From Trauma to Treatment: Advanced Socket Management Strategies in Restorative Dentistry

Gold standard in open healing: Geistlich Bio-Gide®

Dr. Alecsandru Ionescu · Romania
 · February 03, 2020

BioBrief - Extraction Socket Management

The Situation

The patient complained of “tooth mobility” that first occurred 3 months priviously, after a sports accident that caused a trauma in that region. As he had no serious pain, he assumed that everything would go back to normal after a while. However, clinical control and a CBCT scan demonstrated that there was a root fracture at tooth 11, and, due to the root micro movement in the alveolar ridge together with the periodontal bacterial infiltration, the buccal bone was resorbed (type 2 class).


The Approach

Tooth 11 was extracted atraumatically and the socket preservation procedure was performed in accordance with the open-healing protocol. Geistlich Bio-Oss® and Geistlich Bio-Gide® were used. The procedure involved no flap elevation or periosteal incisions; instead, the membrane was intentionally left exposed, and a continuous PTFE suture was meticulously placed along the free gingival margins to stabilize the membrane.


The Outcome

Clinical control and CBCT scan showed long-term stability of soft and hard tissues. The final outcome was stable, from both functional and esthetic points of view, reinforcing the biological advantages using the open-healing technique followed by flapless tissue level implants in the esthetic zone.


Keys to Success

  • No flap
  • No incision in the periosteum
  • Membrane insertion inside the extraction socket
  • Bone granules to fix the membrane inside the extraction socket
  • Tension-free suturing
  • Continuous PTFE sutures

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About the author

Dr. Alecsandru Ionescu | Romania

Dental surgeon
Private dental clinic, research and training center aesthetics ONE in Bucharest