Socket Preservation

Getting a tooth extracted can be a nerve-racking experience. You may require a tooth extraction due to decay, abscess or impaction.

Whatever the reason may be, it is always in your best interest to get the extraction done in a manner that preserves the socket and the jaw bone.

The procedure of tooth removal often leaves an empty socket in the bone. Over time, this area undergoes significant degeneration.

Socket preservation is critical for several reasons. It mainly helps to maintain the height and density of the underlying bone.

While maintaining the integrity of the bone, socket preservations act as support for future tooth replacement procedures.

An oral surgeon can list out the best possible options for you to preserve the socket after tooth extraction.

Let’s quickly dive into the article to understand the importance of socket preservation and look at some professional techniques used to preserve the bone.

What is tooth extraction?

Tooth extraction is a process of removing the tooth from the alveolar socket. It is performed by a dentist or an oral surgeon and is usually done under local anesthesia. (1)

There are several reasons for tooth extraction –

  • Grossly decayed tooth
  • Fracture of the tooth below the gum line
  • Periapical abscess
  • Impacted third molar

What happens after tooth removal?

The bone that supports and holds the teeth firmly in its position is called the alveolar ridge. When a tooth is extracted, the alveolar ridge begins to degenerate. This degeneration occurs in two phases –

  • First, the horizontal width of the bone decreases. This makes the ridge narrow and weak.
  • In the second phase, the vertical height starts to deteriorate. The loss of vertical height is faster as compared to the horizontal loss of width. (2)

Another incident that can happen after tooth removal is a dry socket.

Dry socket is a condition wherein the blood clot formed in the socket gets dislodged. Formation of a blood clot after extraction aids in the healing of the extraction site.

Any disturbance in this process exposes the underlying nerves and impairs the process of healing. Dry socket causes excruciating pain and discomfort. The socket site becomes red, dry and tender.

Why is it essential to preserve the socket and bone?

As a result of tooth extraction, the alveolar bone continues to disintegrate. The bone loses its purpose of providing support to the teeth.

Loss of bone creates a permanent space between the adjacent teeth. Such spaces allow the adjacent teeth to shift from their original position. It further moves them out of alignment.

Socket preservation, in this case, helps to preserve the alveolar ridge. The process of socket preservation involves the placement of bone graft into the hollow socket after extraction.

The graft can be natural from human bone or synthetic from alloplastic materials. After placement of the graft, the socket is covered by a collagen membrane and sutured back to allow healing. (3)

During the process of healing, the graft material gets replaced by alveolar bone. This bone aids in future tooth replacement procedures like implants, dental bridge or denture.

What types of tooth replacements can be done after socket preservation?

There are a variety of tooth replacements that can be done depending on the patient’s need, bone support and aesthetic requirements.

Dental Implants

Implants are titanium based, root-shaped supports. These are embedded in the alveolar bone.

Implants act as a support to hold the replacement crown in the mouth. Placement of an implant depends upon the strength and quality of the underlying alveolar bone.

Socket preservations are excellent for implant placements. They provide long-lasting support. A dental implant is placed around four to twelve months after socket preservation. (4)

Dental Bridge

A dental bridge is another option to replace the missing tooth. This is a restorative procedure that takes support from the adjacent teeth, while the replacement tooth or pontic spans across space.

Socket preservation in such cases helps to maintain the height of the alveolar bone.

If the bone is not preserved, an unsightly space begins to create under the pontic. This space traps the food particles and affects the speech.

Other Options

Alternative tooth replacement procedures may include complete or partial dentures. Dentures are dental appliances that take support from the underlying bone while holding artificial teeth in alignment.

Bone preservation becomes a crucial step in fabricating a denture. Without proper support from the bone, the denture loses its retention ability. As a result, it causes discomfort to the soft tissues and interferes in chewing and speaking.

What is the cost of a socket preservation procedure?

The average cost of single tooth extraction varies from $100 – $200. Cost of preserving a single socket with bone graft is $100.

Some grafting materials may require additional use of collagen membrane to avoid soft tissue ingrowth into the socket. Such procedures may cost around $150 – $300.

Take away message

Extraction of a tooth affects the health of the underlying bone and the adjacent teeth. Socket preservation techniques come as an advantage in such situations.

Preservation of a socket with a bone graft maintains the width, height, and strength of the alveolar bone. It aids in future tooth replacement procedures. (5)

Socket preservation techniques are the best solutions for implant placements. Bone preservation provides the required density and quality of the bone which is ideal for implant placement.

In addition to this, bone and socket preservations aid in other replacement procedures as well. A dentist will recommend the best possible treatment plan to preserve the bone and replace the tooth.