Socket Preservation

A 61-year-old woman has pain after RCT at #14 (Fig.1).  Exam shows subgingival crack.  After difficult extraction, allograft with Osteogen is placed in the 3 sockets, followed by Osteogen plug and 4-0 Chromic Gut Suture.  The distal gingiva appears to be migrating into the center of the sockets (Fig.2 arrow).  Due to insurance issue, an implant will be placed early next year.  The patient returns 9 months post extraction (Fig.3).  If the ridge proves to be not so wide, make incision, start osteotomy with 1.6 mm pilot drill, followed by 4.3 mm Magic Drill for 7 mm and 3.8 mm Magic Expander for another 2 mm (sinus lift, BEB, Fig.4).  Otherwise start Magic Split.  If the bone is dense, use drills and Expander as mentioned above with the depths 2 mm more (Fig.5), followed by Magicore.  The tissue-level implant improves the crown/implant ratio over the FC.  After socket healing, gingival cuff height is stable.  The cuff of Magicore is easy to determine vs. immediate case.

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Xin Wei, DDS, PhD, MS 1st edition 05/28/2017, last revision 09/16/2018