Extraction site preservation for future dental implant fixture placement.
There was recent article in the October issue of the Journal of the American Dental Association by Gerard Byrne, BDSc, MSD asked the following:
Does the use of extraction site preservation interventions result in better maintenance of the ridge height and width after tooth extraction (in the esthetic zone: anterior teeth and premolars) than does no intervention (natural healing)?
Two online English-language databases were searched through June 2010. The studies that were reviewed included randomized controlled trials, controlled clinical trials, prospective cohort studies and and case series comparing socket preservation therapies with no treatment. There were 4 studies altogether.
The study interventions included a variety of bone augmentation techniques using, bone fillers, collagen sponges, recombinant human bone morphogenic protein and membranes that were resorbable or non-resorbable.
The article describes and compares at some length the studies that were evaluated. However, the conclusion drawn from the review is that although socket preservation interventions may aid in reducing the bony dimensional changes after tooth extraction, they do not prevent ridge resorption.
Commentary in the latter part of the article states that esthetics is an important outcome for patients receiving implant-supported restorations. To achieve this outcome, patients need to have good bone volume and quality, as well as good bone and soft-tissue height. The implications from the review were that extraction site preservation is important for achieving optimum esthetics with implant restorations. The authors of this review generally reported improved alveolar height and width for socket preservation interventions compared with sockets that healed naturally. The data, however, was limited and clinical significance could not be inferred. Good bone level alone does not imply improved esthetics. More studies are indicated.