Alveolar Ridge Preservation in Posterior Extraction Sockets: A Literature Review and Proposal of a Novel Therapeutic...

Alveolar ridge preservation (ARP) is a critical procedure used to maintain post-extraction socket dimensions and the residual bone morphology is a key determinant of surgical outcomes. However, existing classification systems predominantly focus on the timing of implant placement rather than ARP protocols. Limited studies have developed classifications specifically for ARP, and none have addressed the unique anatomical challenges of posterior extraction sockets.

A comprehensive review of the literature was conducted in PubMed, Web of Science and Scopus from January 2000 to June 2025. Keywords such as "extraction socket", "tooth socket", and "classification" were used to evaluate existing classification systems.

The existing classification systems primarily target timing selection for implant placement in the anterior zone. To date, only three studies have developed classification systems specifically for ARP, all of which fail to differentiate between anterior and posterior sites despite their distinct resorption patterns. Therefore, based on a synthesis of existing literature and clinical rationale, we propose a novel classification system specifically designed for posterior extraction sockets in the context of ARP. Type A sockets are characterized by one compromised wall with a vertical defect of less than 50%, while Type B involves one compromised wall with a vertical defect of no less than 50%. Type C extraction sockets are severely damaged and involve two compromised walls. For each type, specific ARP techniques were recommended, with varying levels of intervention required for optimal ridge preservation.

This study introduces a novel classification system specifically for posterior extraction sockets tailored for ARP procedure. Although the system enhances clinical decision-making, further clinical validation is required to confirm its applicability and effectiveness in practice.