TODENTJ-25-03-2019_TODENTJ-8-66 1553505528 Bentham Open doi@benthamopen.net Bentham Open The Open Dentistry Journal TODENTJ 1874-2106 5 16 2014 8 1 Elizabeth M Tomlin Shelby J Nelson Jeffrey A Rossmann Healing of the extraction socket after tooth removal involves retention of the blood clot followed by a sequence of events that lead to changes in the alveolar process in a three dimensional fashion. This normal healing event results in a minimal loss of vertical height (around 1 mm), but a substantial loss of width in the buccal-lingual plane (4-6 mm). During the first three months following extraction that loss has been shown to be significant and may result in both a hard tissue and soft tissue deformity affecting the ability to restore the site with acceptable esthetics. Procedures that reduce the resorptive process have been shown to be predictable and potentially capable of eliminating secondary surgery for site preparation when implant therapy is planned. The key element is prior planning by the dental therapist to act at the time of extraction to prevent the collapse of the ridge due to the loss of the alveolus. Several techniques have been employed as ridge preservation procedures involving the use of bone grafts, barrier membranes and biologics to provide a better restorative outcome. This review will explore the evidence behind each technique and their efficacy in accomplishing site preparation. The literature does not identify a single technique as superior to others; however, all accepted therapeutic procedures for ridge preservation have been shown to be more effective than blood clot alone in randomized controlled studies. 5 16 2014 66 76 TODENTJ-8-66 1 10.2174/crossmark_policy opendentistryjournal.com benthamopen.com true Peer Reviewed Single blind Checked with iThenticate 2014-1-10 2014-1-30 2014-2-12 2014-5-16 http://creativecommons.org/licenses/by-nc/3.0/ 10.2174/1874210601408010066 1553505528 https://opendentistryjournal.com/VOLUME/8/PAGE/66/ https://opendentistryjournal.com/contents/volumes/V8/TODENTJ-8-66/TODENTJ-8-66.pdf https://opendentistryjournal.com/contents/volumes/V8/TODENTJ-8-66/TODENTJ-8-66.pdf https://opendentistryjournal.com/contents/volumes/V8/TODENTJ-8-66/TODENTJ-8-66.pdf https://opendentistryjournal.com/contents/volumes/V8/TODENTJ-8-66/TODENTJ-8-66.pdf https://opendentistryjournal.com/contents/volumes/V8/TODENTJ-8-66/TODENTJ-8-66.pdf https://opendentistryjournal.com/contents/volumes/V8/TODENTJ-8-66/TODENTJ-8-66.pdf https://opendentistryjournal.com/contents/volumes/V8/TODENTJ-8-66/TODENTJ-8-66.pdf https://opendentistryjournal.com/contents/volumes/V8/TODENTJ-8-66/TODENTJ-8-66.xml Mosby Rose LF 2004 Rose LF, Mealey BL, Genco R, Cohen W. Periodontics: medicine. surery.and implants, Mosby 2004. Int J Periodont Restorat Dent Schropp L 23 313 2003 Schropp L, Wenzel A, Kostopoulos L, Karring T. Bone healing and soft tissue contour changes following single-tooth extraction: a clinical and radiographic 12-month prospective study. Int J Periodont Restorat Dent 2003; 23 (4) : 313-24. J Oral Implantol Ohta Y 19 184 1993 Ohta Y. Comparative changes in microvasculature and bone during healing of implant and extraction sites. J Oral Implantol 1993; 19 (3) : 184-98. J Prosthet Dent Jahangiri L 80 224 1998 Jahangiri L, Devlin H, Ting K, Nishimura I. Current perspectives in residual ridge remodeling and its clinical implications: a review. J Prosthet Dent 1998; 80 (2) : 224-37. Oral Surg Oral Med Oral Pathol Amler MH 27 309 1969 Amler MH. The time sequence of tissue regeneration in human extraction wounds. Oral Surg Oral Med Oral Pathol 1969; 27 (3) : 309-18. Anat Rec Lin WL 240 492 1994 Lin WL, McCulloch CA, Cho MI. Differentiation of periodontal ligament fibroblasts into osteoblasts during socket healing after tooth extraction in the rat. Anat Rec 1994; 240 (4) : 492-506. J Am Dent Assoc Amler MH 61 32 1960 Amler MH, Johnson PL, Salman I. Histological and histochemical investigation of human alveolar socket healing in undisturbed extraction wounds. J Am Dent Assoc 1960; 61 : 32-44. J Prosthet Dent Pietrokovski J 34 456 1975 Pietrokovski J. The bony residual ridge in man. J Prosthet Dent 1975; 34 (4) : 456-62. J Oral Implantol Misch CE 25 244 1999 Misch CE, Dietsh-Misch F, Misch CM. A modified socket seal surgery with composite graft approach. J Oral Implantol 1999; 25 (4) : 244-50. Gen Dent Ashman A 48 304 2000 Ashman A. Ridge preservation: important buzzwords in dentistry. Gen Dent 2000; 48 (3) : 304-12. J Prosthet Dent Atwood DA 12 441 1962 Atwood DA. Some clinical factors related to rate of resorption of residual ridges. J Prosthet Dent 1962; 12 (3) : 441-50. J Clin Periodontol Yilmaz S 25 832 1998 Yilmaz S, Efeoglu E, Kiliç AR. Alveolar ridge reconstruction and/or preservation using root form bioglass cones. J Clin Periodontol 1998; 25 (10) : 832-9. J Contemp Dent Pract Younis L 10 35 2009 Younis L, Taher A, Abu-Hassan MI, Tin O. Evaluation of bone healing following immediate and delayed dental implant placement. J Contemp Dent Pract 2009; 10 (4) : 35-42. J Prosthet Dent Atwood DA 26 280 1971 Atwood DA, Coy WA. Clinical. cephalomeric.and densitometric study of reduction of residual ridges. J Prosthet Dent 1971; 26 (3) : 280-95. Acta Odontol Scand Carlsson GE 25 45 1967 Carlsson GE, Bergman B, Hedegard B. Changes in contour of the maxillary alveolar process under immediate dentures: a longitudinal clinical and x-ray cephalometric study covering 5 years. Acta Odontol Scand 1967; 25 (1) : 45-75. J Periodontol Soehren SE 50 128 1979 Soehren SE, Van Swol R. The healing extraction site: a donor area for periodontal grafting material. J Periodontol 1979; 50 (3) : 128-33. Ann Acad Med Stetin Allegrini S 54 70 2008 Allegrini S, Koening B, Allegrini MRF , et al. Alveolar ridge sockets preservation with bone grafting--review. Ann Acad Med Stetin 2008; 54 (1) : 70-81. J Periodontol Schallhorn RG 43 3 1972 Schallhorn RG. Postoperative problems associated with iliac transplants. J Periodontol 1972; 43 (1) : 3-9. J Calif Dent Assoc Robinson RE 46 18 1970 Robinson RE. The osseous coagulum for bone induction technique: a review. J Calif Dent Assoc 1970; 46 (1) : 18-27. J Periodontol Diem CR 43 295 1972 Diem CR, Bowers GM, Moffitt WC. Bone blending: a technique for osseous implants. J Periodontol 1972; 43 (5) : 295-7. J Periodontol Iasella JM 74 990 2003 Iasella JM, Greenwell H, Miller RL , et al. Ridge preservation with freeze-dried bone allograft and a collagen membrane compared to extraction alone for implant site development: a clinical and histologic study in humans. J Periodontol 2003; 74 (7) : 990-. J Bone Miner Res Goldring SR 3 117 1988 Goldring SR, Roelke M, Glowacki J. Multinucleated cells elicited in response to implants of devitalized bone particles possess receptors for calcitonin. J Bone Miner Res 1988; 3 (1) : 117-20. J Periodontol 72 834 2001 Committee on Research. Science and Therapy of the American Academy of Periodontology . Tissue banking of bone allografts used in periodontal re-generation. J Periodontol 2001; 72 (6) : 834-. J Periodontol Schwartz Z 67 918 1996 Schwartz Z, Mellonig JT, Carnes DL , et al. Ability of commercial demineralized freeze-dried bone allograft to induce new bone formation. J Periodontol 1996; 67 (9) : 918-26. J Periodontol Shapoff CA 51 625 1980 Shapoff CA, Bowers GM, Levy B, Mellonig JT, Yukna RA. The effect of particle size on the osteogenic activity of composite grafts of allogeneic freeze-dried bone and autogenous marrow. J Periodontol 1980; 51 (11) : 625-30. J Periodontol Zaner DJ 55 406 1984 Zaner DJ, Yukna RA. Particle size of periodontal bone grafting materials. J Periodontol 1984; 55 (7) : 406-9. J Periodontol Mellonig JT 63 979 1992 Mellonig JT, Prewett AB, Moyer MP. HIV inactivation in a bone allograft. J Periodontol 1992; 63 (12) : 979-83. Clin Orthop Relat Res Buck B 240 129 1989 Buck B, Malinin TI, Brown MD. Bone transplantation and human immunodeficiency virus: an estimate of risk of acquired immunodeficiency syndrome (AIDS). Clin Orthop Relat Res 1989; 240 : 129-36. Clin Orthop Relat Res Buck B 251 249 1990 Buck B, Resnick L, Shah S, Malinin T. Human immunodeficiency virus cultured from bone: implications for transplantation. Clin Orthop Relat Res 1990; 251 : 249-53. J Periodontol Wood RA 83 329 2012 Wood RA, Mealey BL. Histologic comparison of healing after tooth extraction with ridge preservation using mineralized versus demineralized freeze-dried bone allograft. J Periodontol 2012; 83 (3) : 329-6. J Periodontol Hoang TN 83 174 2012 Hoang TN, Mealey BL. Histologic comparison of healing after ridge preservation using human demineralized bone matrix putty with one versus two different-sized bone particles. J Periodontol 2012; 83 (2) : 174-81. J Periodontol [Epub] Eskow AJ 1 2013 Eskow AJ, Mealey BL. Evaluation of healing following tooth extraction with ridge preservation using cortical versus cancellous freeze-dried bone allograft. J Periodontol [Epub] 2013; 1-10. Clin Oral Implants Res Ten Heggeler JM 22 779 2011 Ten Heggeler JM, Slot DE, Van der Weijden GA. Effect of socket preservation therapies following tooth extraction in non-molar regions in humans: a systematic review. Clin Oral Implants Res 2011; 22 (8) : 779-88. J Periodontol Rummelhart J 60 655 1989 Rummelhart J, Mellonig J, Gray J, Towle H. A comparison of freeze-dried bone allograft and demineralized freeze–dried bone allograft in human periodontal osseous defects. J Periodontol 1989; 60 (12) : 655-3. J Periodontol Sanders JJ 54 1 1983 Sanders JJ, Sepe WW, Bowers GM , et al. Clinical evaluation of freeze-dried bone allografts in periodontal osseous defects.Part III. Composite freeze-dried bone allografts with and without autogenous bone grafts. J Periodontol 1983; 54 (1) : 1-8. Clin Oral Implants Res Araujo MG 20 433 2009 Araujo MG, Lindhe J. Ridge preservation with the use of Bio-Oss collagen: a 6-month study in the dog. Clin Oral Implants Res 2009; 20 (5) : 433-0. J Periodontol Artzi Z 71 1015 2000 Artzi Z, Tal H, Dayan D. Porous bovine bone mineral in healing of human extraction sockets.Part 1: histomorphometric evaluations at 9 months. J Periodontol 2000; 71 (6) : 1015-23. J Periodontol Artzi Z 72 152 2001 Artzi Z, Tal H, Dayan D. Porous bovine bone mineral in healing of human extraction sockets: 2.Histochemical observations at 9 months. J Periodontol 2001; 72 (2) : 152-9. Int J Oral Maxillofac Implants Lee DW 24 609 2009 Lee DW, Pi SH, Lee SK, Kim EC. Comparative histomorphometric analysis of extraction sockets healing implanted with bovine xenografts. irradiated cancellous allogrfts.and solvent-dehydrated allografts in humans. Int J Oral Maxillofac Implants 2009; 24 (4) : 609-15. Pract Periodontics Aesthet Dent Froum S 12 393 2000 Froum S, Orlowski W. Ridge preservation utilizing an alloplast prior to implant placement--clinical and histological case reports. Pract Periodontics Aesthet Dent 2000; 12 (4) : 393-402. Oral Surg Oral Med Oral Pathol Oral Radiol Endod Camargo PM 90 581 2000 Camargo PM, Lekovic V, Weinlaender M , et al. Influence of bioactive glass on changes in alveolar process dimensions after exodontia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000; 90 (5) : 581-6. Int J Oral & Maxillofacial implants Norton MR 17 249 2002 Norton MR, Wilson J. Dental implants placed in extraction sites implanted with bioactive glass: human histology and clinical outcome. Int J Oral & Maxillofacial implants 2002; 17 (2) : 249-57. Implant Dent Froum S 13 153 2004 Froum S, Cho SC, Elian N, Rosenberg E, Rohrer M, Tarnow D. Extraction sockets and implantation of hydroxyapatites with membrane barriers: a histologic study. Implant Dent 2004; 13 (2) : 153-64. J Periodontol Froum S 73 94 2002 Froum S, Cho SC, Rosenberg E, Rohrer M, Tarnow D. Histological comparison of healing extraction sockets implanted with bioactive glass or demineralized freeze-dried bone allograft: a pilot study. J Periodontol 2002; 73 (1) : 94-102. Clin Oral Implants Res Serino G 14 651 2003 Serino G, Biancu S, Iezzi G, Piattelli A. Ridge preservation following tooth extraction using a polylactide and polyglycolide sponge as space filler: a clinical and histological study in humans. Clin Oral Implants Res 2003; 14 (5) : 651-8. Clin Oral Implants Res Serino G 19 26 2008 Serino G, Rao W, Iezzi G, Piattelli A. Polylactide and polyglycolide sponge used in human extraction sockets: bone formation following 3 months after its application. Clin Oral Implants Res 2008; 19 (1) : 26-31. Atlas Oral Maxillofac Surg Clin North Am Sclar A 7 39 1999 Sclar A. Preserving alveolar ridge anatomy following tooth removal in conjunction with immediate implant placement: the Bio-Col technique. Atlas Oral Maxillofac Surg Clin North Am 1999; 7 (2) : 39-59. J Periodontol Neiva RF 79 291 2008 Neiva RF, Tsao YP, Eber R, Shotwell J, Billy E, Wang HL. Effects of a putty-form hydroxyapatite matrix combined with the synthetic cell-binding peptide P-15 on alveolar ridge preservation. J Periodontol 2008; 79 (2) : 291-9. J Periodontol Fiorellini JP 76 605 2005 Fiorellini JP, Howell TH, Cochran D , et al. Randomized study evaluating recombinant human bone morphogenetic protein-2 for extraction socket augmentation. J Periodontol 2005; 76 (4) : 605-13. Quintessence Int Wang HL 32 504 2001 Wang HL, Carroll MJ. Guided bone regeneration using bone grafts and collagen membranes. Quintessence Int 2001; 32 (7) : 504-15. Int J Periodontics Restorat Dent Salama H 13 312 1993 Salama H, Salama M. The role of orthodontic extrusive remodeling in the enhancement of soft and hard tissue profiles prior to implant placement: a systematic approach to the management of extraction site defects. Int J Periodontics Restorat Dent 1993; 13 (4) : 312-3. Ann Periodontol Spray JR 5 119 2000 Spray JR, Black CG, Morris HF, Ochi S. The influence of bone thickness on facial marginal bone response: stage 1 placement through stage 2 uncovering. Ann Periodontol 2000; 5 (1) : 119-28. Int J Periodontics Restorat Dent Braut V 31 125 2011 Braut V, Bornstein MM, Belser U, Buser D. Thickness of the anterior maxillary facial bone wall-a retrospective radiographic study using cone beam computed tomography. Int J Periodontics Restorat Dent 2011; 31 (2) : 125-31. J Periodontol Scantlebury TV 64 1129 1993 Scantlebury TV. 1982-1992: a decade of technology development for guided tissue regeneration. J Periodontol 1993; 64 (Suppl 11 ) : 1129-37. J Periodontol Hardwick R 66 495 1995 Hardwick R, Hayes BK, Flynn C. Devices for dentoalveolar regeneration: an up-to-date literature review. J Periodontol 1995; 66 (6) : 495-505. Clin Oral Implants Res Buser D 1 22 1990 Buser D, Bragger U, Lang NP, Nyman S. Regeneration and enlargement of jaw bone using guided tissue regeneration. Clin Oral Implants Res 1990; 1 (1) : 22-32. Int J Periodont Restorat Dent Murphy KG 15 548 1995 Murphy KG. Postoperative healing complications associated with Gore-Tex periodontal material.Part II. Effect of complications on regeneration. Int J Periodont Restorat Dent 1995; 15 (6) : 548-61. Clin Oral Implants Res Lang NP 5 92 1994 Lang NP, Hammerle CH, Bragger U, Lehmann B, Nyman SR. Guided tissue regeneration in jawbone defects prior to implant placement. Clin Oral Implants Res 1994; 5 (2) : 92-7. J Periodontol Machtei EE 72 512 2001 Machtei EE. The effect of membrane exposure on the outcome of regenerative procedures in humans: a meta-analysis. J Periodontol 2001; 72 (4) : 512-6. J Periodontol Hoffmann O 79 1355 2008 Hoffmann O, Bartee BK, Beaumont C, Kasaj A, Deli G, Zafiropoulos GG. Alveolar bone preservation in extraction sockets using non-resorbable dPTFE membranes: a retrospective non-randomized study. J Periodontol 2008; 79 (8) : 1355-69. J Periodontol Walters SP 74 1161 2003 Walters SP, Greenwell H, Hill M, Drisko C, Pickman K, Scheetz JP. Comparison of porous and non-porous teflon membranes plus a xenograft in the treatment of vertical osseous defects: a clinical reentry study. J Periodontol 2003; 74 (8) : 1161-8. Clin Oral Implants Res [Epub] Ronda M 2013 Ronda M, Rebaudi A, Torelli L, Stacchi C. Expanded vs.dense polytetrafluoroethylene membranes in vertical ridge augmentation around dental implants: a prospective randomized controlled clinical trial. Clin Oral Implants Res [Epub] 2013. J Periodontol Bunyaratavej P 72 215 2001 Bunyaratavej P, Wang HL. Collagen membranes: a review. J Periodontol 2001; 72 (2) : 215-9. J Periodontol Marinucci L 72 753 2001 Marinucci L, Lilli C, Baroni T , et al. In vitro comparison of bioabsorbable and non-resorbable membranes in bone regeneration. J Periodontol 2001; 72 (6) : 753-9. J Periodontal Res Pitaru S 24 247 1989 Pitaru S, Tal H, Soldinger M, Noff M. Collagen membranes prevent apical migration of epithelium and support new connective tissue attachment during periodontal wound healing in dogs. J Periodontal Res 1989; 24 (4) : 247-53. J Periodontol Blumenthal NM 59 830 1988 Blumenthal NM. The use of collagen membranes to guide regeneration of new connective tissue attachment in dogs. J Periodontol 1988; 59 (12) : 830-6. Clin Oral Investig Alpar B 4 219 2000 Alpar B, Leyhausen G, Gunay H, Geurtsen W. Compatibility of resorbable and non-resorbable guided tissue regeneration membranes in cultures of primary human periodontal ligament fibroblasts and human osteoblast-like cells. Clin Oral Investig 2000; 4 (4) : 219-5. Implant Dent Luczyszyn SM 14 176 2005 Luczyszyn SM, Papalexiou V, Novaes AB, Grisi MFM, Souza SLS, Taba M. Acellular dermal matrix and hydroxyapatite in prevention of ridge deformities after tooth extraction. Implant Dent 2005; 14 (2) : 176-84. Int J Oral Maxillofac Implants Darby I 24 Suppl 260 2009 Darby I, Chen ST, Buser D. Ridge preservation techniques for implant therapy. Int J Oral Maxillofac Implants 2009; 24 Suppl : 260-71. Clin Oral Investig Horvath A 17 341 2013 Horvath A, Mardas N, Mezzomo LA, Needleman IG, Donos N. Alveolar ridge preservation: a systematic review. Clin Oral Investig 2013; 17 (2) : 341-63. Clin Implant Dent Relat Res [Epub] Morjaria KR 1 2012 Morjaria KR, Wilson R, Palmer RM. Bone healing after tooth extraction with or without an intervention: a systematic review of randomized controlled trials. Clin Implant Dent Relat Res [Epub] 2012; 1-20. Clin Oral Implants Res Vignoletti F 23 22 2012 Vignoletti F, Matesanz P, Rodrigo D, Figuero E, Martin C, Sanz M. Surgical protocols for ridge preservation after tooth extraction: a systematic review. Clin Oral Implants Res 2012; 23 (Suppl 5 ) : 22-38. Int J Oral Maxillofac Implants Vittorini Orgeas G 28 1049 2013 Vittorini Orgeas G, Clementini M, De Risi V, de Sanctis M. Surgical techniques for alveolar socket preservation: a systematic review. Int J Oral Maxillofac Implants 2013; 28 (4) : 1049-61.