Extraction Site Defect

Teeth are removed for several reasons, including periodontal disease, extreme decay, and for orthodontic reasons.  Once a tooth is removed, the shape of the ridge (i.e., the supporting bone and gum in which the tooth was situated and retained) changes.  If there has been extensive bone loss, or if the tooth needed to be surgically removed (bone had to be cut away to gain access to the area), the change will b e more dramatic.  The ridge shrinks, collapses into itself, and over time decreases width and height.  As more time passes after the extraction, the more change occurs.  This is an extraction site defect.

The extraction site defect presents a problem when the area is to be restored with a bridge or an implant.  When the ridge architecture has significantly changed, the replacement tooth will have to deviate from the ideal shape.  This could easily make the area more difficult to keep clean, difficult for the dentist to restore, and cosmetically quite unsightly.  Perhaps the cosmetics may not matter to you when there is a back tooth being replaced -- one that is not visible when you speak or smile.  An extraction sit defect in an area visible when you speak or smile will create a severe esthetic problem.  The more the ridge has changed, the more the pontic will need to be either longer, wider, or fatter in order to fill up the extraction site.  If you have a smile line that shows the tooth or gumline, the replacement tooth will be very obviously misshaped.  It will never look right and will always be a cosmetic failure.

It is clear that for the replacement tooth to have a normal appearance, the extraction site must be rebuilt.  The closer it can be made to the ideal, the better the replacement tooth will appear.  The site (or ridge as it is called by dentists) will be restored through soft tissue or soft and hard tissue minor periodontal surgical procedures.  If the ridge needs only a small amount of augmentation, only soft tissue procedures will be needed.  If there is a large defect, the underlying supporting bone will have to be replaced as well.  If the site is especially visible or needs an extensive amount of rebuilding, more than one augmentation procedure may be necessary.  Our goal is to make the replacement tooth appear to be growing out of the extraction site, not merely lying against the soft tissue ridge.

If a dental implant is to be placed to act as an anchor for the replacement tooth,  the extraction site must have enough bone thickness and height to properly surround the implant.  These procedures almost always involve hard (bone) and soft tissue modification.  We will let you know what is appropriate for you.

If you have any questions, please feel free to ask us at (512)250-5012.

Information directly from, "Dental Practice Tool Kit: Patient Handouts, Forms, and Letters," 2004, Elsavier Inc.