Perio defect grafting

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Posted on 07.15.2021 03:30 PM By bruce birchenough In Bone Grafting

64 yo white female needs #2 extracted as recommended by periodontist. They are also recommending socket grafting at the same time to preserve/ protect bone level and furcation area on the distal of #3. Will grafting the socket of #2 keep the bone from remodeling or will anatomy of bone distal and mesial to extraction socket #2 dictate final bone level even with grafting?

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Jonathan Blansett says on 07.16.2021 04:04 PM

Horizontal biologic width invasion / root proximity is a problem for 2nd molars next to 1st molars like this. The bone level will likely split the difference as the site heals and given the large volume of soft tissue there appears to be distal to the socket from the tuberosity you should have a good result with socket grafting. I would try and do this procedure flapless and place a ridge preservation bone graft of your choice w/ resorbable membrane of your choice. Protect the proximal bone at all costs, avoid trauma from a bur or elevator if at all possible, leaving the soft tissue intact will preserve the blood supply further. If the bone grafting is not done and / or if the extraction is difficult / traumatic, then the bone on the distal of the first molar can resorb resulting in a defect that will be next to impossible to fix in the future. -jonathan