Socket preservation

Socket preservation is a procedure that is intended to reduce bone loss following the extraction of a tooth. Once a tooth is extracted, the jawbone resorbs relatively quickly, causing the bone to narrow and change its shape; bone resorption happens in the first six months following an extraction. This can pose challenges when trying to replace the extracted tooth with an implant, which requires a substantial and stable base, and it may also affect the function or appearance of the mouth and jaw. Socket preservation, also called alveolar ridge preservation, involves grafting bone into the socket immediately after the tooth is extracted, with the intention of preventing this bone loss. The procedure involves pulling away the gum, removing the tooth, placing a bone substitute in the socket, protecting this material with a barrier membrane, and suturing the extraction site closed. After about a month, the barrier membrane can be removed, or it may resorb, depending on the type of membrane that is used, and new gum tissue grows over the extraction site. Socket preservation may or may not improve the success of implants that are placed in preserved sites, but it has been proven to prevent bone loss and its possible cosmetic side effects.

Following a tooth extraction, the loss of bone volume can make it challenging to securely place dental implants. The bone may be inadequate in width, entirely preventing the possibility of placing an implant, or it may be too narrow to adequately support an implant-supported denture. Socket preservation may also be used to provide unerupted teeth space in which to erupt without disturbing existing teeth. There are few contraindications for socket preservation, though areas of bone that have been exposed to radiation treatment may be too fragile or adversely affected for the procedure to be effective. Certain health conditions and habits may adversely affect the overall healing potential for bone, including smoking, diabetes, the use of certain medications, and the presence of infection.

During the same extraction procedure in which the tooth is removed, the dental professional will lift the gum away from the bone, clean and disinfect the socket, and then pack the socket with bone grafting material. Then, a barrier membrane is affixed to the gum, and the wound is closed. Ideally, the graft heals into the bone within 3-9 months. Materials used for bone grafting may be natural bone from the patient’s own body, collagen or bone from cattle or pigs, bone from human cadavers, or various synthetic materials. Barrier membrane material may be non-resorbable, like biocompatible polymer materials, or it can be resorbable, like collagen or synthetic lactic or glycolic acid. Socket preservation maintains the integrity of the extraction socket, providing a natural-looking and stable foundation for future restorative dental procedures. Dental prostheses require the support of the jaw bone to ensure their success and durability, and socket preservation can be an effective way to provide this. Additionally, bone resorption can lead to undesirable aesthetic changes in the shape of the jaw and the face; this can be prevented with socket preservation procedures.