Considerations for tooth extraction before dental implants

As dental implant technology is becoming more and more accepted by the general public, more and more patients are receiving dental implant treatment. Compared to the more developed countries such as Europe, America, Japan and Korea, the dental implant business in China is still at an early stage of development. More patients do not think about the option of dental implants until they need dental veneers. However, suddenly they find that their existing tissue conditions are not suitable for dental implants, or they need to undergo additional bone grafting surgery to receive dental implant treatment, because the height and width of the alveolar ridge and the surrounding soft tissues in the missing tooth area are important for the success of the implant. So how do you ensure that the missing tooth area has abundant alveolar bone and healthy soft tissues? This needs to be considered at the time of extraction, with minimally invasive extraction and site-preservation techniques to protect the alveolar bone and gingiva and to provide a good foundation for successful implant placement. The traditional extraction technique uses chisels, collars and forceps to extract the tooth, and the tooth is extracted by the percussion of the chisel or the wedging of the collar to squeeze the alveolar bone or to cause some small fractures in the alveolar bone, enlarging the bone cavity around the tooth. Such an extraction method inevitably results in partial loss of alveolar bone, which is not conducive to future implantation. The minimally invasive extraction technique protects the hard and soft tissues around the tooth as much as possible during the whole extraction process, and uses minimally invasive extraction instruments to compress the alveolar bone, cut the periodontal membrane, and gently remove the tooth. The entire extraction process minimizes the damage to the periodontal tissues and allows for faster and better healing. The normal physiological stimulation of the alveolar ridge is lost after tooth loss, and irreversible resorption of the remaining alveolar ridge occurs, resulting in a decrease in the height and width of the alveolar bone, especially in the anterior region, which directly affects the selection of implants and the effectiveness of the implant restoration. Studies have shown that 70-80% of the total alveolar bone resorption within 2 years after tooth extraction occurs within 3 months after extraction. At 6 months after extraction, the average horizontal resorption of the alveolar ridge is 4.4 mm and the vertical resorption is 1.2 mm. Therefore, the effective preservation of the bone volume in the three-dimensional direction of the original alveolar ridge is of great importance for the long-term success and aesthetics of the implant. How to use an effective and minimally invasive alveolar ridge site preservation technique to effectively solve the problem of insufficient bone volume in the implant area has gradually become a hot topic in oral implant research. At present, the mainstream site preservation technique implants artificial bone material, bone collagen or collagen membrane at the same time of tooth extraction to avoid the resorption of soft and hard tissues, and can increase the height and width of the alveolar bone to varying degrees to establish a good foundation for successful dental implantation in the future. Therefore, if you are considering the use of dental implants to restore missing teeth, you can discuss the extraction plan with your doctor at the time of extraction and try to use minimally invasive techniques to protect the alveolar ridge and gums, and if necessary, you need to use the alveolar ridge site preservation technique to facilitate the implant restoration in the future. In order to avoid the need for implantation when the bone volume is found to be insufficient, it is necessary to use each implant bone surgery, which prolongs the treatment time on the one hand, and accepts more surgical trauma on the other.