Socket Healing - The First Step in Esthetic Dentistry Following Extraction

By Eiji Kato, DDS

When a dentist extracts a tooth, they are already thinking about how to restore it. The dentistwould like the extraction socket to heal quickly for the purpose of planning a cosmeticallypleasing restoration.

If a maxillary anterior tooth with a labial dehiscence or fenestration is extracted, rapid boneloss is expected because of the thin or missing alveolar bone. In the case of this type ofextraction, there have been many ways to restore the tooth with a pontic on a fixed bridge orwith a false tooth attached to a removable partial denture. Implants have also been a method by whichextracted teeth have been restored.

The criteria for what type of material will be used is dependent on how many walls remain in the bonydefect, the size of the mesial-distal or palatal-labial defect, and how much soft tissue remains. Foundation, acollagen-based, bone filling augmentation material, is frequently used for many cases.

Foundation is most effective when four walls remain with at least 2mm of bone on the labial side, but it isstill effective in more advanced defects.

Another indication for Foundation is in immediate implant surgery. The material has been used to fill thespace between implant and soft tissue to gpump uph the soft tissue and support the implant.

Foundation was originally used as a scaffolding or framework to absorb blood in the extraction socket. Thedesign of the collagen in Foundation also contains a portion that stimulates the bone to grow into thescaffolding, filling the socket with the patients own bone.Clinical success is dependent on osteoblast activity. This is determined by age of patient or whether it iscortical or cancellous bone.

In order to induce osteoblast activity it may be necessary to use autogenousbone graft or decortication of the bone. We expect that there will be moreresearch and development of this new product in the near future.

Eiji Kato, DDS practices at The Kato Dental Clinic and is a member of theImplant & Tissue-Engineering Dental Network (ITDN), Tokyo, Japan.
from News Views 2006 No.3
A newsletter for the dental profession
Published by J. Morita USA, Inc.