Dr. Ilham Mounssif

A 47-year-old male patient (ASA I) presented with a compromised left mandibular second premolar indicated for extraction and subsequent alveolar ridge preservation. The patient was medically healthy, reported no regular medication use, was a non-smoker, and was enrolled in a supportive periodontal therapy (SPT) program.

Preoperative assessment included buccal, occlusal, and lingual clinical photographs together with radiographic examination, which confirmed the compromised status of the left mandibular second premolar and the need for post-extractive ridge reconstruction.

Surgical Procedure

An atraumatic extraction of the tooth was performed to preserve the integrity of the surrounding hard and soft tissues. Following extraction, the socket was grafted with cerabone^® + HyA to support alveolar ridge preservation and regeneration.

NOVAMag^® SHIELD was trimmed and shaped intraoperatively and was then positioned at the buccal aspect of the extraction site, extending at least 3 to 4 mm beyond the defect margins to ensure appropriate stabilization and space maintenance for guided bone regeneration.

mucoderm^® was subsequently adapted over the magnesium shield to improve soft-tissue adaptation and was then stabilized using monofilament PGA 7-0 sutures, creating an occlusal seal over the grafted socket.

The flap was then coronally advanced and stabilized using monofilament PGA 6-0 sutures, with the aim of achieving primary intention closure. Sutures were removed at 14 days postoperatively.

The patient was evaluated at 7, 14, 30, 90, and 180 days postoperatively. At each follow-up visit, standardized clinical photographs were obtained and comprehensive healing assessments were performed to document wound closure, tissue appearance, and the presence or absence of complications.

Healing progressed uneventfully. Clinical assessment at the 6-month follow-up demonstrated favorable soft-tissue healing, characterized by healthy tissue integration, satisfactory soft-tissue volume, complete wound closure, and preservation of the ridge contour. No significant complications were observed during the healing phase.

This case shows that a combined regenerative approach using NOVAMag^® SHIELD, cerabone^® + HyA, and mucoderm^® resulted in successful alveolar ridge preservation with favorable soft-tissue maturation, providing a stable foundation for an implant-supported rehabilitation.