Socket Preservation Techniques

The overall goal of periodontal therapy is to save your existing teeth and to replace your missing teeth with restorations that restore your comfort, function, esthetics, and confidence. During the course of some typical treatment sequences, Dr. Caldwell, Dr. Dimmitt, or your dentist may identify hopeless teeth that will have to be extracted. These extractions may be necessary because of pain, fracture, infection, bone loss related to periodontal disease, and/or to facilitate upcoming restorative treatment. In a typical dental extraction, the dentist must “fracture” the bony socket that surrounds the tooth, allowing expansion of the bone to allow the irregularly shaped roots to be removed through the narrow socket. In the past, the loss of bone related to this expansion of the surrounding bone was unavoidable, but today, modern atraumatic surgical techniques have provided a means of surgically removing a tooth without fracturing any of the surrounding bone. Atraumatic surgery involves the use of a series of surgical techniques and instruments that allow the tooth to be taken out in small pieces without compromising the surrounding bone at all. In many cases, this simple step can prevent the need for more advanced and expensive bone grafting techniques to regenerate adequate bone that is needed to support your implants or to prevent large gaps under a cemented bridge.

In some cases, the bone around the circumference of the socket is thick enough and strong enough to heal without the need for grafting bone in the new extraction socket. But in most cases, the damaged tooth and the resulting infection or fracture has either destroyed a portion of the socket wall or the remaining bone is so thin that preservation of the remaining precious bone needs to be considered at the time of the extraction. Dr. Caldwell and Dr. Dimmitt recommend that extractions in potential implant sites be completed using atraumatic surgical techniques, placing a bone graft in the extraction socket at the time of the extraction. Various types of donor bone and bone substitutes are used for these socket grafts and the grafted material acts as scaffolding that is replaced by your own bone over the next six to twelve months. A layer of a biocompatible material is placed over the socket graft site to limit the passage of gum tissue into this active bone graft site. The region is usually allowed to mature for three to four months before an implant is placed in the site.

If your dentist, Dr. Caldwell, Dr. Dimmitt have recommended tooth removal, be sure to ask whether atraumatic extraction techniques and socket preservation will be possible to help you achieve your treatment goals and set the foundation for dental implants and restorations that will bring a happy, healthy smile for years to come.