Postextraction Maintenance of the Alveolar Ridge

Tooth extraction is one of the most common dental procedures. Healing of the resulting extraction socket normally occurs uneventfully. However, even with completely normal healing, there is often some resorption or melting away of the surrounding bone, resulting in less bone height and width than were present prior to tooth extraction. In addition, as bone resorbs, the overlying gum tissue also tends to lose volume and normal anatomic form. These changes can occur anywhere, but the most severe loss of bone and gum tissue tends to occur following removal of incisor teeth located in the front of the mouth.

Loss of bone and gum tissue following tooth extraction often results in both functional and cosmetic defects. Such tissue loss may result in an unsightly collapsed appearance, especially in the front of the mouth where proper maintenance of tissue health is critical to normal esthetics. In addition, loss of bone and gum tissue can compromise the restoring dentist’s ability to adequately replace the missing tooth, or teeth, with either conventional removable or fixed bridgework, or with a dental implant supported restoration. Sometimes the loss of bone is so severe that additional surgical procedures are required prior to replacing the missing tooth with either a conventional or implant supported restoration.

Today, because of advances in dental surgical procedures and bioengineering, bone and gum tissue loss following tooth removal can either be greatly reduced or completely eliminated. To benefit from this technology, the procedure must be done at the time of the extraction.

A typical socket graft procedure in office would proceed as follows: following gentle, atraumatic tooth removal by, graft material that helps support bone formation is placed within the extraction socket. The graft material is then covered with a collagen sheet which protects the graft and helps support and guide new soft tissue growth. This routine procedure will prevent bone and gum loss following tooth removal, allowing a predictable, esthetic tissue framework result regardless of the chosen restoration.