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Osteology Consensus Report

Objectives: The fresh extraction socket in the alveolar ridge represents a special challenge in everyday clinical practice. Maintenance of the hard and soft tissue envelope and a stable ridge volume were considered important aims to allow simplifying subsequent treatments and optimizing their outcomes in particular, when implants are planned to be placed. Material and Methods: : Prior to the consensus meeting four comprehensive systematic reviews were written on two topics regarding ridge alteration and ridge preservation following tooth extraction and implant placement following tooth extraction. During the conference these manuscripts were discussed and accepted thereafter. Finally, consensus statements and recommendations were formulated. Results: : The systematic reviews demonstrated that the alveolar ridge undergoes a mean horizontal reduction in width of 3.8 mm and a mean vertical reduction in height of 1.24 mm within 6 months after tooth extraction. The techniques aimed at ridge preservation encompassed two different approaches: i) maintaining the ridge profile, ii) enlarging the ridge profile. Regarding timing of implant placement the literature showed that immediate implant placement leads to high implant survival rates. This procedure is primarily recommended in premolar sites with low esthetic importance and favorable anatomy. In the esthetic zone, however, a high risk for mucosal recession was reported. Hence, it should only be used in stringently selected situations with lower risks and only by experienced clinicians. In molar sites a high need for soft and hard tissue augmentation was identified. Conclusions: : Future research should clearly identify the clinical and patient benefits resulting from ridge preservation compared with traditional procedures. In addition, future research should also aim at better identifying parameters critical for positive treatment outcomes with immediate implants. The result of this procedure should be compared to early and late implant placement. The fresh extraction socket in the alveolar ridge represents a special challenge in everyday clinical practice. Regardless of the subsequent treatment maintenance of the ridge contour will frequently facilitate all further steps of therapy. This is particularly true for treatments involving the placement and reconstruction of dental implants. It has been demonstrated in numerous animal and clinical studies in humans that following tooth extraction undisturbed wound healing will lead to loss of ridge volume and change in ridge shape. The aim of the present consensus report was to critically evaluate the scientific evidence regarding ridge alterations following tooth extraction and to assess the effects of treatment strategies aiming at preservation of the ridge following tooth extraction. Furthermore, this consensus analyzed the clinical outcomes of implant placement into sockets at different time spans following tooth extraction. Workshop discussion and consensus The group discussing the evidence and generating the consensus statements consisted of individuals competent in different disciplines of medical dentistry with a special emphasis on implant therapy. Prior to the consensus meeting, two groups of researchers wrote comprehensive systematic reviews on two topics each regarding ridge alterations and *Osteology Consensus Group 2011: Mauricio G. Araújo, Maringa, Parana, Brazil; Dieter Bosshardt, Daniel Buser, Berne, Switzerland; William V. Giannobile, Ann Arbor, Michighan, USA; Reinhard Gruber, Vienna, Austria; Christoph H.F. Hämmerle, Ronald E. Jung, Zürich, Switzerland; Niklaus P. Lang, Hong Kong SAR PRC; Myron Nevins, Boston, Massachusetts, USA; Friedrich Neukam, Nuremberg, Germany; Mariano Sanz, Madrid, Spain; Massimo Simion, Milano, Italy; Georg Watzek, Vienna, Austria Date: Accepted 8 October 2011 To cite this article: CHF Hämmerle, Araújo MG, Simion M, On Behalf of the Osteology Consensus Group 2011. Evidence-based knowledge on the biology and treatment of extraction sockets. Clin. Oral Impl. Res. 23(Suppl. 5), 2012, 80–82 doi: 10.1111/j.1600-0501.2011.02370.x © 2011 John Wiley & Sons A/S 80 ridge preservation following tooth extraction and implant placement following tooth extraction. During the conference, the reviewers first presented their manuscripts explaining how the literature search was conducted, how the data were extracted, analyzed, which results were found and which conclusions could be drawn. The entire group then discussed these reports. Thereafter, all four manuscripts were accepted. Another thorough discussion followed on published data on lower levels of evidence than the one included in the manuscripts and its impact on the conclusions to be drawn. Finally, the group formulated consensus statements and recommendations for clinical practice and for future research.