Extractions and augmentation for ridge preservation
The case demonstrates extractions and augmentation for ridge preservation followed by implants placement three months following the extractions
In order to perform extractions and ridge preservation a diagonal vertical incision was performed from the neck of the tooth and carried inferiorly up to 2mm in to the movable mucosa. Full thickness flap was elevated in order to expose the site and clearly appreciate the defect dimensions in the area.
Immediately following the extractions, site and sockets debridement was accomplished. Augmentation was performed using Bond Apatite bone graft cement.
Placement of the cement in to the graft site is relatively easy due to the ability to inject the cement in to the site, placement of a sterile gauze pad on top and adaptation of the graft by pressing ( with finger pressure or instrument handle – if space is narrow) over the pad for three seconds. Flap closure immediately follows directly over the graft without any membranes, by stretching the flap to achieve maximal closure.
It is important to note that use of this material does not require excessive releasing incisions. The flap does not need to be tension free and in primary closure. The opposite is what is needed. The flap has to be under tension and maximal closure is enough. Up to 3mm of incision line opening is adequate, for graft volume preservation and appropriate wound healing, but not more than that.
Three months following the initial surgery, the deficient bone in the area was rebuilt and regenerated and the ridge was optimal for placement of dental implants.