Following an extraction, preservation of the jaw bone supporting the tooth is very important if one is to have a natural looking and properly functioning replacement. Every person at some point in there life will need a tooth extracted. Infections, trauma and pathology are just some of the reasons people lose teeth. Unfortunately once a tooth is lost, the surrounding bone begins to atrophy (dissolve away). Research indicates 40% of the bone will be lost in 6 months. Should the extracted tooth be in the smile zone, this bone loss can create a very awkward looking, non-symmetrical smile. Furthermore, if the lost tooth was to be replaced by an implant, 40% bone loss could make implant placement impossible.
Two procedures are recommended to control bone loss following extraction:
Careful management of extraction sockets after tooth removal prevents unsightly bone loss and provides a better cosmetic outcome for tooth replacement. A Ridge Preservation is the best way to manage bone resorption and consists of careful extraction of the tooth, debridement of the soft tissue of the tooth socket, preparation of the bony socket walls and placement of bone grafts into the socket with coverage by a resorbable membrane. This procedure takes about 1 hour and usually results in a faster and less complicated healing than standard tooth extraction.
Should a tooth have to be extracted in an emergency situation outside our office or if the tooth was previously removed, a ridge preservation is not possible and the socket must be allowed to heal before rebuilding bone. The procedure is then called a ridge augmentation.
Once a tooth is extracted, 40% of the surrounding bone can be lost in the first 6 months. Often, patients begin to notice endentations and loss of symmetry in the area. In many instances, the magnitude of bone loss is such that not enough bone remains to place an implant. When enough bone does exist, it is often not thick enough to support a ‘natural looking’ tooth. The best way to prevent and lessen bone loss is to have a ridge preservation graft at the time of extraction.
Once bone has been lost, a ridge augmentation procedure can be performed to regrow lost bone. This procedure consist of adding bone to the area and coverage of the bone with a resorbable membrane. Once the graft has matured, an implant can be placed. Should bone loss be severe multiple procedures may be necessary.
In today’s fast paced world, healing time is constantly being shortened. Immediate implants are implants placed into an extraction socket at the time of tooth removal and bone grafting. In this situation, the dental implant and bone mature together. This can shorten the overall healing time of the implant process. Unfortunately, immediate implants can only be placed in certain situations. Infections, previous root canal treatments and soft tissue architecture can hamper the placement of an immediate implant. Although researchers have shown success, knowledge of the wound healing process as well as bone physiology often lean the practitioner to a more conservative (slower) approach.