SOCKET GRAFT is indicated when the clinician wants to preserve the maximum amount of bone after tooth extraction. SOCKET GRAFT is designed to retain the alveolar ridge and speed bone fill into the socket. However, SOCKET GRAFT will not rebuild any part of the ridge lost prior to placement of SOCKET GRAFT. If the clinician knows prior to extraction that a significant amount of alveolar ridge is missing and more ridge is needed for implant placement or for esthetics then a ridge augmentation procedure is indicated with the use of hard bone graft material and the placement of a barrier to retain the graft. The following case demonstrates that when implants are planned, one socket is appropriate for the use of SOCKET GRAFT but he other socket requires more invasive surgery due to a significant loss of buccal alveolar bone.
This patient had trauma to her anterior bridge and required the removal of teeth #8 and #10. In this image it appears that the socket is supporting the gingiva in the area of tooth #8 but the alveolar ridge is lost on the buccal of tooth #10.
Due to the adequate bony socket in the area of tooth #8 SOCKET GRAFT was planned to treat this socket. However, due to the loss of the buccal alveolus in the area of tooth #10 the decision was made to place a hard tissue graft using an equal mixture of low density hydroxylapatite and demineralized freeze dried bone allograft mixed with REGEN BIOCEMENT wetted with HYDRASE. The hard graft for tooth #10 was then covered with a slowly resorbing collagen membrane and sutured with primary closure.
After ridge augmentation was completed for the area of tooth #10, a socket preservation procedure was used for the socket of tooth #8. This photo shows the placement of SOCKET GRAFT in the socket of tooth #8.
In order to protect the grafts an adhesive foil supplied with SOCKET GRAFT was placed over the entire surgical site.
This patient was unable to abstain from rubbing the surgical site with her tongue and had worn away the foil after two days. The following photo shows the surgical site after two weeks. The site where SOCKET GRAFT was used is nearly healed. However, the ridge augmentation site is open with exposure of the membrane. Due to the use of a slowly resorbing membrane and REGEN BIOCEMENT to stabilize the hard graft material the bone graft is still in place.
The bone regenerated is seen on this photograph. The bone is adequate with an exception of the bone on the buccal surfaces which required additional grafting at the time of implant placement. REGEN BIOCEMENT was used as the graft material for the buccal surfaces of the newly placed implants. Healing was uneventful.
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