Are socket and ridge preservation techniques at the day of tooth extraction efficient in maintaining the tissues of the alveolar ridge?

Purpose: In recent years questions have arisen whether extraction sockets of future implant sites should be treated differently than sockets where no implant therapy will be done in the future. It was the aim of this systematic review to provide a basis for an expert consensus on the current status of socket preservation (SP) and ridge preservation (RP) procedures at the day of tooth extraction. Materials and methods: A systematic literature search was performed in PubMed and in selected journals by hand, covering the years 1981 to 31 July 2010. Only prospective controlled studies in humans with or without randomisation were included. The control groups had to consist of an untreated extraction socket, and clinical or radiographic measurements of the ridge dimensions after extraction and after the respective healing time were required. Weighted means were calculated and compared. Results: Ten studies met all inclusion criteria and could be evaluated in detail. Horizontal ridge loss was reduced by 59%, and vertical ridge loss by 109%, if SP/RP was applied after tooth extraction. The need for hard tissue augmentation at implant placement was five times higher, if no SP/RP was performed on the day of tooth extraction. Conclusions: SP/RP seems to be effective in maintaining ridge dimensions after tooth extraction. No recommendations for a specific technique or material can be made yet. Further studies are needed to clarify these issues. Keywords: bone augmentation, bone graft, dental implant, extraction socket, ridge preservation, socket preservation