A Socket Seal Technique With the Use of Autologous Dental Roots for Socket Seal: A Case Series
The literature identified variations in socket seal surgery, each with limitations. This case series aimed to observe the outcome of using autologous dental root (ADR) for socket sealing on socket preservation (SP). A total of 9 patients with 15 extraction sockets were documented. After flapless extraction, the xenograft or alloplastic grafts were placed in the sockets. Autologous dental roots were prepared extraorally and applied to seal the socket entrance. All SP sites healed uneventfully. Cone-beam computed tomography (CBCT) scan was performed after 4–6 months of healing to evaluate ridge dimensions. The preserved alveolar ridge profiles were verified on CBCT scans and during implant surgery. Implants were placed successfully with a reduced need for guided bone regeneration. Histological biopsy specimens were examined in 3 cases. The histological examination demonstrated vital bone formation and osseointegration of graft particles. All patients completed the final restorations and were monitored for 15.56 ± 9.08 months after functional loading. The favorable clinical outcomes support the use of ADR for SP procedures. It was not only accepted to patients but also easy to perform with low complication rates. The ADR technique is thus a feasible method for socket seal surgery.

The initial status of hopeless teeth. (a) Case 1. (b, c) Case 2. (d) Case 3. (e) Case 4. (f, g) Case 5. (h) Case 6. (i) Case 7. (j) Case 8. (k) Case 9.

Autologous dental root preparation and fixation at surgical sites. (a, b) Case 1. (c, d) Case 2. (e, f) Case 3. (g, h) Case 4. (i, j) Case 5. (k, l) Case 6. (m, n) Case 7. (o, p) Case 8. (q, r) Case 9.

Periapical radiographs taken at the time of socket preservation or at suture removal. Notice of the autologous dental root at the crestal region of most surgical sites. (a) Case 1. (b, c) Case 2. (d) Case 3. (e) Case 4. (f, g) Case 5. (h) Case 6. (i) Case 7. (j) Case 8. (k, l) Case 9.

Retention of autologous dental roots (ADRs) and soft tissue conditions immediately after ADR removal. Connective tissue underneath was healthy. (a, b) Case 2 after 6 months of healing. (c, d) Case 6 after 4 months of healing with socket preservation.

Cone-beam computed tomography scans after 4–6 months of healing with socket preservation. Alveolar ridge profiles were maintained. (a–c) Case 1. (d, e) Case 2; notice of the autologous dental root at the soft tissue level of the crest. (f) Case 3. (g) Case 4. (h) Case 5. (i, j) Case 6. (k) Case 7. (l) Case 8. (m) Case 9.

Outcomes of socket preservation after approximately 6 months of healing, before and during implant surgery. Most socket preservation sites had relatively favorable ridge profiles for implant placement. (a, b) Case 1. (c, d) Case 3. (e, f) Case 4. (g, h) Case 5. (i, j) Case 6. (k, l) Case 7. (m, n) Case 8. (o, p) Case 9. Case 2 is not shown because no implant surgery was planned.

Histological samples with hematoxylin and eosin staining revealed a substantial amount of vital bone formation. (a, c, e) Overview; original magnification, ×50. (b, d, f) Local site; original magnification, ×100. (a, b) Case 3; osseointegration of bone particles and vital bone was observed. (c, d) Case 4. (e, f) Case 8.

Periapical radiographs of definitive restorations at an average follow-up time of 15 months after loading. (a) Case 1 with 3 years of loading. (b, c) Case 2. (d) Case 3. (e) Case 4. (f) Case 5. (g) Case 6. (h) Case 7. (i) Case 8. (j) Case 9.

Clinical photos of definitive restorations at an average follow-up time of 15 months after loading. (a) Case 1 with 3 years of loading. (b) Case 2. (c) Case 3. (d) Case 4. (e) Case 5. (f) Case 6. (g) Case 7. (h) Case 8. (i) Case 9.
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