The Decision‐Making Process for Ridge Preservation Procedures After Tooth Extraction

Focused Clinical Question: How should the extraction socket be managed after tooth removal? Summary: Resorptive changes that take place after tooth extraction can result in a significant reduction in alveolar ridge width and height. This may create a problem for proper implant placement and fabrication of esthetic restorations. Ridge preservation has been shown to be effective in decreasing alveolar bone resorption after tooth removal. During ridge preservation, the extraction socket is filled with graft material, and a barrier is generally used to contain the graft. Flap reflection is usually not recommended if the socket walls are intact and the ridge width is sufficient after tooth removal. However, if significant breakdown of the buccal bony plate is present, mucoperiosteal flap elevation may be required to allow proper placement of the bone graft and membrane. Different types of bone grafts (autograft, allograft, and xenograft) and barrier membranes (resorbable and non‐resorbable) have been evaluated in clinical studies. They all are shown to be effective regardless of the material or technique used. Conclusions: Ridge preservation is an effective procedure for minimizing horizontal and vertical alveolar ridge resorption after tooth extraction. Current evidence does not support one technique as being superior to another. The selection of the technique to be used should be based on the clinical situation.