Dental News - Interview: Dr Nele van Assche on the possibilities of ridge preservation

Dental Tribune International

Thu. 25. April 2019

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Since ridge preservation is one of the main congress topics of the International Osteology Symposium, which is taking place from 25 to 27 April in Barcelona in Spain, Dental Tribune International asked speaker Dr Nele van Assche to answer a couple of questions on this treatment option. In addition to running her own periodontics and implant treatment practice in Belgium, she has been a member of the Expert Council of the Osteology Foundation since 2015 and of the European Association for Osseointegration Certification Committee since 2016. Van Assche is widely published in international journals and lectures frequently at congresses—including the upcoming event, where she will be informing dentists about surgical and material options for ridge preservation, as well as the procedure’s advantages.

Dr Van Assche, you are giving a presentation titled “Ridge preservation: Surgical techniques for predictable outcomes” on Friday. What is your lecture about, and what are your intended main learning objectives?
Alveolar ridge resorption occurs after unassisted extraction, and ridge preservation is a technique to minimise this ridge resorption process. Thus, my lecture will give the audience a general overview of the possibilities of ridge preservation. The clinicians will get an idea of the surgical choices they have to make and how to perform the procedure.

What are the main advantages of ridge preservation as opposed to simple tooth extraction regarding function and aesthetics?
Well, ridge preservation is especially indicated when implant treatment is delayed owing to the patient’s young age or in situations with high aesthetic demands, such as thin buccal plates or damaged bone plates, for which a poor outcome is expected because of unassisted healing. Another indication for performing ridge preservation techniques is sites where you expect limited bone height after tooth extraction, for example towards the sinus or alveolar nerve.

What material types are available to fill the extraction socket?
Different materials, including synthetic materials, xenografts and L-PRF [leucocyte- and platelet-rich fibrin], can be used. Also, to seal the socket, autogenous or non-autogenous membranes are available. However, well-designed RCTs [randomised controlled trials] are needed to compare different materials. My lecture will also focus on the surgical aspect of the use of these materials.

Would you recommend ridge preservation for all cases, even if no implant is planned after tooth extraction?
No, I would not recommend it for all extraction sockets. For example, in cases with a thick buccal bone plate, less resorption occurs after unassisted healing, which means that it might not be additionally beneficial. In contrast, ridge preservation is highly recommended at pontic sites with high aesthetic demands or in situations in which the implant placement is delayed in young patients.

Is immediate implant placement an option to bypass ridge preservation?
Immediate implant placement itself will not prevent the resorption of the alveolar ridge after tooth extraction. Only filling the extraction socket will minimise this process.

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