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Soft-tissue graft or matrix?

Socket Sealing

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Should the extraction socket be sealed with a soft-tissue punch graft or with a collagen matrix? The matrix has some advantages over the autologous punch.

Ass. Prof. Stefan Fickl | Germany

Studies over the past few years have clearly shown that Ridge Preservation significantly reduces ridge volume loss after tooth extraction. Animal and clinical trials have demonstrated that the combination of a xenogeneic bone replacement biomaterial (Geistlich Bio-Oss® Collagen) with an autologous  soft-tissue punch graft can preserve the ridge volume effectively.1,2

But this technique is not without its clinical disadvantages, which include high patient morbidity and the danger of scar formation in the buccal region due to incomplete healing of the soft-tissue graft.

Preconditions for Socket Sealing

A xenogeneic soft-tissue replacement material for the sealing of the extraction socket (Geistlich Mucograft® Seal) in the context of Ridge Preservation appears to provide results similar to an autologous soft-tissue graft.3 At the same time, postoperative  levels of patient morbidity are clearly lower.

It also appears that the collagen structure of Geistlich Mucograft® Seal reduces the risk of scar formation, ensuring a more pleasing tissue match with surrounding native tissues (“blending").4-6

The preconditions for a successful application of the Socket Seal technique are an inflammation-free marginal soft tissue situation, precise suturing and an intact extraction socket with retained buccal bone lamella. In these cases – and as found by the Geistlich Mucograft® Seal Advisory Board Meeting in February 2013 in Geneva – no additional barrier membrane is needed.

An early implantation time (8–10 weeks after extraction) is possible. If portions of the buccal bone lamella are dehisced, a membrane should also be used to protect the bone replacement biomaterial, and the healing time should be extended.

Ass. Prof. Stefan Fickl

Ass. Prof. Stefan Fickl | Germany

Department of Periodontology
University Hospital Würzburg

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