Page 6 - GP Fall 2024

Dental Implants in the Anterior Maxilla: Socket Preservation vs.
No Socket Preservation

Authors: Yael Muladjanov, Gary Berkowitz, DDS and Analia Veitz-Keenan, DDS, FAGD

Dental implants are widely recognized as volume for optimal implant place- ing the likelihood of requiring
an effective solution for replacing missing ment without additional grafting additional surgeries. These proce-
teeth, particularly in the aesthetically de- procedures. dures prolong treatment time and
manding anterior maxilla. The management increase the risk of complications
of the tooth extraction site significantly 2. Implant Success Rates and patient discomfort.
influences dental implant success. Socket ○ With Socket Preservation: A sys-
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preservation, a technique to minimize bone tematic review by Morjaria et al. Clinical Implications
loss after tooth extraction, has gained trac- indicated higher implant survival The evidence strongly supports the use of
tion. This article critically examines the rates in preserved sockets. Socket socket preservation in the anterior maxilla
evidence from systematic reviews on the preservation techniques facilitate for several reasons:
outcomes of dental implants in the anterior better primary stability and osse-
maxilla with and without socket preserva- ointegration, which is crucial for ● Maintenance of Alveolar Ridge Di-
tion. the success of implants in the an- mensions: Preserved sockets retain
terior maxilla. more bone volume, facilitating easier
○ Without Socket Preservation:
Importance of the Anterior Maxilla Implants placed in non-preserved and more predictable implant place-
The anterior maxilla, often called the “es- sites face higher risks of complica- ment.
thetic zone,” is crucial for functionality and tions. A lack of adequate bone vol- ● Higher Implant Success Rates:
facial esthetics. Bone loss in this region can ume often necessitates secondary Improved primary stability and osse-
lead to significant aesthetic deficiencies, bone augmentation procedures, in- ointegration lead to higher long-term
making preserving alveolar bone volume creasing treatment complexity and success rates for implants.
paramount for successful implant place- potential for implant failure. ● Superior Aesthetic Outcomes: Bet-
ment and restoration. ter maintenance of soft tissue con-
3. Aesthetic Outcomes tours and reduced gingival recession
Methodology ○ With Socket Preservation: Sock- enhance the aesthetic results, which
We searched different electronic databases et preservation leads to superior are particularly important in the ante-
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for systematic reviews related to this topic aesthetic outcomes highlighted rior maxilla.
for this review. Systematic reviews collect that immediate and early implant ● Reduction in Additional Proce-
all possible research and analyze the data placement in preserved sockets dures: Socket preservation maintains
available from existing studies. in the anterior maxilla resulted bone volume, minimizing the need
in better soft tissue contours and for secondary grafting procedures and
Key Findings from Systematic Reviews less recession. This is critical for reducing treatment complexity and
achieving a natural and harmoni- duration.
1. Bone Volume Maintenance ous appearance.
○ With Socket Preservation: Stud- ○ Without Socket Preservation, Conclusion
ies consistently show that socket bone loss, and subsequent soft Socket preservation offers significant ad-
preservation significantly reduces tissue changes can compromise vantages over natural healing for dental
horizontal and vertical bone loss. aesthetics. Issues such as gingival implants in the anterior maxilla. Preserv-
A systematic review by Horváth et recession and loss of interdental ing alveolar bone volume, higher implant
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al. found that ridge preservation papillae are more common, affect- success rates, improved aesthetics, and re-
techniques resulted in better main- ing the implant’s visual integration duced clinical complications make socket
tenance of alveolar ridge dimen- with the surrounding dentition. preservation a valuable practice in implant
sions compared to spontaneous 4. Clinical Complications dentistry. Clinicians should consider incor-
porating socket preservation techniques,
healing. Using graft materials, ○ With Socket Preservation: While particularly in cases where aesthetic out-
such as allografts, xenografts, and complications like graft material comes are paramount and significant bone
synthetic substitutes, effectively infection or delayed healing can loss is anticipated.
preserves bone volume.
○ Without Socket Preservation: occur, they are relatively rare. The
Without intervention, significant research found that socket pres- References
resorption occurs. Van der Weijden ervation is a safe procedure with 1. Horváth, A., Mardas, N., Mezzomo,
L. A., Needleman, I. G., & Donos, N.
et al. noted that the anterior max- minimal adverse effects when per- (2013). Alveolar ridge preservation. A
2
1,5
illa experiences substantial dimen- formed correctly. systematic review. Clinical Oral In-
sional changes post-extraction, ○ Without Socket Preservation: vestigations, 17(2), 341-363.
often resulting in inadequate bone Natural healing often results in 2. Van der Weijden, F., Dell’Acqua, F., &
insufficient bone volume, increas- Slot, D. E. (2009). Alveolar bone di-
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