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17-04-2024 | Tooth Extraction

Socket Preservation in Dentistry: a Comprehensive Review on Efficacy, Tissue Volume Maintenance, and Economic Considerations with Focus on Membrane Types and Bone Regeneration Dynamics

Authors: Nicola De Angelis, E. Colombo, C. Yumang, C. Canepa, D. Baldi, F. Bagnasco, P. Pesce

Published in: Current Oral Health Reports

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Abstract

Purpose of the Review

Socket preservation post-tooth extraction is crucial for optimal conditions for subsequent dental implant placement. This review explores the efficacy, impact on tissue volumes, and economic considerations of socket preservation techniques.

Recent Findings

Socket preservation involves grafting the alveolar cavity with a bone substitute and sealing it with a membrane. Various graft and membrane types offer different outcomes. Xenograft materials are favored for optimal clinical outcomes. Membranes range from autogenous grafts to synthetic options like collagen matrixes, with resorption time being a key differentiator. Recent systematic reviews highlight the effectiveness of socket preservation in maintaining alveolar ridge dimensions and soft tissue integrity, with favorable outcomes across various studies.

Summary

This review examines the efficacy, impact on tissue volumes, and economic considerations of socket preservation techniques. Favorable outcomes in maintaining alveolar ridge dimensions and preserving soft tissue integrity are highlighted. However, further research is needed to assess long-term stability and efficacy.
Literature
1.
go back to reference • López-Pacheco A, Soto-Peñaloza D, Gómez M, Peñarrocha-Oltra D, Alarcón MA. Socket seal surgery techniques in the esthetic zone: a systematic review with meta-analysis and trial sequential analysis of randomized clinical trials. Int J Implant Dent. 2021;7:13. https://doi.org/10.1186/s40729-021-00294-2. Important systematic review which shows the efficacy of socket preervation in aesthic sites.CrossRefPubMedPubMedCentral • López-Pacheco A, Soto-Peñaloza D, Gómez M, Peñarrocha-Oltra D, Alarcón MA. Socket seal surgery techniques in the esthetic zone: a systematic review with meta-analysis and trial sequential analysis of randomized clinical trials. Int J Implant Dent. 2021;7:13. https://​doi.​org/​10.​1186/​s40729-021-00294-2. Important systematic review which shows the efficacy of socket preervation in aesthic sites.CrossRefPubMedPubMedCentral
2.
go back to reference • Zhou X, Yang J, Wu L, Tang X, Mou Y, Sun W, Hu Q, Xie S. Evaluation of the effect of implants placed in preserved sockets versus fresh sockets on tissue preservation and esthetics: a meta-analysis and systematic review. J Evid Based Dent Pract. 2019;19:101336. https://doi.org/10.1016/j.jebdp.2019.05.015. Review with meta-analysis on implants outcomes after the placement into regenerated areas.CrossRefPubMed • Zhou X, Yang J, Wu L, Tang X, Mou Y, Sun W, Hu Q, Xie S. Evaluation of the effect of implants placed in preserved sockets versus fresh sockets on tissue preservation and esthetics: a meta-analysis and systematic review. J Evid Based Dent Pract. 2019;19:101336. https://​doi.​org/​10.​1016/​j.​jebdp.​2019.​05.​015. Review with meta-analysis on implants outcomes after the placement into regenerated areas.CrossRefPubMed
5.
go back to reference •• Canellas JVDS, Ritto FG, Figueredo CMDS, Fischer RG, de Oliveira GP, Thole AA, Medeiros PJD. Histomorphometric evaluation of different grafting materials used for alveolar ridge preservation: a systematic review and network meta-analysis. Int J Oral Maxillofac Surg. 2020;49:797–810. https://doi.org/10.1016/j.ijom.2019.10.007. Very qualified review and meta-analysis on different grafting materials.CrossRefPubMed •• Canellas JVDS, Ritto FG, Figueredo CMDS, Fischer RG, de Oliveira GP, Thole AA, Medeiros PJD. Histomorphometric evaluation of different grafting materials used for alveolar ridge preservation: a systematic review and network meta-analysis. Int J Oral Maxillofac Surg. 2020;49:797–810. https://​doi.​org/​10.​1016/​j.​ijom.​2019.​10.​007. Very qualified review and meta-analysis on different grafting materials.CrossRefPubMed
11.
go back to reference • Seyssens L, Eeckhout C, Cosyn J. Immediate implant placement with or without socket grafting: a systematic review and meta-analysis. Clin Implant Dent Relat Res. 2022;24:339–51. https://doi.org/10.1111/cid.13079. Review which compares implant placement with and without socket preservation providing important clinical conclusions.CrossRefPubMed • Seyssens L, Eeckhout C, Cosyn J. Immediate implant placement with or without socket grafting: a systematic review and meta-analysis. Clin Implant Dent Relat Res. 2022;24:339–51. https://​doi.​org/​10.​1111/​cid.​13079. Review which compares implant placement with and without socket preservation providing important clinical conclusions.CrossRefPubMed
15.
go back to reference • Santana R, Gyurko R, Kanasi E, Xu WP, Dibart S. Synthetic polymeric barrier membrane associated with blood coagulum, human allograft, or bovine bone substitute for ridge preservation: a randomized, controlled, clinical and histological trial. Int J Oral Maxillofac Surg. 2019;48:675–83. https://doi.org/10.1016/j.ijom.2018.02.012. Human histolocical randomized clinical trial that shows the efficacy of different grafting materials.CrossRefPubMed • Santana R, Gyurko R, Kanasi E, Xu WP, Dibart S. Synthetic polymeric barrier membrane associated with blood coagulum, human allograft, or bovine bone substitute for ridge preservation: a randomized, controlled, clinical and histological trial. Int J Oral Maxillofac Surg. 2019;48:675–83. https://​doi.​org/​10.​1016/​j.​ijom.​2018.​02.​012. Human histolocical randomized clinical trial that shows the efficacy of different grafting materials.CrossRefPubMed
16.
go back to reference Thoma DS, Bienz SP, Lim H-C, Lee WZ, Hämmerle CHF, Jung RE. Explorative randomized controlled study comparing soft tissue thickness, contour changes, and soft tissue handling of two ridge preservation techniques and spontaneous healing two months after tooth extraction. Clin Oral Implants Res. 2020;31:565–74. https://doi.org/10.1111/clr.13594.CrossRefPubMed Thoma DS, Bienz SP, Lim H-C, Lee WZ, Hämmerle CHF, Jung RE. Explorative randomized controlled study comparing soft tissue thickness, contour changes, and soft tissue handling of two ridge preservation techniques and spontaneous healing two months after tooth extraction. Clin Oral Implants Res. 2020;31:565–74. https://​doi.​org/​10.​1111/​clr.​13594.CrossRefPubMed
17.
go back to reference Shahdad S, Gamble E, Matani J, Zhang L, Gambôa A. Randomized clinical trial comparing PEG-based synthetic to porcine-derived collagen membrane in the preservation of alveolar bone following tooth extraction in anterior maxilla. Clin Oral Implants Res. 2020;31:1010–24. https://doi.org/10.1111/clr.13648.CrossRefPubMed Shahdad S, Gamble E, Matani J, Zhang L, Gambôa A. Randomized clinical trial comparing PEG-based synthetic to porcine-derived collagen membrane in the preservation of alveolar bone following tooth extraction in anterior maxilla. Clin Oral Implants Res. 2020;31:1010–24. https://​doi.​org/​10.​1111/​clr.​13648.CrossRefPubMed
18.
go back to reference Ovcharenko N, Greenwell H, Katwal D, Patel A, Hill M, Shumway B, Cockerham BL 3rd. A comparison of the effect of barrier membranes on clinical and histologic hard and soft tissue healing with ridge preservation. Int J Periodontics Restorative Dent. 2020;40:365–71. https://doi.org/10.11607/prd.4120.CrossRefPubMed Ovcharenko N, Greenwell H, Katwal D, Patel A, Hill M, Shumway B, Cockerham BL 3rd. A comparison of the effect of barrier membranes on clinical and histologic hard and soft tissue healing with ridge preservation. Int J Periodontics Restorative Dent. 2020;40:365–71. https://​doi.​org/​10.​11607/​prd.​4120.CrossRefPubMed
20.
go back to reference Iorio-Siciliano V, Ramaglia L, Blasi A, Bucci P, Nuzzolo P, Riccitiello F, Nicolò M. Dimensional changes following alveolar ridge preservation in the posterior area using bovine-derived xenografts and collagen membrane compared to spontaneous healing: a 6-month randomized controlled clinical trial. Clin Oral Investig. 2020;24:1013–23. https://doi.org/10.1007/s00784-019-02979-w.CrossRefPubMed Iorio-Siciliano V, Ramaglia L, Blasi A, Bucci P, Nuzzolo P, Riccitiello F, Nicolò M. Dimensional changes following alveolar ridge preservation in the posterior area using bovine-derived xenografts and collagen membrane compared to spontaneous healing: a 6-month randomized controlled clinical trial. Clin Oral Investig. 2020;24:1013–23. https://​doi.​org/​10.​1007/​s00784-019-02979-w.CrossRefPubMed
24.
go back to reference • Canullo L, Rossi-Fedele G, Camodeca F, Menini M, Pesce P. A pilot retrospective study on the effect of bone grafting after wisdom teeth extraction. Mater (Basel, Switzerland). 2021; 14. https://doi.org/10.3390/ma14112844. Important pilot study which enpowers the use of grafting materials in extraction sockets. • Canullo L, Rossi-Fedele G, Camodeca F, Menini M, Pesce P. A pilot retrospective study on the effect of bone grafting after wisdom teeth extraction. Mater (Basel, Switzerland). 2021; 14. https://​doi.​org/​10.​3390/​ma14112844. Important pilot study which enpowers the use of grafting materials in extraction sockets.
25.
go back to reference Velasquez D, Araújo MG, Clem DS, Gunsolley JC, Heard RH, Janakievski J, McClain PK, McGuire MK, Misch CM, Nevins M, et al. A prospective, randomized, controlled, multicenter evaluation of extraction socket management comparing a wound dressing and a soft tissue substitute. Int J Periodontics Restorative Dent. 2022;42:e161–74. https://doi.org/10.11607/prd.6124.CrossRefPubMed Velasquez D, Araújo MG, Clem DS, Gunsolley JC, Heard RH, Janakievski J, McClain PK, McGuire MK, Misch CM, Nevins M, et al. A prospective, randomized, controlled, multicenter evaluation of extraction socket management comparing a wound dressing and a soft tissue substitute. Int J Periodontics Restorative Dent. 2022;42:e161–74. https://​doi.​org/​10.​11607/​prd.​6124.CrossRefPubMed
26.
go back to reference •• Gabay E, Katorza A, Zigdon-Giladi H, Horwitz J, Machtei EE. Histological and dimensional changes of the alveolar ridge following tooth extraction when using collagen matrix and collagen-embedded xenogenic bone substitute: a randomized clinical trial. Clin Implant Dent Relat Res. 2022;24:382–90. https://doi.org/10.1111/cid.13085. Very important study with histology on different types of membranes.CrossRefPubMedPubMedCentral •• Gabay E, Katorza A, Zigdon-Giladi H, Horwitz J, Machtei EE. Histological and dimensional changes of the alveolar ridge following tooth extraction when using collagen matrix and collagen-embedded xenogenic bone substitute: a randomized clinical trial. Clin Implant Dent Relat Res. 2022;24:382–90. https://​doi.​org/​10.​1111/​cid.​13085. Very important study with histology on different types of membranes.CrossRefPubMedPubMedCentral
27.
29.
go back to reference Matumoto EK, Corrêa MG, Couso-Queiruga E, Monteiro MF, Graham Z, Braz SHG, Ribeiro FV, Pimentel SP, Cirano FR, Casati MZ. Influence of partially exposed nonabsorbable membrane for alveolar ridge preservation: a randomized controlled trial. Clin Implant Dent Relat Res. 2023;25:447–57. https://doi.org/10.1111/cid.13202.CrossRefPubMed Matumoto EK, Corrêa MG, Couso-Queiruga E, Monteiro MF, Graham Z, Braz SHG, Ribeiro FV, Pimentel SP, Cirano FR, Casati MZ. Influence of partially exposed nonabsorbable membrane for alveolar ridge preservation: a randomized controlled trial. Clin Implant Dent Relat Res. 2023;25:447–57. https://​doi.​org/​10.​1111/​cid.​13202.CrossRefPubMed
30.
go back to reference Zampara E, Alshammari M, De Bortoli J, Mullings O, Gkisakis IG, BenalcázarJalkh EB, Tovar N, Coelho PG, Witek L. A histologic and histomorphometric evaluation of an allograft, xenograft, and alloplast graft for alveolar ridge preservation in humans: a randomized controlled clinical trial. J Oral Implantol. 2022;48:541–9. https://doi.org/10.1563/aaid-joi-D-21-00012.CrossRefPubMed Zampara E, Alshammari M, De Bortoli J, Mullings O, Gkisakis IG, BenalcázarJalkh EB, Tovar N, Coelho PG, Witek L. A histologic and histomorphometric evaluation of an allograft, xenograft, and alloplast graft for alveolar ridge preservation in humans: a randomized controlled clinical trial. J Oral Implantol. 2022;48:541–9. https://​doi.​org/​10.​1563/​aaid-joi-D-21-00012.CrossRefPubMed
31.
go back to reference • De Angelis N, Kassim ZH, MohdYusof E, Yumang C, Menini M. Bone augmentation techniques with customized titanium meshes: a systematic review of randomized clinical trials. Open Dent J. 2023;17:1–9. https://doi.org/10.2174/18742106-v17-230228-2022-172. Important systematic review that shows the efficacy of various techniques to achieve the correct bone volume prior to the implant placement.CrossRef • De Angelis N, Kassim ZH, MohdYusof E, Yumang C, Menini M. Bone augmentation techniques with customized titanium meshes: a systematic review of randomized clinical trials. Open Dent J. 2023;17:1–9. https://​doi.​org/​10.​2174/​18742106-v17-230228-2022-172. Important systematic review that shows the efficacy of various techniques to achieve the correct bone volume prior to the implant placement.CrossRef
33.
go back to reference •• Canullo L, Del Fabbro M, Khijmatgar S, Panda S, Ravidà A, Tommasato G, Sculean A, Pesce P. Dimensional and histomorphometric evaluation of biomaterials used for alveolar ridge preservation: a systematic review and network meta-analysis. Clin Oral Investig. 2022;26:141–58. https://doi.org/10.1007/s00784-021-04248-1. Very important systematic review which enlights the use of socket preervation for bone volume maintenance.CrossRefPubMed •• Canullo L, Del Fabbro M, Khijmatgar S, Panda S, Ravidà A, Tommasato G, Sculean A, Pesce P. Dimensional and histomorphometric evaluation of biomaterials used for alveolar ridge preservation: a systematic review and network meta-analysis. Clin Oral Investig. 2022;26:141–58. https://​doi.​org/​10.​1007/​s00784-021-04248-1. Very important systematic review which enlights the use of socket preervation for bone volume maintenance.CrossRefPubMed
35.
go back to reference • De Angelis N, Felice P, Pellegrino G, Camurati A, Gambino P, De Angelis N. Guided bone regeneration with and without a bone substitute at single post-extractive implants: 1-year post-loading results from a pragmatic multicentre randomised controlled trial. 2011;4, 313–325. Important randomized trial included as pionieristic result on the efficacy of grafting materials after teeth extraction. Eur J Oral Implantol. 2011;4(4):313–325. • De Angelis N, Felice P, Pellegrino G, Camurati A, Gambino P, De Angelis N. Guided bone regeneration with and without a bone substitute at single post-extractive implants: 1-year post-loading results from a pragmatic multicentre randomised controlled trial. 2011;4, 313–325. Important randomized trial included as pionieristic result on the efficacy of grafting materials after teeth extraction. Eur J Oral Implantol. 2011;4(4):313–325.
38.
go back to reference Canellas JVDS, da Costa RC, Breves RC, de Oliveira GP, da Silva Figueredo CM, Fischer RG, Thole AA, Medeiros PJD, Ritto FG. Tomographic and histomorphometric evaluation of socket healing after tooth extraction using leukocyte- and platelet-rich fibrin: a randomized, single-blind, controlled clinical trial. J Cranio-Maxillo-Facial Surg Off Publ Eur Assoc Cranio-Maxillo-Facial Surg. 2020;48:24–32.CrossRef Canellas JVDS, da Costa RC, Breves RC, de Oliveira GP, da Silva Figueredo CM, Fischer RG, Thole AA, Medeiros PJD, Ritto FG. Tomographic and histomorphometric evaluation of socket healing after tooth extraction using leukocyte- and platelet-rich fibrin: a randomized, single-blind, controlled clinical trial. J Cranio-Maxillo-Facial Surg Off Publ Eur Assoc Cranio-Maxillo-Facial Surg. 2020;48:24–32.CrossRef
Metadata
Title
Socket Preservation in Dentistry: a Comprehensive Review on Efficacy, Tissue Volume Maintenance, and Economic Considerations with Focus on Membrane Types and Bone Regeneration Dynamics
Authors
Nicola De Angelis
E. Colombo
C. Yumang
C. Canepa
D. Baldi
F. Bagnasco
P. Pesce
Publication date
17-04-2024
Publisher
Springer International Publishing
Published in
Current Oral Health Reports
Electronic ISSN: 2196-3002
DOI
https://doi.org/10.1007/s40496-024-00375-2