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After tooth extraction

“Ridge Preservation simplifies treatment”

05.09.2015
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Ridge Preservation is more forgiving for dentists with less experience, says Dr. Dietmar Weng.

Assoc. Prof. Dietmar Weng | Germany

Is it always “Tooth out – bone replacement in”?

Dr. Weng: No, you really can’t make such a generalization. It depends on several variables, for example: the treatment you are planning, the bone condition and the level of inflammation.

 

GBR is five-times less likely to be needed at the time of implant placement if Ridge Preservation was already performed.1 Doesn’t that save a considerable amount of operating time and pain for the patient? 

Dr. Weng: Ridge Preservation, above all, is less traumatic for the patient than performing GBR later. A periosteal incision must often be performed after a horizontal bone augmentation so that the soft tissue can be closed without tension. This incision can cause hematomas and swelling.

The time saving is, on the other hand, less important. With Ridge Preservation, the tooth extraction takes longer, because one wants to remove the tooth more gently and damage the bone structure as little as possible. Therefore, Ridge Preservation, done correctly, also takes time. 

 

There are cases where an implant can be placed without GBR and without Ridge Preservation. Can you tell beforehand? 

Dr. Weng: Buccal and lingual alveolar ridge loss is less if the buccal bone lamella is wider than 0.8 mm. But in practice, it is hard to measure the socket walls accurately either before or after an extraction, and without a flap it is also difficult to judge the bone situation. 

 

So, taking this into account, when should Ridge Preservation be performed?

Dr. Weng: I would always carry it out – both in the anterior and lateral tooth areas – if an implant is planned, but not when an immediate implant is being considered.

 

Which situations are these?

Dr. Weng: Molar sockets or sockets with demonstrable wall dehiscences, which are not cases for an immediate implantation, in my view. I would perform Ridge Preservation first in such cases. 

 

Does the patient’s biotype play a role?

Dr. Weng: Over the years I have developed my treatments so that I can operate independently of biotype. As for Ridge Preservation, I would say it is just as effective for patients with thick or thin bony walls. 

 

Often the person who removed a tooth does not place the implant but refers the patient to an oral surgeon…

Dr. Weng: Many dentists aren’t confident about implants, because some implants are associated with complex augmentations. But Ridge Preservation makes treatment much simpler. The therapy itself is uncomplicated and minimally invasive. And it preserves the ridge width, which means that a later implantation can be performed by less experienced dentists. 

 

So dentists should have “more confidence when it comes to placing implants”?

Dr. Weng: Yes. When you use a suitable procedure, the whole treatment - from extraction to prosthetic restoration - can be completed in a minimally invasive way.

Assoc. Prof. Dietmar Weng

Assoc. Prof. Dietmar Weng | Germany

Practice for Dentistry Böhm & Weng
Starnberg

References
  1. Weng D, et al.: Eur J Oral Implantol 2011; 4 Supplement: 59–66.

Illustration header: Alessandro Holler / Quaint

 

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