Socket Preservation

Biomaterial and Procedure

Rudhanton Sidharta
 What is socket preservation?
Why its important to implant placement?
Socket preservation or alveolar ridge preservation (ARP) is a procedure
to reduce bone loss after tooth extraction to preserve the dental
alveolus (tooth socket) in the alveolar bone.
Classification...?
 Grade 1 Grade 2 Grade 3
<25% buccal palate loss 25% - 50% buccal palate loss >50% buccal palate loss
Adequate interproximal bone Adequate interproximal bone Indequate interproximal bone
Adequate apical tomography Adequate apical tomography Inadequate apical tomography

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 Grade 1 Theraphy
<25% buccal palate loss Immediate implant pacement with possible provisionalization,
Adequate interproximal bone bone graft
Adequate apical tomography
 Grade 2 Theraphy
25% - 50% buccal palate loss
Adequate interproximal bone
Adequate apical tomography
Thick biotype Thin biotype

Immediate Maxilla : socket

implant preservation
pacement with bone graf
without using RPPCTG
provisional, with
bone graft and Mandible :
membrane socket
preservation
with bone graft
 Grade 3 Theraphy
>50% buccal palate loss Proximal bone Inadequate
Indequate interproximal bone loss with or apical
Inadequate apical tomography without buccal tomography
plate loss

Maxilla : or Socket
socket preservation
preservation becomes a
with bone graf Forced ridge
using RPPCTG erruption augmentation

Mandible :
Grade 1 Grade 2
socket
preservation
with bone graft
Graft Materials
 Can be taken from.... ?

Autograft Allograft

Syntetic Material

Xenograft Alloplast
Autograft
• Bones
• Osseus coagulum
• Bone Blend
• Platellet rich Plasma
Allograft
• Mineralized freeze-dried bone allograft (FDBA)

• Demineralized freeze-dried bone allograft (DFDBA)

• Frozen iliac cancellous bone & marrow
Xenograft
• Source :
• Bovine bone
• Natural Coral
• Form :
• Calf Bone
• Kiel Bone
• Anorganic Bone
Alloplast

Polymers Ceramics Metals

Biology C: Calcium Phosphate Titanium Alloy
Collagene Hidroxyappatite Chrome Cobalt Alloy
Fibrin Tricalcium phosphat
Calcium sulphate
Synthetic C:
Polylactic
Polyglycolic
Acid Polymers
Biomechanism of Graft Materials
Biomechanism Meaning Source/materials Limitatitons

Osteogenesis Synthesize new bone Bone marrow aspirates Unpredictable

outcomes

Osteoconduction Fassilitate blood Calcium sulfate, Need barier

vessels ingrowth and ceramic, collagen, membrane
bone formation into bioactove glass,
scaffold tissues syntetic polymers

Osteoinduction Recruit host Extracellular matrix,

mesencymal stem cells growth factor, gene
into the graft that theraphy
differentiate into
osteoblast
 Biologic Properties of various Bone Graft
Materials
Source Osteoconductive OsteoInductive Osteogenesis

Alloplast Yes No No

Xenograft Yes No No

Allograft Yes Yes/No No

Autograft Yes Yes Yes

 The barrier membrane

PTFE Membrane Titanium membrane Collagen Membrane Syntetic Membrane

Non Resorbable
Resorbable membrane
membrane
 Technique

Atraumatic tooth extraction Remove granulation tissues Bone graft material

Plug in socket site Suturing

 Technique

Immediate radiograph after bone graf placement After 3 months radiograph

Still radiolucent

Ridge is ready to After implant placement

implant placement
References
• Kosinski, T. Simple & Predictable Socket Preservation Techniques All
Dentists Can Implement Regardless of Extraction or Grafting
Experience. TDP : 2016.
TERIMA KASIH