Socket preservation attempts to prevent bone loss by bone grafting the socket immediately after extraction. With the procedure, the tooth is removed, material (usually a bone substitute) is placed in the tooth socket, it is covered with a barrier membrane, and sutured closed. Roughly 30 days after socket preservation, the barrier membrane is either removed, or it resorbs.

Socket preservation procedure prevents immediate bone resorption after extraction thus keeping the contour and integrity of the socket with a successful and natural-looking appearance for tooth restorative procedures. All dental prosthesis requires good jaw bone support for it to be successful in the long run. Without socket preservation, residual bones could lose volume resulting in loss of facial vertical and horizontal dimension and changes in facial soft tissues aesthetics.

When is a Tooth Extraction Necessary?

The two primary reasons for tooth extractions are cavities and periodontal disease. Oral bacteria can damage your teeth and gums. In some cases, tooth decay can affect the deep, inner layers of a tooth. In other instances, periodontal disease can erode the bone that supports the teeth. Both of these may require an extraction if other restorative treatments are not feasible.

Types of Extractions

There are two types of dental extractions: simple and surgical. 

Here are the differences between the two:

• Simple Extraction: This type of tooth removal is typically performed on teeth that are clearly visible above the gum line. To perform this, Dr. Swerdlof will simply loosen the tooth and gently lift it from the socket.
• Surgical Extraction: If a tooth is weak, decayed, or fractured at the gum line, a surgical extraction is necessary. This involves slight removal of gum and bone tissue around the tooth. At times, the tooth may be divided into sections to make removal easier. Surgical extractions typically require stitches.
• What is Bone Grafting?

In many cases a bone graft is needed after a tooth extraction. Dental bone grafts can increase your eligibility for dental implants and other restorative treatments. It adds volume and density to your jaw in areas where bone loss has occurred. Bone grafting materials can be divided into several categories:

• Autograft (bone harvested from patient’s own body), is considered the gold standard 
• Allograft (block bone graft from cadaver)
• Xenograft (bone grafts or collagen from bovine or porcine origin) 
• Alloplast (synthetic biomaterials)

Once the bone graft has been placed, it holds space for your own body to do the repair work. In other words, a dental bone graft is like a scaffold on which your own bone tissue can grow and regenerate.

Following a dental bone graft, you may have pain, swelling and bruising. These are normal side effects that should diminish in a few days. Symptoms can be managed with pain relievers. You might notice small fragments of bone coming out of the site over the first few days. These pieces often resemble grains of salt or sand. This usually isn’t a cause for concern, but call your dentist to make sure that you’re healing as expected. Most people who have dental bone grafts report little to no pain.

Though you will probably feel back to normal within a week or two, complete dental bone graft healing can take between three and nine months – sometimes longer. Recovery times depend on several factors, including the type of graft, the area in which the graft was placed and your body’s healing capacity.

Barrier Membrane

The purpose of a membrane is to protect bone graft while it is integrating inside of the extraction socket. The membrane separates bone graft from the soft tissue, giving time for the bone cells to fill the defect. In absence of a barrier membrane, the defect would be occupied by soft tissue cells preventing the bone graft integration.

Barrier membranes can be either resorbable, or non-resorbable. 

• Non-resorbable membranes require surgical removal.  
• Resorbable membranes are either animal-derived collagen or synthetic polymers and do not require surgical removal.