![](/fileadmin/_processed_/2/a/csm_Clinical_Case_Regenfast_Header_2400x1000_Rivara_b569ecd44c.jpg)
Extraction socket management with REGENFAST®
Ridge reconstruction before implant placement
"After the extraction, I realized that the buccal wall was missing and I had to leave the membrane exposed. The regenerative potential of the site could be poor, so I decided to boost the biomaterials’ effect with polynucleotides and hyaluronic acid."
The Situation
The patient (45 years old, female, non-smoker, no previous pathologies) is referred for extraction of tooth 45 and immediate implant placement. The site showed an increased probing depth and a marked bone loss.
![1 | Initial situation: the tooth has been treated endodontically without success.](/fileadmin/_processed_/0/9/csm_ESM_Rivara_01_01d706e4de.png)
![2 | The buccal bone is not intact.](/fileadmin/_processed_/9/e/csm_ESM_Rivara_02_700e102ef3.png)
![3 | Geistlich Bio-Oss® mixed with REGENFAST® is applied. Geistlich Bio-Gide® Compressed is rebutted vestibular and soaked with REGENFAST®.](/fileadmin/_processed_/e/f/csm_ESM_Rivara_03_265f6e6a94.png)
![4 | The flap is repositioned in its initial position with 5-0 polyamide sutures, leaving the membrane to heal occlusally by second intention.](/fileadmin/_processed_/9/f/csm_ESM_Rivara_04_02ec3537a0.png)
![5 | After 5 months, the situation is stable and the keratinized tissue is restored.](/fileadmin/_processed_/1/6/csm_ESM_Rivara_05_287d9b8f0a.png)
![6 | An intermediate abutment is placed at the time of implant insertion.](/fileadmin/_processed_/7/b/csm_ESM_Rivara_06_fb6f8c62cf.png)
![7 | The flap is moved vestibular and sutured.](/fileadmin/_processed_/e/1/csm_ESM_Rivara_07_9311909664.png)
![8 | At the control at 12 months, the papillae are preserved, and the proportion of keratinized tissue is ideal.](/fileadmin/_processed_/4/5/csm_ESM_Rivara_08_6f4afa8790.png)
![9 | The stability of the hard tissue is visible both with the 2D examination and at the 3D level (12 months).](/fileadmin/_processed_/4/0/csm_ESM_Rivara_09_4f46d69701.png)
![1 | Initial situation: the tooth has been treated endodontically without success.](/fileadmin/_processed_/0/9/csm_ESM_Rivara_01_4e4f4514bf.png)
![2 | The buccal bone is not intact.](/fileadmin/_processed_/9/e/csm_ESM_Rivara_02_dc1e3852e4.png)
![3 | Geistlich Bio-Oss® mixed with REGENFAST® is applied. Geistlich Bio-Gide® Compressed is rebutted vestibular and soaked with REGENFAST®.](/fileadmin/_processed_/e/f/csm_ESM_Rivara_03_b5265e2c14.png)
![4 | The flap is repositioned in its initial position with 5-0 polyamide sutures, leaving the membrane to heal occlusally by second intention.](/fileadmin/_processed_/9/f/csm_ESM_Rivara_04_32298999b6.png)
![5 | After 5 months, the situation is stable and the keratinized tissue is restored.](/fileadmin/_processed_/1/6/csm_ESM_Rivara_05_c0ca1aa55f.png)
![6 | An intermediate abutment is placed at the time of implant insertion.](/fileadmin/_processed_/7/b/csm_ESM_Rivara_06_cf592b2030.png)
![7 | The flap is moved vestibular and sutured.](/fileadmin/_processed_/e/1/csm_ESM_Rivara_07_0a46b096ef.png)
![8 | At the control at 12 months, the papillae are preserved, and the proportion of keratinized tissue is ideal.](/fileadmin/_processed_/4/5/csm_ESM_Rivara_08_c79813ef95.png)
![9 | The stability of the hard tissue is visible both with the 2D examination and at the 3D level (12 months).](/fileadmin/_processed_/4/0/csm_ESM_Rivara_09_2b7a834cea.png)