Managing the Extraction Socket Flashcards
bundle bone (3)
histologic term for the portion of the alveolar bone that surrounds teeth and into which the collagen fibers of the PDL are embedded
-alveolar bone proper
-dependent on the tooth
post extraction dimensional changes
-marked dimensional changed during the first 00 weeks
bundle bone is resorbed and replaced with —
more – reduction in buccal bone (more bundle bone)
8
woven bone
vertical
on avg in 6 months
avg vertical bone loss:
avg width bone loss:
1.2-1.7 mm
3.7-3.9 mm
classification of the extraction socket is based on the
status of the buccal bone and soft tissue
intact buccal bone =
maginal dehiscence = severe dehiscence
type of socket affects
our tx approach
at 6-12 mo post extraction
avg VBL:
avg wifth bone loss:
most changes during
1.5-2 mm
40-50%
first 3 mo
patient factors (4)
smoking
oral hygiene
systemic conditions
compliance
atraumatic extraction (4)
diagnostic planing
RCT, restored, or fractured teeth
sectioning teeth
flap or flapless
regeneration (3)
-regeneration of PDL, cementum, and bone (teeth)
-regeneration of (bone) through osteoblasts and exclusion of CT
-requires space maintenance, osteoconduction, and osteoinduction
requirements (3)
stable clot formation
epithelial cell exclusion
graft containment
osteoinductive materials (2)
autograft - local or peripheral sites
allograft - freeze dried bone (cortical/cancellous)
osteoconductive materials (2)
xenogradt (BioOss)
alloplast - ca sulfate, btcp
barrier materials
collagen membrane -resorbable vs nonresorbable
socket presentation adv (3)
-reduce vertical and horizontal dimensional changes
-maintain soft tissue integrity and esthetics
-improve dental implant tx outcome
socket presentation disadv (3)
-increase tx time and costs
-technique sensitive/surgical factors
-usage of regenerative materials
immediate implant placement
placement of the dental implant immediately into a fresh extraction socket
type 1
immediate placement
type 2
3-8 weeks
early implant (soft tissue healing)
type 3
3-4 mo
early implant (partial healing)
type 4
6 mo
late implant (complete healing)
immediate implant placement indications
(5)
presence of buccal plate
soft tissue may/may not be intact
adequate alveolar bone in the palatal aspect of extraction socket for primary stability of the implant
esthetic considerations
reduce tx time
surgical planning:
proper position= restorative driven
post op management (5)
abx (amoxicillin 500 mg or clindamycin 300 mg)
0.12% chlorhexidine gluconate rinse
medrol dose pack
NSAID 600-800 mg ibuprofen
narcotics
post of timeline
suture removal:
update home care and diet instructions
new radiographs:
total healing time:
2 weeks
6-8 weeks and at day of uncovery or impression taking
3-6 mo depending on integrity of extraction socket and primary stability of immediate implant at time of surgery
proper understandning of – to improve tx outcome
extraction socket
(2) are most critical considerations fo immediate implant placement
bone quality and quantity
immediate implant placement in the anterior region requires
esthetic work up
orientation of the implant should be
restoratively driven
