Bone Preservation

Socket Preservation

Even though Dr. Scharf uses some of the gentlest extraction techniques available, proper management of the socket is essential for a good outcome. One size does not fit all when it comes to socket management. How the socket is handled is a function of whether or not an implant will be placed and whether the bony walls of the socket are present after the extraction.

Even though Dr. Scharf uses some of the gentlest extraction techniques available, proper management of the socket is essential for a good outcome.

Some practices simply graft every socket. Dr. Scharf uses a more sophisticated approach. Believe it or not, placing a bone graft in a socket actually slows the healing of a socket. So a graft should only be placed if it is indicated. If a tooth is extracted gently and the bone walls of the socket are intact and of adequate thickness, and an implant in planned to be placed as soon as possible, then usually no graft is placed. We wait 8 weeks after an extraction and then place the implant. An exception to this rule may be a highly esthetic region like an upper front tooth. If no implant is planned in the site in the immediate future, then we usually place a graft into the socket. This minimizes bone loss due to lack of function or stimulation to the bone.

If a tooth is extracted and one of the bone walls of the socket are missing, or very thin, then a graft is indicated. In this case we place a collagen membrane into the socket. This recreates the missing bone wall and prevents gum tissue from growing into the socket. Next a graft material is placed into the socket. This is usually material from a tissue bank or a synthetic material. Finally, the collagen membrane is folded over the top of the socket to keep the graft material in place. This approach usually requires 3-4 months of healing before an implant can be placed.