What are the current perspectives on the role of ridge (socket) preservation procedures in dental implant treatment in the aesthetic zone?

This summary is based on the article published in the Australian Dental Journal: Current perspectives on the role of ridge (socket) preservation procedures in dental implant treatment in the aesthetic zone (March 2014)

B Kassim, S Ivanovski, N Mattheos 

Context

• Augmentation of the extraction socket (ridge preservation) is increasingly being advocated in anticipation of implant placement.
• Substantial tissue loss leads to increased difficulty in placing the implant fixture in a prosthodontically suitable position. To facilitate such placement, guided bone regeneration (GBR) procedures (either simultaneous at implant placement or staged as a separate surgical procedure) are often required.
• Ridge preservation, or ‘socket’ preservation (as it is sometimes paradoxically referred to) involves placement of graft material within the socket; this can be combined with either a membrane and/or an advanced or rotated flap.
• The context of ridge preservation studied in this article refers to the preservation of the ridge volume within the tissue envelope existing at the time of extraction. (1)

Purpose of the Article

• To review the available evidence with regards to ridge preservation procedures, investigating whether these techniques improve dental implant treatment outcomes.
• Evidence is examined to compare these techniques to other treatment alternatives such as implant placement with simultaneous lateral augmentation.

Key Findings 

• Ridge preservation techniques are effective in minimizing post-extraction alveolar ridge contraction. However, there is insufficient evidence to suggest that the use of these techniques in conjunction with dental implant treatment improves implant treatment outcomes.
• Ridge preservation does not necessarily eliminate the need for further simultaneous augmentation at the time of implant placement.
• The delayed healing associated with ridge preservation using socket grafting necessitates a commitment to a delayed placement protocol.
• The extended treatment time, compromised healing and expense related to ridge preservation suggests a more cautious approach with regards to the indication of such techniques.

Reference

1. Hammerle CH, Araujo MG, Simion M. Evidence-based knowledge on the biology and treatment of extraction sockets. Clin Oral Implants Res 2012;23 Suppl 5:80–82.

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