https:\/\/doi.org\/10.3390\/ma15030733<\/a> Tooth removal inevitably results in dimensional reductions of the alveolar process. Alveolar socket and ridge preservation procedures have been demonstrated to minimize ridge resorption after tooth extraction. However, although the present clinical literature suggests different treatment modalities for ridge preservation, a guideline on when to use which kind of grafting material is currently missing. Therefore, the aim of this study was to provide decision guidance for the most suitable ridge preservation technique.<\/p>\n The authors performed a systematic literature search to define parameters with respect to the phenotype of alveolar sockets that affect the outcome of ridge preservation procedures. Buccal bone thickness, buccal bone integrity, and dehiscences or fenestrations of the buccal bone wall were found to be crucial factors. Thus, based on the morphology of the labial bone wall a classification of extraction sites and a treatment decision tree was proposed.<\/p>\n Based on the buccal bone characteristics, three types of extraction sockets were described:<\/p>\n Sockets type 1 are additionally subdivided based on the thickness of the bone wall, i.e. \u2265 1.0 mm (subclass ST1A) or < 1.0 mm (subclass ST1B) thickness. Similarly, sockets type 3 are further divided according to the dehiscence height, i.e. 1\/3 (subclass ST3A), 1\/3 \u2013 2\/3 (subclass ST3B) or \u2265 2\/3 (subclass ST3C) of the buccal bone height.\u00a0<\/strong><\/p>\n Based on the defined types of extraction sockets different treatment modalities were proposed.<\/p>\n<\/div><\/div><\/div><\/div><\/div> Fig. 1. Proposed biomaterials and treatment approaches for the different socket types.<\/p>\n<\/div><\/div><\/div> Socket type 1 (ST1) \u2013 Intact buccal bone wall<\/strong><\/p>\n Socket type 2 (ST2) \u2013 Buccal fenestration<\/strong><\/p>\n Sockets with a fenestration defect at the labial bone wall can be treated with a particular grafting material and a collagen membrane applied according to the ice-cream-cone technique, which omits the need of flap reflection.<\/p>\n<\/div><\/div><\/div> Socket type 3 (ST3) \u2013 Buccal bone dehiscence<\/strong><\/p>\n Treatment approaches for sockets presenting with a dehiscent buccal bone wall are based on the use of a particulate bone substitute in conjunction with a barrier membrane.<\/p>\n The anatomical structure of the buccal bone plate guides the treatment approach and biomaterial selection for the different socket types.<\/p>\n<\/div> – collacone\u00ae<\/sup> for sockets with intact, thick bone wall (Type 1A) to support the blood clot<\/p>\n – For thin, dehiscent or absent buccal bone (Type 1B, 2 and 3), cerabone\u00ae<\/sup> (bovine), maxgraft\u00ae<\/sup> (allograft) or maxresorb\u00ae<\/sup> (synthetic) are options for grafting<\/p>\n – mucoderm\u00ae<\/sup> for sockets with intact, thin bone wall (Type 1B) to seal the site and to protect the grafting material<\/p>\n – collprotect\u00ae<\/sup> membrane for Ice Cream Cone Approach (Type 2 and 3A sockets)<\/p>\n – permamem\u00ae<\/sup> for severely dehiscent sockets<\/p>\n
\n<\/strong>Steigmann L, Di Gianfilippo R, Steigmann M, Wang HL. Materials (Basel). 2022 Jan 19;15(3):733.<\/p>\nBACKGROUND AND OBJECTIVE<\/strong><\/h4>\n
APPROACH <\/strong><\/h4>\n
CLASSIFICATION OF EXTRACTION SOCKETS<\/strong><\/h4>\n
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PROPOSED TREATMENT OPTIONS<\/strong><\/h4>\n
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<\/span><\/div><\/div><\/div><\/div><\/div>CONCLUSION<\/strong><\/h4>\n
BIOMATERIAL RECOMMENDATIONS<\/strong><\/h4>\n
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