The extraction of a tooth is often considered a treatment of last resort, meaning it is the indicated treatment for a tooth where no other treatment to salvage the tooth is possible or any possible treatment has a very poor long-term prognosis. Once a tooth is extracted there is a lasting effect to the surrounding tissues. The alveolar bone which encases teeth in the upper and lower jaw bones relies on functional loading in order to maintain itself. The result is that following tooth extraction, the bone in the area of extraction steadily resorbs, decreasing in both height and width. This progressive bone loss significantly limits the options one may have regarding restoration of the space with teeth in the future, be it with fixed prostheses such as dental implants and bridges, or removable prostheses such as partial or complete dentures.
There are many options to augment areas of bone loss in order to facilitate restoration with either fixed treatments like dental implants or support teeth involved in bridges, or create adequate base for partial or full dentures. Bone grafting procedures for the upper and lower jaws have been a staple or oral surgery practices for a long time and are constantly evolving with improvements in research, techniques, and biomaterials. As reliable and time-tested as bone grafting procedures are at this time, like many problems, it is more effective to prevent the problem rather than treat it later.
One of the most effective ways to prevent horizontal and vertical bone loss in the upper and lower jaws following tooth extraction is a procedure called extraction site preservation grafting. While technical details differ among clinicians, the general idea is that immediately following tooth extraction, the extraction site is vigorously debrided to be sure it is free of infection. That site, or socket, is then packed with a grafting material that will serve several purposes with regard to healing of the site. The graft material serves as a scaffold for the body to use to regenerate and re-grow bone. The graft also serves as a volume stabilizer, by its physical nature, the graft maintains the topography, shape, and volume of the extraction site while the body re-grows bone in the area. There are many different sources for the graft material. Most of the time this graft material is not harvested from the individual, rather it is taken off the shelf, originally harvested from human cadavers or bovine sources. This material, following harvest is treated with combinations of radiation and chemical drying agents to remove all living material, so that all that is left is crystalline bone structure.
Site preservation grafts require a specific amount of time for proper healing prior to procedures to replace the missing teeth. This time period depends on the specific graft material used, the patient’s health status, and several other factors, but ranges from 3 to 6 months. Following this period of healing dental implants or other restorative procedures may introduced to the site.
If in the future you require extraction of a tooth, ask your dentist/surgeon about extraction site preservation, this simple procedure can significantly improve the ease and eventual quality of the finished product.