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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 Augmenation Gain of Keratinized 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 randomized 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 esthetic 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)