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Extraction Socket Management

Therapeutic Areas overview Extraction Socket Management Minor Bone Augmentation Major Bone Augmentation Sinus Floor Elevation Soft tissue Regeneration Peri-Implantitis Periodontal Treatment

Immediate implant placement Early implant placement Delayed/Late implant placement No implant placement

Lateral Sinus Floor Elevation Crestal Sinus Floor Elevation Sinus Floor Elevation and Bone Augmentation Prevention of Sinus Floor Augmentation

Soft Tissue Thickness Augmentation Gain of Keratinised Tissue Socket Seal Recession Coverage

Scientific background

Bone and soft tissue remodeling after tooth extraction has been investigated thoroughly.

Clinical studies show that:

after tooth extraction, severe volume loss occurs because of bone and soft tissue resorption^1–5
two-thirds of resorption take place within the first three months¹

Therefore, at the time of implant placement and if no Ridge Preservation is performed,

the need for Guided Bone Regeneration is ten times higher⁶
the need for Sinus Floor Elevation is two times higher and the number of more invasive procedures four times higher⁷

References

Schropp L, et al.: Int J Periodontics Restorative Dent 2003; 23(4): 313-23. (Clinical study)
Van der Weĳden F, et al.: J Clin Periodontol 2009; 36(12): 1048-58. (Systematic review)
Sanz M, et al.: Clin Oral Implants Res 2010; 21(1): 13-21. (Clinical study)
Hammerle CH, et al.: Clin Oral Implants Res 2012; 23 Suppl 5: 80-82. (Systematic review)
Jung RE, et al.: J Clin Periodontol 2013; 40(1) :90-98. (Clinical study)
Weng D, et al.: Eur J Oral Implantol 2011; 4 Suppl: 59-66. (Systematic review)
Cha JK, et al.: Clin Oral Implants Res 2019; 30: 515-23. (Clinical study)
Nevins M, et al.: Int J Periodontics Restorative Dent 2006; 26(1): 19-29. (Clinical study)
Vignoletti F, et al.: Clin Oral Implants Res 2012; 23 Suppl 5: 22-38. (Systematic review)
Avila-Ortiz G, et al.: J Dent Res 2014; 93(10): 950-58. (Systematic review)
Cardaropoli D, et al.: Int J Periodontics Restorative Dent 2012; 32(4): 421-30. (Clinical study)
Cardaropoli D, et al.: Int J Periodontics Restorative Dent 2014; 34(2): 211-17. (Clinical study)
Morjaria KR, et al.: Clin Implant Dent Relat Res 2014; 16(1): 1-20. (Systematic review)
Horvath A, et al.: Clin Oral Investig. 2013; 17(2): 341-63. (Systematic review)
Vittorini Orgeas G, et al.: Int J Oral Maxillofac Implants 2013; 28(4): 1049-61. (Systematic review)
Ackermann KL: Int J Periodontics Restorative Dent 2009; 29(5): 489-97. (Clinical study)
Schlee M, Esposito M: Eur J Oral Implantol 2009; 2(3):209-17. (Clinical study)

Fig. 1: Spontaneous healing. A: After tooth extraction. B: 2 months after tooth extraction

On the other hand, several studies, including randomised controlled clinical trials and meta-analyses, show that Ridge Preservation with Geistlich biomaterials can:

prevent horizontal and vertical volume loss even in sites with thin buccal bone walls⁸
optimize the bone and soft tissue situation irrespective of the chosen time for implantation^5,9-16
improve the aesthetic outcome by preserving the alveolar ridge volume and contour under pontics¹⁷

References

Schropp L, et al.: Int J Periodontics Restorative Dent 2003; 23(4): 313-23. (Clinical study)
Van der Weĳden F, et al.: J Clin Periodontol 2009; 36(12): 1048-58. (Systematic review)
Sanz M, et al.: Clin Oral Implants Res 2010; 21(1): 13-21. (Clinical study)
Hammerle CH, et al.: Clin Oral Implants Res 2012; 23 Suppl 5: 80-82. (Systematic review)
Jung RE, et al.: J Clin Periodontol 2013; 40(1) :90-98. (Clinical study)
Weng D, et al.: Eur J Oral Implantol 2011; 4 Suppl: 59-66. (Systematic review)
Cha JK, et al.: Clin Oral Implants Res 2019; 30: 515-23. (Clinical study)
Nevins M, et al.: Int J Periodontics Restorative Dent 2006; 26(1): 19-29. (Clinical study)
Vignoletti F, et al.: Clin Oral Implants Res 2012; 23 Suppl 5: 22-38. (Systematic review)
Avila-Ortiz G, et al.: J Dent Res 2014; 93(10): 950-58. (Systematic review)
Cardaropoli D, et al.: Int J Periodontics Restorative Dent 2012; 32(4): 421-30. (Clinical study)
Cardaropoli D, et al.: Int J Periodontics Restorative Dent 2014; 34(2): 211-17. (Clinical study)
Morjaria KR, et al.: Clin Implant Dent Relat Res 2014; 16(1): 1-20. (Systematic review)
Horvath A, et al.: Clin Oral Investig. 2013; 17(2): 341-63. (Systematic review)
Vittorini Orgeas G, et al.: Int J Oral Maxillofac Implants 2013; 28(4): 1049-61. (Systematic review)
Ackermann KL: Int J Periodontics Restorative Dent 2009; 29(5): 489-97. (Clinical study)
Schlee M, Esposito M: Eur J Oral Implantol 2009; 2(3):209-17. (Clinical study)