A Clinical Case on Managing the Extraction Socket with R.T.R+ and a Connective Tissue Graft by Dr. Pierre Koumi

Introduction

Any dental extraction brings about inevitable tissue alterations (soft and hard tissues). These alterations often result in bone loss after extraction of 20% to 60% in volume horizontally and 11% and 20% vertically.

So, this bone loss is massive and can reach 50% of the volume if we allow healing to take place spontaneously without the addition of biomaterials, which complicates the three-dimensional positioning of the implant and making the prosthesis. Studies show that the use of low bone resorption biomaterials associated with atraumatic surgery (extraction without flap) and the use of collagen matrices could reduce this bone loss by up to 10-15%, which would allow optimal positioning of the implant in the second surgical phase.

Other studies show that the use of an osteoconductive material with a low resorption rate and the application of a connective graft over the socket could reduce horizontal and vertical bone resorption even further and thus compensate for this bone loss by a thickening of the soft tissues, which would facilitate the optimal placement of the implant and give an aesthetic gingival contour without loss of volume, which would improve the emergence profile of the crown. This is the technique described in this clinical case with the use of R.T.R.+ (80/20 formula) and connective tissue.

The presence of this connective tissue will ensure that the R.T.R.+ will stay in place, and more importantly, it will compensate in vestibular terms for the loss of volume of soft tissue which occurs despite filling.

Read the Clinical Case