The socket is the hole in the alveolar ridge bone that supports the tooth. Disease can create large pockets in the socket. Extraction of a tooth will result in some loss of bone during healing. In order to preserve ridge bone an extraction socket may have bone graft material placed in it. In many cases it is advisable to graft bone into the socket.
Three of the top cases socket grafting is most useful in are:
In all of these cases socket grafting preserves bone height and width. The natural process after a tooth is extracted resorbs the bone in 3 dimensions resulting in total bone volume loss.
In the case of the implant, a smaller implant may have to be used or a bone graft may be necessary at the time of implant placement. Bone grafting after atrophy has occurred is more difficult and less successful. For example, a single tooth extraction site may be socket grafted with bottled bone with 2 sutures. A healed extraction site with bone loss requires a larger incision, flapping back the gum tissue, occasionally collection of autograft from another site, membrane placement and multiple sutures. The loss of bone initially can also result in gingiva (gum) atrophy and a subsequent gum graft may be needed.
In the case of a future bridge, socket grafting with a long lasting hydroxylapatite material can support the bone and slow the resorptive process significantly. This has the effect of improved function and aesthetics of the bridge. Loss of bone would require the pontic (middle tooth in the bridge) to be too long which would be unaesthetic. Also bone loss after the bridge is made results in a gap that is unaesthetic and a food trap.
In the case of the denture, the socket grafting with a slowly resorbing graft material can delay the inevitable bone loss that results in poor denture fit.