Intrasocket reactive soft tissue for primary closure after augmentation of extraction sites with severe bone loss before implant placement.
OBJECTIVE
The normal bone resorption after tooth extraction can be significantly aggravated in the case of pre-existing severe bone loss and chronic infection. Bone augmentation procedures have been proposed, but they require adequate closure of soft tissues. We propose the use of intrasocket reactive tissue to cover extraction sites augmented by bovine bone mineral graft to promote the success of the graft procedure.


METHODS
The study included 24 patients with severe bone loss and chronic pathology in 27 sites. The intrasocket reactive soft tissue was elevated from the bony walls in a subperiosteal plane. Porous bovine or allograft bone mineral was placed in the extraction site without membranes, and the intrasocket reactive soft tissue was sutured over the grafting material to seal the coronal portion of the socket. Twenty-seven implants were placed 6 months after bone augmentation.


RESULTS
Healing progressed uneventfully. Postoperative morbidity was minimal. There was no leakage or infection of the grafting material. The mean time to implant placement was 7.8 months. Supplemental augmentation was not needed. There were no implant failures. Follow-up ranged from 6 to 36 months (mean, 15 months). All implants were rehabilitated with fixed prostheses.


CONCLUSIONS
Intrasocket reactive soft tissue can be used predictably to obtain primary closure of augmented extraction sites with severe bone loss with minimal postoperative morbidity.
Mardinger
Ofer
O
Department of Oral and Maxillofacial Surgery, Maurice and Gabriela Goldschlager School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel. oferanat1@isdn.net.il
Chaushu
Gavriel
G
Ghelfan
Oded
O
Nissan
Joseph
J
D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000601:surgery*; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001857:Bone Matrix / Q000637:transplantation; D018786:Bone Substitutes / Q000627:therapeutic use; D015331:Cohort Studies; D003758:Dental Implantation, Endosseous / Q000379:methods; D015921:Dental Implants; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D003830:Denture, Partial, Fixed; D005500:Follow-Up Studies; D006097:Granulation Tissue / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D008903:Minerals / Q000627:therapeutic use; D010510:Periodontal Diseases / Q000601:surgery; D011446:Prospective Studies; D013536:Suture Techniques; D014081:Tooth Extraction; D014082:Tooth Fractures / Q000601:surgery; D014092:Tooth Root / Q000293:injuries; D020390:Tooth Socket / Q000601:surgery*; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult
C077540:Bio-Oss; D018786:Bone Substitutes; D015921:Dental Implants; D008903:Minerals