional technique is used.We describe a soft tissue flap pedicled in the cranial and caudal directions in the nasal valve area which makes both the reconstruction of the nasal vestibule and sufficient soft tissue coverage of the anterior nasal aperture possible.

PCL–TCP scaffold for bone regeneration of tooth socket facial wall defects and simultaneous immediate implant placement in Macaca fascicularis

PCL–TCP scaffold for bone regeneration of tooth socket facial wall defects and simultaneous immediate implant placement in Macaca fascicularis

The use of a polycaprolactone–tricalcium phosphate scaffold for bone regeneration of tooth socket facial wall defects and simultaneous immediate dental implant placement in Macaca fascicularis

Bone regeneration and aesthetic outcomes may be compromised when immediate implants are placed at extraction sites with dehiscence defects. The aim of this study was to compare, in a monkey model, peri-implant bone regeneration and implant stability after immediate implant placement into tooth sockets with facial wall defects in two treatment groups. In eight control monkeys, the bony defect was reconstructed with autogenous particulate bone, whereas in 10 test monkeys a polycaprolactone-tricalcium phosphate (PCL-TCP) scaffold was used. The monkeys were sacrificed after 6 months and the specimens were analyzed by histology and histomorphometry. Better maintenance of facial bone contour was noted in the test group; however, bone regeneration was seen only at areas adjacent to a bony wall of the defect. The mean bone-to-implant contact was 27.6 ± 19.1% (control group) versus 6.8 ± 7.9% (test group). The mean bone area percentage was 11.8 ± 10.1% (control group) versus 6.8 ± 6.9% (test group). Implant survival was 100% at 6 months for both the groups. It was concluded that although the use of a PCL-TCP scaffold showed better maintenance of the alveolar contour as compared to autogenous particulate bone at 6 months, there was minimal bone regeneration within the defect.

Immediate Placement and Provisionalization With Buccal Plate Preservation: A Case Report of a New Technique

Abstract Abstract Post-extraction resorption of the alveolar ridge is known particularly to affect the buccal plate, increasing the risk of facial soft-tissue recession and other adverse clinical effects. The authors have developed a simple technique for buccal plate preservation that involves surgically creating a pouch facial to the buccal plate that is filled with xenograft material. This technique can also be utilized in cases for which immediate implant placement and provisionalization are planned. A case report illustrating this approach is presented.

Buccal Plate Augmentation: A New Alternative to Socket Preservation

Alveolar ridge resorption occurs after tooth extraction and has the potential to either complicate implant placement or impair the final esthetic result. Techniques to preserve natural bone and soft tissue contours are of great interest to clinicians and patients because even subtle postextraction buccal plate resorption may have significant clinical effects, particularly in the esthetic zone. Buccal plate augmentation (BPA) is a novel approach for ridge preservation aiming to avoid recession of the facial wall of the socket without interfering with the natural healing mechanism of the extraction socket. It consists of placement of bone graft material over an intact buccal plate, underneath the soft tissues in a surgically created pouch with an aim to maintain or augment the soft tissue esthetics of the region.