At the 2019 EAO Congress in Lisbon, a fascinating session was held on treating cases with buccal bone loss after tooth extraction. This important topic, led by esteemed experts J.C. Rosa, M. Quirynen, and I. Zabalegui, delved into different techniques for addressing bone resorption following tooth loss and the challenges it presents in implant dentistry.
The session kicked off with a discussion about the significance of the buccal bone, which supports soft tissues and prevents complications such as tissue recession around implants. With the loss of this vital structure, aesthetic and functional outcomes are at risk, especially in the aesthetic zone where bone resorption can be more pronounced. The experts discussed various reasons for buccal bone loss, including periodontitis, endodontic failures, fractures, and, notably, extractions, which can disrupt the bone's vascular supply and lead to rapid resorption.
The three speakers shared their approaches for addressing this issue. Dr. Rosa introduced the Immediate Dental Restoration (IDR) technique, which focuses on using autogenous bone grafts from the maxillary tuberosity to rebuild the lost buccal bone immediately after extraction. His approach, though complex, offers high predictability in terms of soft tissue stability and long-term bone preservation.
Next, Dr. Quirynen shared his experience with Leukocyte-Platelet-Rich Fibrin (L-PRF) for buccal bone preservation. This method involves using the patient's blood to create membranes that help in bone regeneration. His technique minimizes the need for foreign materials and provides an autogenous solution that simplifies the procedure and reduces patient discomfort, with fewer complications.
Dr. Zabalegui, focusing on soft tissue, presented his approach of compensating for buccal bone loss by enhancing the soft tissue around implants. He emphasized that while the textbook might suggest a minimum of 2mm of buccal bone, in practice, it's the soft tissue that often plays a more significant role in long-term implant success.
Each speaker showcased their innovative techniques, emphasizing the need for experience and careful planning when dealing with buccal bone loss. While autogenous grafts and L-PRF are central to their methods, they also acknowledged that each case might require a tailored approach. The session concluded with discussions on the need for further research and data to solidify these techniques, as well as a call for ongoing education for clinicians to stay abreast of these emerging trends in implantology.
Overall, the session provided invaluable insights into how implantologists can navigate the complex issue of buccal bone loss, offering a range of solutions depending on the clinical situation and the operator's expertise.