Odontologia

Preserving the Topography of The Extraction Site: The External Gingival Support Splint

The extraction of a tooth, or a number of teeth, may lead to unsupported soft and hard tissues surrounding the extraction socket and concomitant retraction of gingival height. Even when trauma to bone is minimized, this is caused by loss of vertical support for the attached gingival tissues as well as the subsequent retraction associated with the healing of the internal blood clot within the socket the resultant depressed alveolar ridge, with loss of interproximal papillae, can be an esthetic, functional, and hygienic problem when treatment planning the final restoration.
In the past, this problem has been addressed by internally supporting the extraction socket with various forms of osseous and soft tissue grafting materials, or with "ovate" pontics extended apically into the healing sockets (Figure 2). These techniques aid in maintaining the form support of the overlying gingival contours during healing, but secondary surgical procedures may be necessary to regain the desired bulk of soft tissue to replicate the adjacent gingival form.
The clinical indication for maintenance of soft and hard tissue contours is essential within the esthetic zone, especially where (1) there is an extraction site(s) due to discase or trauma, (2) a ridge augmentation procedure is performed and (3) implant exposure at the second stage is performed.
To help support and maintain the gingival contours and position of an immediate extraction site (or sites), the authors have developed an adjunctive technique. The concert is to support the buccal unattached keratinized gingival of the extraction site, bracing it to the supporting structures of the adjacent teeth with a thin, splint rigidly fixed to the external surface of these tissues immediately prior to, or immediately after, tooth removal.
This technique is utilized in conjunction with bone grafting of the alveolar aspect of the extraction