Grafting or socket preservation is a procedure done after dental extraction to maintain the bone height. This involves placing a bone graft material in the socket as the scaffold for new bone to form. A platelet rich fibrin membrane is then used to cover the socket to isolate the bone compartment from the overlying soft tissue. The gum is then stretched and stitched up over the grafted site to promote primary healing.
Bone graft materials are classified into a few categories:
Autograft – Bone obtained from an individual’s own body
Xenograft – Bone grafts or collagen derived from bovine or porcine origin.
Allograft – Bone graft harvested from freeze-dried cadaver
Alloplast – Synthetic biomaterials
Dental alveolar bone has the primary function of supporting teeth in the jaw. Without functional stimulus from the tooth and the periodontal ligament, dental alveolar bone will resorb at an alarming rate. Scientific evidence has shown that without socket preservation, up to 60% of bone volume loss will occur within the first 6 months post dental extraction. Once the resorption has occurred in the jawbone without socket preservation, the jawbone will never revert back to its original volume. Soft tissue profile will adapt to the less than ideal bone contour over time.
In certain selected cases, immediate implant placement has the ability to help retain the volume of alveolar bone. This is only possible if total removal of infection from the extraction socket is achieved. A combination of immediate implant placement and bone grafting may provide the best clinical successes.
This simple step will prevent the need for complicated bone block grafting for implant placement in the future.