Extraction with Ridge Repair or Socket Preservation

Dr. Dr. Noraian’s primary goal is to save your teeth, and when he cannot save your teeth, his next goal is to save your jawbone for other restorative options. Dr. Dr. Noraian may have to remove a tooth or multiple teeth because of pain, infection, bone loss, or fracture. If you need to have a tooth extracted because of disease and/or infection, the resulting bone loss might damage the socket, which is the bone that holds the tooth in place. Also, healing from tooth extraction alone may cause the surrounding bone and gums to shrink and recede quickly after the extraction, compromising the available bone for future dental work like dental implants, bridges and dentures; and allowing collapse of the lips and cheeks.

What are Your Options If You Need an Extraction?

As mentioned above, Dr. Dr. Noraian focuses on saving your teeth, and if saving your teeth is not possible, he offers the following options, in order of the amount of preserved bone you have. 

  1. No Treatment – If you need your tooth extracted, this option puts you at the greatest risk of disease or infection when Dr. Dr. Noraian cannot save a tooth.
  2. Conventional Extraction – Ideal for teeth that you need removed for orthodontic reasons, the conventional extraction is a surgical procedure that puts you at the greatest risk of bone loss. When braces move teeth, the teeth remodel the socket bone as they close the space. If the space does not have teeth moved into it, then the bone runs the greatest risk of being resorbed by a process known as disuse atrophy and risks developing a dry socket. A dry socket occurs when the blood clot falls out of the socket exposing the bone inside the socket. This side effect may be very painful and requires multiple return visits to try and get the surgical site comfortable. It may be a slow process, not to mention inconvenient as you may need to return to the office frequently, sometimes daily, until it resolves. 
  3. Extraction with Collagen Plug – By using a collagen plug, or man-made sponge of a naturally occurring molecule in the body, Dr. Dr. Noraian can substantially reduce the risk of a dry socket. Typically, you should not rinse your mouth after any extraction, and if you rinse vigorously with a collagen plug in your socket, you may wash it out. In practice, the collagen plug helps with making the blood clot form. It insulates the bone well and serves to tent up the soft tissue to give more room for the bone to form. It is an intermediate method to save bone as well. If you are not considering using the bone in this area for an implant or support for a denture, then a collagen plug is an excellent option.
  4. Extraction with Ridge Repair or Socket Preservation – The best method to save bone in an extraction site is to use a ridge repair with human donor or cow bone covered with some type of barrier. Typically, Dr. Dr. Noraian will use a barrier of human donor soft tissue, a laser created hemostatic plug, or a combination of the two. This method saves the most bone while reducing the risk of a dry socket. Of course, no rinsing is recommended with the procedure as well.  Ridge repair or socket preservation can prevent jaw deformities from tooth removal. This procedure can greatly improve your smile and increase your chances for successful restorations in years to come.

During your consultation, Dr. Dr. Noraian will review your options and help you make the best decision that is right for you.

What is Ridge Repair/Socket Preservation?

Ridge repair, or socket preservation, is a common dental procedure often performed immediately following a tooth extraction.  Ridge repair helps to recreate the natural contour of the gums and jaw. 

The bone that surrounds the roots of teeth is called the alveolar ridge of the jaw. When you have a tooth removed, you may have an empty space left in the alveolar ridge bone. Usually this empty socket will heal on its own, filling with bone and tissue, though some loss of jaw bone is inevitable. Sometimes when you have a tooth removed, the bone surrounding the socket may break or have difficulty healing on its own. The height and width of the socket may continue to deteriorate. For this reason, Dr. Dr. Noraian typically recommends methods to save bone at the time of the extraction, by performing a ridge repair. However, if the tooth is severely infected, if the socket bone breaks, or you are prone to significant resorption after extractions, Dr. Dr. Noraian may recommend ridge repair to preserve as much bone as possible at the time of the extraction. This method is particularly important to save you both time and expense, because it is typically less involved to save bone at the time of the extraction compared to not doing so, and then having to use more invasive techniques to rebuild the lost bone structure. You may need a rebuilding of the original height and width of the alveolar ridge for functional reasons such as dental implant placement or denture support, or for aesthetic purposes. Dental implants require bone to support their structure, and a ridge augmentation can help rebuild this bone to accommodate the implant.

How is Ridge Repair Accomplished?

Dr. Dr. Noraian completes a ridge repair by placing bone graft material in the tooth socket. It is often done immediately after he removes your tooth to try and avoid the need for a second more invasive procedure. Next, he places a soft tissue graft or hemostatic plug created with a laser over the socket and secures it with sutures to act like a cork which contains the bone graft. With this method, the socket heals reducing shrinkage and collapse of surrounding gum and facial tissues. This procedure is helpful for front teeth and back teeth that you need removed..

Dr. Dr. Noraian performs most ridge repairs in his office under local anesthesia, though you may request sedative medication in addition to the anesthesia.

Transitional Tooth Replacement Options

When you have a tooth extracted by Dr. Dr. Noraian, you may be concerned about going without a temporary replacement tooth. Dr. Dr. Noraian and his staff will coordinate with your general dentist to fabricate an appliance that they may insert at the time of tooth removal or soon after to minimize the time without replacement teeth. This option requires a small amount of preparation and coordination to have the tooth ready for the time of surgery.