A biologic treatment concept for the extraction alveoli: Replantation and extrusion of root segments

For pleasing and long-lasting implant prosthetics, quality and volume of the implant bed are of utmost importance. Therefore, numerous strategies for preservation of the alveoli and a sufficient defect restoration were developed in order to avoid and correct tissue losses caused by extraction, especially resorption. An analysis of the reactive processes that can be seen at replantation and extrusion of teeth clearly shows that the basics for an alternative, biologic concept can be deduced from the structural and functional relations. As a result, the replantation of a tooth can ensure an almost complete preservation of the adjacent tissue structures by functionally reconnecting them. The extrusion of a tooth induces a coronal "follow-up" of the periodontal and alveolar tissue structures. The extent of the vertical tissue regeneration can be guided by the functional connection. The suprabony fibre apparatus seems to be of special significance for this. Because extensive case studies show that isogingivally replanted root segments have nearly the same preservation and regeneration potentials as whole teeth, a biologic tissue management based on this presents many advantages. These range from a minimally invasive surgical intervention to extensive volume and structural preservation and less stress for the patient.