Socket Preservation for Lesion Extending to IAC

Although the bony socket is shallow, the soft tissue one remains deep at #31 with gingival recession (Fig.1 *).  The deep soft tissue socket with hemorrhage after extraction presents difficulty in debridement of granulation tissue apically.  After placement of allograft (Fig.3 *) and overlying collagen membrane (Fig.2 C), the socket is closed with 4-0 Chromic gut suture.  In fact, there is ~ 2 mm granulation tissue left (Fig.4 red (yellow line: upper border of the Inferior Alveolar Canal)).  To reduce socket shrinkage, the tooth #32 is not extracted.  The collagen membrane has lost 1 week postop (Fig.5).  More sutures should have been used, preferably using Human Amnion Chorion Allgraft as a membrane.  The latter promotes wound healing.  The bone graft also seems to have lost in 8.5 months (Fig.6).  A short implant will be placed mesially and obliquely (Fig.7).

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Xin Wei, DDS, PhD, MS 1st edition 01/08/2019, last revision 09/24/2019