Radiographic and Clinical Outcomes of Ridge Augmentation in Molar Extraction Sockets with Severe Bone Wall Defect

Objective: To describe a technique for socket augmentation in molar extraction sockets with severe bone wall defect. Methods: Five teeth in four patients were included in this study. Each tooth had buccal and/ or lingual bone loss identified by bone sounding and periapical radiographs before removal. After a flapless, minimally invasive tooth extraction, the socket was grafted with deproteinized bovine bone mineral with or without a collagen membrane. At the buccal and/or lingual bone defect area, the buccal and/or lingual gingival walls may act as holders, to support the materials. Finally, colloidal silver gelatin sponge was packed gently on top of the graft or membrane to avoid graft or membrane exposure, without attempting to achieve primary closure of the soft tissue. Six months after augmentation, changes in ridge width, ridge height and keratinised tissue were measured on clinical photographs or radiographs. Results: The alveolar bone widths observed at implant surgery were all greater than 6 mm. All patients showed bone augmentation in terms of ridge height. Keratinised tissue width showed increased or minor reductions. Conclusion: Treated with this technique, the deficient socket was re-established in the molar area. Clinically, the quantity and quality of the bone obtained in the grafted sockets allowed for successful implant placement. Keywords: flapless surgery, gelatin sponge, molar teeth, severe bone wall defect, socket augmentation