1. Don’t expand labial plate!
No “Wimpy” Forceps
No Labial Force

2. If must remove bone during extractions, remove:
Interadicular
Interdental
Lingual
Labial

3. If must extract, then remove the smallest amount of the least valuable bone (labial plate in maxilla especially valuable).

4. Roots Tips
Think
Bone
Preservation

5. “Drill to oblivion ”

6. Save (preserve) the buccal and lingual cortical plates by sectioning teeth and or removing interdental / interadicular bone

7. Esthetics Count

8. Implant Prosthodontics by Dr. Sree Koka

9. Removing most difficult tooth last saves bone (consider removing interdental bone)

10. Orthodontic Extrusion Saves Bone

11. Does grafting at the time of extraction minimize ridge resorption?

12. Class 1 Recommendations
Proven efficacy and effectiveness supported by 1 or more randomized controlled trials
Results of trials consistently excellent
Intervention is safe and definitely recommended and useful

13. Class 2a
Multiple studies (prospective, retrospective, nonrandomized) with good results
Considered intervention of choice by majority of prudent dentists
Acceptable and useful

14. Class 2b grafting sockets
Fewer studies (Case reports, intervention done on animals, studies without controls) generally but not always positive
Considered acceptable safe and useful… within standard of care
Considered optional or alternative treatment by most experts
grafting sockets

15. Class 3 Positive evidence completely absent, or studies suggest harm
Unacceptable, no benefit
Intervention may be worse than doing nothing at all

16. Adopted from International Guidelines 2000 for CPR and ECC
Class Indeterminate
Promising, but few studies
Contradictory results
No harm, but benefit uncertain
“More research needed”
Adopted from International Guidelines for CPR and ECC

17. What graft material? Fresh warm autogenous bone
“Hamburger Helpers” for bone:
Allogenic bone (other humans)
Xenogenic bone (other species)
Alloplastic agents (Bioglass, Ca-Sulfate, Methacrylates, Calcium Phosphate cements)
“Biologics” BMP,PRP
Combinations

18. Costs? $20.00-$125.00/gram

19. ALLOGRAFT CONSENT (Check if applicable and if checked consent signature must be completed):
Use of donated bone or tissue products if applicable, has been explained to me and I understand that there are risks associated with implanting these types of products. These risks include reactions, infections such as hepatitis and AIDS. These risks, although extremely rare, can be serious ands possibly fatal. Alternatives to allograft use have been explained to me and include but are not limited to
I CONSENT to use of donated bone/tissue if determined by my physician
Patient Signature
 I DO NOT CONSENT to use of donated bone/tissue

20. “Socket Preservation”… ADA 7953
Int J Periodontics Restorative Dent Feb;26(1): A study of the fate of the buccal wall of extraction sockets of teeth with prominent roots. Nevins M, Camelo M, De Paoli S, Friedland B, Schenk RK,

21. What do I use? Autogenous bone mixed with a resorbable alloplast
‘Donor site morbidity’