Information for Ridge Preservation / Augmentation Procedure

Unfortunately advanced periodontal disease, tooth fractures, or other types of abscesses may cause severe bone loss around a tooth or teeth may ultimately require that they be extracted. Usually when a tooth is extracted, healing occurs by a combination of “shrinkage” of the remaining extraction socket bone, and some bone growth from the base of the extraction site. The result can often be loss of bone where the tooth used to be and a depression in the remaining ridge of bone. This often is not a problem in the back areas of the mouth, but can be a problem in the front and aesthetically sensitive areas of the mouth.  The problem however can now be avoided or minimized by way of a procedure called “Ridge Preservation or Ridge Augmentation”. At the time that the tooth or teeth are extracted, the area is filled with one of a number of either resorbable or biologically compatible calcium “materials” and the area subsequently covered with membrane prevents the gum tissue from growing into the extraction area and protects the underlying filler materials and helps promote the formation of bone into the socket area. The objective of the calcium-based or biologically inert materials is to encourage both bone growth into the area and to preserve the ridge form and height as possible. The objective of the treatment is to minimize the amount of shrinkage and depression in the remaining ridge of bone in the extraction site area.

Regenerating the damaged and lost bone at the time of an extraction of a tooth provides the following advantages:

1. The bone between the extracted tooth and the adjacent teeth is preserved and the health of the adjacent tooth does improve.

2. A ridge deformity is minimized and the appearance of the ridge is more favorable for the appearance of whatever final prosthesis is inserted into the area.

3. The regenerated bone can allow for the placement of an implant to replace the missing tooth or teeth.

Generally the extraction of the tooth, or teeth and placement of the regenerative materials generally takes approximately sixty minutes although the exact length of time will vary from case to case. Any stitches are removed seven to ten days later and then we have a series of follow-up appointments over the next few months. Generally we need three to six months of healing before one would move into final prosthetic and restorative treatment. Generally the amount of discomfort is fairly minimal with a mild to moderate ache and tenderness to the area for the first twenty-four hours and usually some sort of temporary prosthesis is inserted both to protect the socket area and to facilitate suitable aesthetics. A soft diet is essential post-operatively and avoidance of the area as far as eating is essential until the initial healing is complete. As with all surgical procedures, there are individual patient differences with healing and there does exist the risk of some loss of the material or poor healing. Secondary procedures however may be necessary to further augment the site once initial healing is complete. Again the objective is to minimize the amount of depression in the remaining ridge of bone as a result of the extraction as best as possible. Please note that if a ridge deformity does exist despite the initial treatment, that secondary procedures can be completed. Similarly if a ridge deformity exists because the procedure was not performed at the time the tooth was extracted, secondary procedures can be performed at a later date to further augment the ridge depression and deformity. In essence these procedures are a form of plastic surgery and as with medical procedures, more than one procedure may be necessary to provide a suitable result. Please be advised that all materials utilized for these procedures are proven to be sage and are manufactured and tested under the strictest guideline. It is well documented that this therapy is useful to minimize the aesthetic implications of the loss of a tooth particularly in the front of an individuals mouth and that certainly the aesthetic consequences of not performing these procedures are more significant, although as outlined  above, secondary procedures could be considered if necessary. There are circumstances where there are sites that have had extensive and prolonged infections and are best not treated in this manner. Occasionally a simple extraction of the tooth has to be facilitated first with suitable healing, and then secondary ridge augmentation procedures. However the doctor would review the specific circumstances with you at the time of your consultation and examination appointments. Remember, if you have any questions please do not hesitate to ask us.

Taking care of yourself before Periodontal Treatment:
Eat a nutritious meals the night before and the day of the appointment.
Avoid the ise of alcoholic beverages
Of taking full doses of Aspirin (325mg) for medical reasons, please discontinue one week prior. Low doses of Aspirin (81mg) are fine.

One hour before the appointment:
Take Ibuprofen (Advil or Motrin) if recommended
            400mg for an Adult and 200mg for children under twelve.
            Or
            Tylenol #1 for a child under twelve.

You should plan on resting for the remainder of the appointment day.