CSP ridge preservation case

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Posted on By yiannis vergoullis In Bone Grafting

The following is a case where we utilised the Cervical socket Plug technique for ridge preservation. The advantage of this technique relates to the soft tissue cervical profile preservation, that makes the flapless implant placement process easy without sacrificing soft tissue volume and shape. 3 months later we placed the implant and further supported the cervical profile with a custom healer. Whoever is interested can find the paper we published on CSP technique at JIACd 2020.
All custom components (cervical plugs and healers) were fabricated with CERVICO system.


cervical composite plug
fixed in place with composite resin

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Immediate after implant placement, cervico healing abutment connected to the implant for 1 stage protocol


Can you describe HOW you make the socket plug? and it seems you bond it in place to adjacent teeth? What is "below" the bonded plug? Collagen, Gelfoam, PRF? Thanks Maurice


Maurice I make it in Cervico mold with composite resin, polish, clean and place it in direct contact with the bone graft. Stabilise it initially with the cross Horizontal matress suture and send it to my restorative where she stabilizes it further with composite alone or fiber reinforced tape on adjacent teeth :) I.e. BRG only, corticocancellous allograft mixed with TTC Ioannis


Can I ask you to clarify a little -if you suture to hold in place directly against the bone graft then why are you then sending to lab tech?
Is it not possible to simply bond composite over the suture and bond directly in the mouth?
I'm probably missing an important point


Yes we place the composite plug in direct contact to the BRG.

Yes, you can directly bond the plug to the adjacent teeth with no sutures used at time of surgery.

Since I am not restorative and I do not enjoy doing the process of composite bonding myself at time of surgery (blood), I stabilise the plug with this suture and send the case to my restorative dentist to do final bonding/provisionalization on top of the plug (within two weeks pot).

We have done a case series where the plug received only stabilisation with ceralon sutures; no composite bonding. All of the cases (12) lost the plug in between 4-6 weeks pot. The socket healing process applies a vertical pressure to the plug.
Based on the results of this pilot study of ours, my protocol includes composite bonding on the adjacent teeth within the first two weeks pot.

No lab is involved in any stage of the protocol. Everything is done in office.


This is how I chose the right size composite resin plug to make :)