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Video Details
Extraction Site Micro-gap and Treatment Options in Implant Therapy

Description:
In this second of an ongoing informative and clinically relevant series, Dr. Dennis Tarnow, currently Clinical Professor of Periodontology and Director of Implant Education at Columbia School of Dental Medicine, discusses extraction site management with special emphasis on the biology and clinical treatment options of the micro-gap that occurs after immediate implant placement into an extraction site. Specifically, Dr. Tarnow tries to answer such questions as what is the critical jumping distance, should we graft the micro-gap, and how should we manage the soft tissue flap in immediate extraction and implant placement.

Date Added:
11/12/2009

Author(s):

Dennis P. Tarnow, DDS Dennis P. Tarnow, DDS
Dennis P. Tarnow is currently Clinical Professor of Periodontology and Director of Implant Education at Columbia School of Dental Medicine. Dr. Tarnow has a certificate...
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Online Videos / Surgery / Periodontic Surgery / Extraction Site Micro-gap and Treatment Options in Implant Therapy




Questions & Comments
henry salama - (7/18/2016 12:47 PM)

Gabe, the literature tells us that there may be bone and osseointegration on the labial of the implant even without grafting the GAP, however, the buccal plate will remodel and we do see a general loss of bucco-lingual dimension after this modeling takes place especially when no bone grafting is done in the extraction gap. What does that mean to us in the anterior region? Well, we will have bone on the labial of the implant, but we may have a concavity in the soft tissue contour and/or, color/optic deficiencies of the soft tissue. Along with bone grafting the extraction site, a connective tissue graft is often utilized in esthetically demanding areas with thin biotypes to compensate for this possibility. Having said that, If all you're looking for is osseointegration then grafting the gap may not be absolutely necessary as long as you can protect the fibrin clot.

Gabe Joel - (7/17/2016 2:53 PM)

Wow...Does this mean no more grafting implant microgap so long as I have a buccal bone?

Omid Moghaddas - (7/17/2016 1:08 AM)

Robert ,its the clot that will stabilize the particulated graft materials inside the Gap.

Robert Carimi - (7/16/2016 7:23 PM)

What keeps the bone particulate from washing out around the implant if no membrane or primary closure is achieved? Dr. Tarnow showed a case where he filled in the buccal gap with particulate, placed a healing abutment and pt left with only a flipper. Thank You!

Duane Keuning - (10/27/2015 11:00 PM)

Nice proof of your hypothesis! (11/2009) What about today? (Oct-Nov 2015) Buccal socket defect >2mm+ Do you and Dr Chu treat all (most) of your non-graft (clot only) implant cases this way? What about a grafted implant case? Place a membrane for security or rely on what you've shown here? Looking forward to your response.

Jean philippe Peyratoux - (3/2/2015 11:40 AM)

Nice to hear from you again .

Mohannad Al Juhaini - (9/1/2013 6:01 AM)

Thank you for a nice presentation. what would be the oral hygiene instruction in such case ? what about if by mistake a food particle got dislodged in between the implant and the bone ? what if the blood clot didn't form ? Thank you in advance

peer-emil charles-harris - (8/29/2013 4:44 AM)

Thank you Henry, I shall continue to bone graft and connective tissue graft my anterior esthetic cases.

henry salama - (8/27/2013 8:22 AM)

peer-emil, there is nothing in the literature that supports the story-line of the resorption of the buccal plate in 4 years. Having said that, the literature tells us that the buccal plate will remodel and we do see a general loss of bucco-lingual dimension after this modeling takes place especially when no bone grafting is done in the extraction gap. What does that mean to us in the anterior region? Well, we will have bone on the labial of the implant, but we may have a concavity in the soft tissue contour. Along with bone grafting the extraction site, a connective tissue graft is often utilized in esthetically demanding areas to compensate for this possibility.

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