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Postextraction alveolar ridge preservation: biological basis and treatments.

Pagni G, Pellegrini G, Giannobile WV, Rasperini G - Int J Dent (2012)

Bottom Line: Following tooth extraction, the alveolar ridge undergoes an inevitable remodeling process that influences implant therapy of the edentulous area.Socket grafting is a commonly adopted therapy for the preservation of alveolar bone structures in combination or not with immediate implant placement although the biological bases lying behind this treatment modality are not fully understood and often misinterpreted.This review is intended to clarify the literature support to socket grafting in order to provide practitioners with valid tools to make a conscious decision of when and why to recommend this therapy.

View Article: PubMed Central - PubMed

Affiliation: Unit of Periodontology, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Foundation IRCCS Cà Granda, 20142 Milan, Italy.

ABSTRACT
Following tooth extraction, the alveolar ridge undergoes an inevitable remodeling process that influences implant therapy of the edentulous area. Socket grafting is a commonly adopted therapy for the preservation of alveolar bone structures in combination or not with immediate implant placement although the biological bases lying behind this treatment modality are not fully understood and often misinterpreted. This review is intended to clarify the literature support to socket grafting in order to provide practitioners with valid tools to make a conscious decision of when and why to recommend this therapy.

No MeSH data available.


Related in: MedlinePlus

Healing of the extraction socket, with postextractive implant placement, with and without socket grafting. After tooth extraction and immediate implant placement, the blood clot fills the remaining space and the bundle bone undergoes the physiological changes. When grafting material is placed around the implant surface, filling the remaining socket area, the buccal bone wall remodeling process is corrupted, thus leading the maintenance of the horizontal ridge volume.
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Related In: Results  -  Collection


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fig2: Healing of the extraction socket, with postextractive implant placement, with and without socket grafting. After tooth extraction and immediate implant placement, the blood clot fills the remaining space and the bundle bone undergoes the physiological changes. When grafting material is placed around the implant surface, filling the remaining socket area, the buccal bone wall remodeling process is corrupted, thus leading the maintenance of the horizontal ridge volume.

Mentions: Other authors challenged the results of the Canadian reporting that the placement of an implant in the fresh extraction site failed to prevent the remodeling that occurred in the walls of the socket. The height of the buccal and lingual walls at 3 months was similar compared to extraction only sites [86–90]. Vertical bone loss was more pronounced at the buccal aspect even with some marginal loss of osseointegration [87]. Histologically, the gap between the implant and the socket walls filled in at 4 weeks with woven bone, while, the buccal and lingual walls underwent marked surface resorption. After 12 weeks, the buccal crest was located >2 mm apical of the implant margin [88] (Figure 2). Evaluating immediately placed implants, Schropp et al. reported 70% of the 3-wall infrabony defects with a parallel width of up to 5 mm, a depth of maximum 4 mm, and a perpendicular width of maximum 2 mm had a capacity of spontaneous healing within a period of 3 months [18]. Botticelli et al. found that 1–1.25 mm wide and 5 mm deep defects around implants healed uneventfully with or without membrane [91]. Defects up to 2.25 mm wide were found to heal using barrier membranes, although when the buccal bone was intentionally removed, less regeneration at the buccal aspects was observed [92]. These studies adopted an animal model with surgically created defects, which typically exhibit lesser resorption than extraction sockets [90].


Postextraction alveolar ridge preservation: biological basis and treatments.

Pagni G, Pellegrini G, Giannobile WV, Rasperini G - Int J Dent (2012)

Healing of the extraction socket, with postextractive implant placement, with and without socket grafting. After tooth extraction and immediate implant placement, the blood clot fills the remaining space and the bundle bone undergoes the physiological changes. When grafting material is placed around the implant surface, filling the remaining socket area, the buccal bone wall remodeling process is corrupted, thus leading the maintenance of the horizontal ridge volume.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3378971&req=5

fig2: Healing of the extraction socket, with postextractive implant placement, with and without socket grafting. After tooth extraction and immediate implant placement, the blood clot fills the remaining space and the bundle bone undergoes the physiological changes. When grafting material is placed around the implant surface, filling the remaining socket area, the buccal bone wall remodeling process is corrupted, thus leading the maintenance of the horizontal ridge volume.
Mentions: Other authors challenged the results of the Canadian reporting that the placement of an implant in the fresh extraction site failed to prevent the remodeling that occurred in the walls of the socket. The height of the buccal and lingual walls at 3 months was similar compared to extraction only sites [86–90]. Vertical bone loss was more pronounced at the buccal aspect even with some marginal loss of osseointegration [87]. Histologically, the gap between the implant and the socket walls filled in at 4 weeks with woven bone, while, the buccal and lingual walls underwent marked surface resorption. After 12 weeks, the buccal crest was located >2 mm apical of the implant margin [88] (Figure 2). Evaluating immediately placed implants, Schropp et al. reported 70% of the 3-wall infrabony defects with a parallel width of up to 5 mm, a depth of maximum 4 mm, and a perpendicular width of maximum 2 mm had a capacity of spontaneous healing within a period of 3 months [18]. Botticelli et al. found that 1–1.25 mm wide and 5 mm deep defects around implants healed uneventfully with or without membrane [91]. Defects up to 2.25 mm wide were found to heal using barrier membranes, although when the buccal bone was intentionally removed, less regeneration at the buccal aspects was observed [92]. These studies adopted an animal model with surgically created defects, which typically exhibit lesser resorption than extraction sockets [90].

Bottom Line: Following tooth extraction, the alveolar ridge undergoes an inevitable remodeling process that influences implant therapy of the edentulous area.Socket grafting is a commonly adopted therapy for the preservation of alveolar bone structures in combination or not with immediate implant placement although the biological bases lying behind this treatment modality are not fully understood and often misinterpreted.This review is intended to clarify the literature support to socket grafting in order to provide practitioners with valid tools to make a conscious decision of when and why to recommend this therapy.

View Article: PubMed Central - PubMed

Affiliation: Unit of Periodontology, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Foundation IRCCS Cà Granda, 20142 Milan, Italy.

ABSTRACT
Following tooth extraction, the alveolar ridge undergoes an inevitable remodeling process that influences implant therapy of the edentulous area. Socket grafting is a commonly adopted therapy for the preservation of alveolar bone structures in combination or not with immediate implant placement although the biological bases lying behind this treatment modality are not fully understood and often misinterpreted. This review is intended to clarify the literature support to socket grafting in order to provide practitioners with valid tools to make a conscious decision of when and why to recommend this therapy.

No MeSH data available.


Related in: MedlinePlus