Deep periodontal defects with advanced bone loss of the buccal cortical plate represent a challenge for periodontal treatment in the upper front region. Literature data suggest that one and two-wall periodontal defects do not have tendency for complete periodontal regeneration and bone fill (Eickholz et al. 1996, 1998, 2000). Remaining residual pockets can also jeopardize the long term result of periodontal treatment (Matuliene et al. 2008). Tooth extraction in the upper front region even without any periodontal defect will result in certain amount of oro-vestibular and eventually vertical shrinkage of the original soft tissue contour (Schropp et al. 2003). Due to bone remodelling appropriate implant placement cannot be achieved in most of the cases. Socket preservation and different alveolar site developments are used to offset this unfavourable feature (Camargo & Lekovic, 2004; Lekovic & Kenney, 1997). It is obvious that the application of one of these techniques can be of great importance when tooth extraction is being considered at periodontally compromised teeth with advanced buccal plate involvement. It is not clear that ridge preservation procedures are effective in limiting horizontal and vertical ridge alterations in postextraction sites...
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