| Case 10 (Soft Tissue Grafting & Socket Preservation) |
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This patient suffered from recurrent loss of his upper right front crown. The crown was ill fitting and the root was decayed and had fractured and as a result, the crown kept debonding.
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Due to the root's long standing recurrent infection, the bone at the front of the root had resorbed and the gum margin had shrunk back.
As a result the patient had asymmetry between his upper crowns with one crown looking longer than the other. |
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So we first extracted the root but in a gentle and careful fashion to avoid any more damage to the bone and gum margin. |
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The extraction socket can be seen here immediately after root extraction.
If the socket is left to heal as it is, very rapidly the gum margin will shrink even further due to the lack of bone. This will mean that the implant placed in future will be cosmetically compromised. |
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The root can now be seen outside of the mouth with fracture and decay and a broken post. |
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We first placed a Porcine derived Bio-Gide membrane between the outside gum and the socket to stop the gum from collapsing into the socket. |
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We then placed Bovine derived Bio-Oss bone grafting granules within the extraction socket to build it up. This promotes the patients body to lay down more of his own bone into the socket. |
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We then placed a Perio Collagen membrane over the Bio-Oss Granules to keep them there and give them time to act as a scaffolding for bone formation. |
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We raised a gum flap from the patients palate. We left the periosteum intact to allow the palatal area to heal by granulation.
We attached the soft tissue graft to our extraction socket with sutures. |
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The soft tissue graft is now fully attached to the socket and fully protecting the bone graft material within the socket. In time, the gum in this region will replace the soft tissue graft. |
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The socket will now be left for 6 months to allow the patients own bone to replace the bone graft granules. We can then use the newly formed bone to place an implant.
The patients own gum will now heal at a higher level allowing the future implant to have a much better cosmetic finish. |
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So you can see that the correct extraction of the tooth prior to implant placement is very important and should be done very carefully in order to have a better cosmetic result with the implant treatment. |
