Medical Uses and Benefits of Socket Preservation:
- Socket preservation reduces bone loss after tooth extraction.
- Jaw bone naturally becomes narrow and loses shape after extraction, resulting in significant bone volume loss.
- Bone loss can affect the placement of dental implants and compromise aesthetics and function.
- Socket preservation prevents bone loss by grafting the socket immediately after extraction.
- Good jaw bone support is essential for successful long-term dental prostheses.
- Without socket preservation, residual bones could lose volume, affecting facial dimensions and soft tissue aesthetics.
- Socket preservation improves height and width compared to extraction without preservation.
- Insufficient data exists to conclude its impact on implant failures, aesthetics, or the superiority of one grafting material over another.
Risks and Complications of Socket Preservation:
- Caution is required in areas previously exposed to radiation treatment or osteomyelitis.
- Other considerations include concurrent use of certain medications, smoking, diabetes, immunocompromise, and infection.
- Socket preservation has been associated with a greater risk of marginal bone loss.
- No absolute contraindications to socket preservation exist, but caution is necessary.
- Risk of bone and soft tissue loss on subsequent implants in the long-term.
Technique of Socket Preservation:
- Socket preservation is performed at the time of extraction.
- The socket is thoroughly cleansed after tooth removal, and antibiotic powder may be used.
- A barrier membrane is attached to the gum, and the socket is filled with bone grafting material.
- The wound is closed over the barrier membrane.
- The barrier membrane is removed approximately 30 days after placement, and the graft becomes incorporated into the healing bone.
Types of Materials Used in Socket Preservation:
- Autograft (patient's own bone) is considered the gold standard for bone grafting.
- Other types of grafting materials include xenograft, allograft, and alloplast.
- Barrier membranes can be resorbable or non-resorbable.
- Non-resorbable membranes include expanded polytetrafluoroethylene (ePTFE).
- Resorbable membranes include collagen and synthetic resorbable materials.
Conclusion and Overall Considerations:
- Socket preservation is an important procedure to prevent bone loss after tooth extraction and maintain jaw bone support.
- Risks and complications should be carefully considered, especially in patients with certain medical conditions or risk factors.
- The technique involves thorough cleansing of the socket, placement of a bone graft and barrier membrane, and subsequent healing and incorporation of the graft.
- Various types of materials can be used for grafting and barrier membranes.
- While socket preservation has demonstrated benefits, more research is needed to fully understand its impact on implant outcomes and aesthetics, as well as the optimal choice of grafting material.
Socket preservation or alveolar ridge preservation is a procedure to reduce bone loss after tooth extraction. After tooth extraction, the jaw bone has a natural tendency to become narrow, and lose its original shape because the bone quickly resorbs, resulting in 30–60% loss in bone volume in the first six months. Bone loss, can compromise the ability to place a dental implant (to replace the tooth), or its aesthetics and functional ability.
Socket preservation attempts to prevent bone loss by bone grafting the socket immediately after extraction. With the procedure, the gum is retracted, the tooth is removed, material (usually a bone substitute) is placed in the tooth socket, it is covered with a barrier membrane, and sutured closed. Roughly 30 days after socket preservation, the barrier membrane is either removed, or it resorbs, and the callous of bone covers with new gingiva. While there is good evidence that socket preservation prevents bone loss, there is no definitive proof that this leads to higher implants success or long-term health.
