Alveolar Ridge

Preservation Prior to
Implant Treatment
 Introduction
• Millions of teeth are still extracted in Indonesia
• The fast pace of soaring popularity of implants in dentistry by clinicians
• The reduction of the alveolar bone volume which may interfere with the
placement and influence the treatment success
 Introduction
1. Johnson reported (2018) :
most of the dimensional alterations horizontal as well as vertical of the alveolar ridge during 3
months.
2. Schropp et. al (2018) reported their study :
46 patients following single tooth extraction that approximately the loss of two thirds of
horizonal and vertical alveolar ridge
40-60% of original height and width is expected to be lost after extraction

Fatme Mouchref H, Fady El Hajj, Rita Ozeir . 2018. Socket Preservation tehnique ‘bio oss and Periacryl Biological Adhesive ; A 7 Year
Follow Up Period : A Case Report.
 • Clasiffication of extraction sockets Nicholas
Caplanis, et.al (2009) :
1. Type 1 : The bony socket is intact and soft
tissue form is undisturbed.
2. Type 2 : the bony socket is intact in the coronal
aspect of the socket. But a fenestration is
present in the apical area.
3. Type 3 : Bone loss is present in the coronal
aspect of the socket The soft tissue remains
intact and undisturbed.
4. Type 4 : Bony Defect exist in conjuction with
soft tissue deformity.

Nicholas Caplanis, Jamie L, Joseph YK. 2009. Extraction defect : Assement, Clasiffication, and Management
 Introduction
• The severity of the healing pattern become a problem to placement of dental implant.
• Today, using socket preservation technique, it is possible to preserve the height and width
alveolar ridge.
• This is particulary important for placement of dental implants allowing for more ideal
placement for implant

Mohammad Adel Helmy . 2017. Review of Socket Preservation Technique

 Tooth Extraction
• Atraumatic extraction technique should be minimize damage to the alveolar
bone during extraction.
• The initial incision can be made with microsurgical blade.
• The blade incises the gingival fibers and begins separation of the periodontal
ligament.
• Periotome can be used to separated periodontal ligament and root for the
futher.

Nicholas Caplanis, Jamie L, Joseph YK. 2009. Extraction defect : Assement, Clasiffication, and Management
Manoj G, Neeti M, Gopal KG, Mayank S. 2018. Ridge Augmentation in implant Dentistry.
Manoj G, Neeti M, Gopal KG, Mayank S. 2018. Ridge Augmentation in implant Dentistry.
Manoj G, Neeti M, Gopal KG, Mayank S. 2018. Ridge Augmentation in implant Dentistry.
• Dimensions of the Buccal and Lingual Plates of Bone
• In general, the buccal plate of bone is thinner than the lingual bony plate and
is more prone to being fractured during tooth extractions. This is of
particular concern in the aesthetic zone, because a buccal bone fracture may
result in gingival recession. Furthermore, even if a labial plate fracture does
not occur upon tooth extraction, its thinness renders it prone to resorption
after tooth removal.
Manoj G, Neeti M, Gopal KG, Mayank S. 2018. Ridge Augmentation in implant Dentistry.
John Cavallaro, Gary Greenstein, Ben Greenstein. 2017. Extracting Teeth in Preparation for Dental Implants.
John Cavallaro, Gary Greenstein, Ben Greenstein. 2017. Extracting Teeth in Preparation for Dental Implants.
John Cavallaro, Gary Greenstein, Ben Greenstein. 2017. Extracting Teeth in Preparation for Dental Implants.
John Cavallaro, Gary Greenstein, Ben Greenstein. 2017. Extracting Teeth in Preparation for Dental Implants.
John Cavallaro, Gary Greenstein, Ben Greenstein. 2017. Extracting Teeth in Preparation for Dental Implants.
John Cavallaro, Gary Greenstein, Ben Greenstein. 2017. Extracting Teeth in Preparation for Dental Implants.
 Type Of Bone Graft
1. Autografts
• These refer to grafts transplanted from one place to other within the same
individual.
• These are referred to as the “gold standard” owing to the only graft types
with all three mechanisms of bone regeneration, i.e., osteogenesis,
osteoconduction, and osteoinduction as well.
• These can be harvested from neighboring intraoral sites or remote extraoral
sites.
Sources of intraoral grats

Journal of the International Clinical Dental Research Organization | Supplement 1 | Vol 7 | 2015
Comparative summary of different types of graft

Journal of the International Clinical Dental Research Organization | Supplement 1 | Vol 7 | 2015
2. Harvesting autogenous graft
- Ramus graft
- Chin/symphysis graft
- Tuberosity graft
 TECHNIQUES OF RIDGE
AUGMENTATION
• The various techniques of ridge augmentation can be differentiated either on the
basis of the form of graft, i.e., block or particulate, guidance or use of membrane,
i.e., GBR, transportation of vital structures, i.e., maxillary sinus lift and inferior
alveolar nerve transportation.
1. Onlay grafting
2. Particulate onlay grafting
3. Subperiosteal tunnel grafting
4. Block onlay grafting
 Evaluation
1. Succesfull osseointegration and complete bone healing were observed for all
patient.
2. The new extraction technique was found to be effective in immediate
implant cases in order no to damage the thin plate of buccal bone.
3. Socket preservation maintain the height and width of the remaining viable
alveolar ridge post extraction. This can be achieved through adequate flap
design whenever needed, atraumatic extraction, adequate selection of grafting
material and the membrane barrier.
 References
1. Goyal, Manoj, dkk. “ Ridge augmentation in implant dentistry”. Journal of
the iternational clinical dental research organization | suplement 1 | vol
7|2015
2. Helmy, Mohammad Adel. “Review of Socket Preservation Technique“. EC
Dental Science 14.1 (2017): 07-14.