Ridge preservation: review of the literature
From: Terry Pannkuk
Sent: Thursday, May 13, 2010 2:58 PM
Subject: Ridge preservation: review of the literature
Whether 75 percent bone volume is lost or not, one has to ask themselves what
does that volume consist of? If it isnít native bone it isnít osteoinductive
unless it is BMP which is still a bit out of the economic picture as a routine
especially for minor ridge defects. If you are simply filling a socket with
osteoconductive hamburger helper that is unlikely to integrate threads of an
implant who cares that you are getting it down to 25%? Itís very misleading in
the same way focusing on survivability as opposed to success is.
The literature seems to point this out. Grafting is more financial than
benefical in the majority of cases it is employed. Stuff burger helper and you
get paid more. It seems much more elegant to meticulously and atraumatically
extract a tooth protecting the interseptal bone/furcation/buccal bone then allow
maximum native bone regeneration, because the implant will be integrating in the
new forming socket bone. What in the world is the problem with placing an onlay
graft or tacked membrane pouch of foo foo after the socket completely heals
only if you need it? The morbidity is decreased. The risk of infection sequelae
is decreased; and the maximum amount of true implant-bone integration is
accomplished. Quite frankly we wouldnít be talking about needing to place long
implants if you didnít have to get them deep through the crap people are routinely
placing in sockets.- Terry
Ridge preservation techniques for implant therapy.
Darby I, Chen ST, Buser D.
Periodontics, School of Dental Science, University of Melbourne,
720 Swanston Street, Parkville, Victoria 3010, Australia. firstname.lastname@example.org
PURPOSE: The aim of this review was to evaluate the techniques and outcomes of
postextraction ridge preservation and the efficacy of these procedures in relation
to subsequent implant placement.
MATERIALS AND METHODS: A MEDLINE/PubMed search was conducted and the
bibliographies of reviews from 1999 to March 2008 were assessed for appropriate
studies. Randomized clinical trials,controlled clinical trials, and prospective/
retrospective studies with a minimum of five patients were included.
RESULTS: A total of 135 abstracts were identified, from which 53 full-text articles
were further examined, leading to 37 human studies that fulfilled the search
criteria.Many different techniques, methodologies, durations, and materials were
presented in the publicationsreviewed, making direct comparison difficult.
CONCLUSIONS: Despite the heterogeneity of the studies,it was concluded that ridge
preservation procedures are effective in limiting horizontal and vertical ridge
alterations in postextraction sites. There is no evidence to support the superiority
of one technique over another.
There is also no conclusive evidence that ridge preservation procedures improve
the ability to place implants.