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Posted on By Luca Mangani In Bone Grafting

TOOTH 1.1:
This afternoon I performed an atraumatic extraction after root perforation.
I decided to preserve the ridge volume with Concentrated Growth Factors (CGF) and heterologous cortico-cancellous 0,5g bone.
As immediate provisional, I put a Rochette Maryland bridge.I will remove sutures after 14 days. A the moment the provisional has not the right shape cause I will wait the final healing process and the correct tissue maturation.

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did you bone sound the facial. I would think there is a fenestration, dehiscence or very thin facial wall. Do you have a CBCT to evaluate thickness?


Dear colleague,unfortunately I don't have CBCT but I think that for this case is superfluous. The tooth perforation started from an internal resorption and the whole wall was quite perfect without bone dehiscence. After tooth extraction I probed the socket, three was no defect so I performed a classic ridge preservation with heterologous cortico-cancellous bone mixed with Concentrated Growth Factors (CGF):the sticky bone.If really deeper there will be some really micro perforation, the power of Concentrated Growth Factors will close them thanks to TGF new collagene fibers,VEGF new blood microcirculation and CD34 stem cells bone formation.


2 weeks post op
1 month post op


Healing of the extraction socket with and without socket grafting. When socket grafting is not adopted, major alveolar ridge resorption occurs. In a first phase, initially the blood clot, subsequently the granulation tissue and later the provisional matrix and the woven bone fill up the alveolus. The bundle bone is completely resorbed causing a reduction in the vertical ridge. In a second phase, the buccal wall and the woven bone are remodeled causing the horizontal and further vertical ridge reduction. When socket grafting is adopted, the first phase and vertical bone reduction still occur, however, the second phase and the horizontal contraction are reduced.Get full details at