Treatment Options for the Management of the Postextraction Socket: Report From the First Giuseppe Cardaropoli Foundation Consensus Conference.

Abstract

Aim: Different approaches have been proposed for implant placement following tooth extraction. A Consensus conference was organised to provide expert-based recommendations for the treatment of the postextraction site in the aesthetic zone in conjunction with implant therapy.

Methods: A panel of eight experts with a documented longstanding clinical and research experience in the field of implant therapy in the aesthetic zone were invited to participate in a structured survey. Participants were asked to select their preferred treatment approach for different clinical scenarios of the postextraction site from a list of different treatment options. Results were summarised and discussed in person at a 2 day consensus conference. Based on the outcome, treatment recommendations were phrased and are reported here.

Results: The group agreed that in case of an intact alveolus, immediate implant placement with immediate prosthetics represents the reference choice if proper primary stability can be achieved and the buccal bone plate is present. A bone-to-implant gap more than 2 mm should be seeked and grafted. Alveolar ridge preservation and early placement with contour augmentation may represent an alternative. If the alveolus is compromised, a staged approach (early or delayed placement) with bone augmentation may be preferred.

Conclusions: The characteristics of the site, in terms of the available bone volume, the integrity of the buccal bone plate and the periodontal phenotype are determining factors in the therapeutic choice. Therefore, case selection based on well-defined selection criteria is extremely important and is the adequate way to guide the clinician in choosing the most appropriate approach to postextraction site management and timing for implant placement.