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After Extraction, Upper Premolars Undergo Programmed Socket Collapse with Development of Cavitations Rather than
Shahram Ghanaati1, Joanna Śmieszek-Wilczewska2, Sarah Al-Maawi1
1FORM-Lab (Frankfurt Orofacial Regenerative Medicine-Research Laboratory), Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Goethe University, 60590 Frankfurt am Main, Germany.
Tooth extraction causes significant alveolar ridge volume loss. Socket healing involves inward wall movement and bone apposition, forming cavitations, requiring 3D imaging for dental implant planning.
Area of Science:
- Dentistry
- Oral Surgery
- Regenerative Medicine
Background:
- Alveolar ridge volume loss and atrophy occur post-tooth extraction.
- Understanding socket healing is crucial for successful dental implant placement.
Purpose of the Study:
- To analyze the socket healing process after upper premolar extraction over six months.
- To focus on morphological changes in the alveolar crest and socket using cone beam computed tomography (CBCT).
Main Methods:
- Retrospective analysis of patients undergoing flapless tooth extraction.
- CBCT imaging performed immediately after extraction, and at three and six months post-extraction.
- Quantification of vertical and horizontal socket collapse and bone formation.
Main Results:
- Sockets showed inward wall movement, reducing ridge and defect volume.
- Vertical socket collapse reached up to 34.3%, and buccal collapse up to 55.7%.
- Bone formation occurred mainly via apposition along socket walls, forming intra-socket cavitations.
Conclusions:
- Socket healing involves significant collapse and bone apposition, creating cavitations.
- These findings challenge current understanding, highlighting socket healing as patient-specific.
- 3D radiographic analysis is essential for planning dental implants post-extraction.
