The contour and integrity of the extraction socket should be preserved for optimal restoration conditions. Therefore, the goal of socket preservation is the protection of bone and soft tissues following tooth extraction. In the anterior area, this approach is especially important in order to achieve an optimum aesthetic result. In this case, socket preservation is performed inserting a free mucosal graft obtained from the tuber area using the soft tissue punch technique.
Professor Hannes Wachtel (Munich) performs the extraction of a middle incisor (tooth 21) carefully to avoid any tissue damage and cleans the socket thoroughly. The epithelium at the socket margin is removed with a rough diamond drill. A free mucosal transplant is obtained from the tuber region with a tissue cutter in accordance with the punch technique. After the thick transplant is transferred and inserted into the socket, microsurgical sutures are carefully applied to fix the graft to the deepithelialized soft tissue margins of the socket.
A close circular contact and adaptation between the transplanted and the socket tissue is crucial for the successful biologic and aesthetic integration of the graft. The gap in region 21 is closed with a temporary crown that is fixed adhesively to the neighboring teeth. The wound at the donor site is treated with a mattress suture using a Gore-Tex thread.