Senior woman smiling and posing indoors

Home / Implants / Procedures

Socket preservation after extraction

Socket preservation (alveolar ridge preservation) places graft material in the socket when a tooth is removed. Randomized trials show it reduces the bone shrinkage that follows extraction.

What it is

Socket preservation, also called alveolar ridge preservation, is a procedure done when a tooth is removed.1 Graft material is placed in the empty socket, usually with a membrane or seal over it.1 AAOMS describes the aim as maintaining the natural bone structure and contours after extraction.2

Why it is done

The ridge shrinks after a tooth is removed.3 A systematic review measured horizontal bone loss of 29 to 63 percent and vertical loss of 11 to 22 percent within 6 months of extraction.3 Most of this change happens in the first 3 to 6 months.3

What the trials show

A 2019 meta-analysis pooled 22 randomized trials comparing socket grafting with extraction alone.1

Measure (3 to 6 months after extraction)Bone loss prevented by grafting
Width (horizontal)1.99 mm
Height, cheek side1.72 mm
Height, tongue side1.16 mm

The review identified nine different preservation methods, including animal-derived bone, human donor bone, synthetic material, blood-derived products, cell therapy, a growth protein (rhBMP-2) and sealing the socket alone.1 Patient-reported outcomes were similar between grafted and non-grafted sites in the two studies that measured them.1 Particulate animal-derived or human donor bone covered with a collagen membrane or collagen sponge gave the most favorable width results.1 Sites with a cheek-side bone wall thicker than 1.0 mm had better results than sites with a thinner wall.1 The review could not name one method as best.1

Timing

AAOMS advises discussing bone and socket preservation with the surgeon before the tooth is removed.2 An implant can also be placed into the socket on the day of extraction; see the topic on immediate placement.4

General information about dental implants. Treatment decisions are made with a licensed dentist.

Sources

  1. Avila-Ortiz G et al. Effect of alveolar ridge preservation after tooth extraction: systematic review and meta-analysis. J Clin Periodontol 2019. pubmed.ncbi.nlm.nih.gov
  2. AAOMS (MyOMS.org): Preserving Bone for Dental Implants. myoms.org
  3. Tan WL et al. Post-extraction alveolar hard and soft tissue dimensional changes: systematic review. Clin Oral Implants Res 2012. pubmed.ncbi.nlm.nih.gov
  4. ICOI Glossary: Immediate Implant Placement. icoi.org

Evidence

Sourced facts

Each line links to the study or the specialty body it comes from.

  1. A meta-analysis of 22 randomized trials found socket grafting reduced horizontal bone loss by 1.99 mm and mid-cheek-side vertical loss by 1.72 mm compared with extraction alone.

    Avila-Ortiz G et al. Effect of alveolar ridge preservation after tooth extraction: systematic review and meta-analysis. J Clin Periodontol 2019 · checked October 2, 2026

  2. The review found particulate animal or human donor bone covered with a collagen membrane or sponge gave the most favorable width preservation.

    Avila-Ortiz G et al. Effect of alveolar ridge preservation after tooth extraction: systematic review and meta-analysis. J Clin Periodontol 2019 · checked October 2, 2026

  3. Sites with a cheek-side bone wall thicker than 1.0 mm showed more favorable preservation results.

    Avila-Ortiz G et al. Effect of alveolar ridge preservation after tooth extraction: systematic review and meta-analysis. J Clin Periodontol 2019 · checked October 2, 2026

  4. Without grafting, horizontal bone loss of 29 to 63 percent occurs within 6 months of extraction.

    Tan WL et al. Systematic review of post-extraction alveolar hard and soft tissue dimensional changes. Clin Oral Implants Res 2012 · checked October 2, 2026

  5. AAOMS advises discussing bone and socket preservation options with the surgeon before a tooth is extracted.

    AAOMS (MyOMS.org): Preserving Bone for Dental Implants · checked October 2, 2026

  6. ICOI defines immediate implant placement as placing an implant into the extraction socket at the time of extraction.

    ICOI Glossary: Immediate Implant Placement · checked October 2, 2026

Smiling senior woman portrait in a bright home

Florida

Implant doctors near you

Ranked from public data: reviews, search visibility, associations and implant pages.

Top doctors by region

Read next

Related topics

Radiant senior woman with long grey hair smiling Anatomy

Jawbone changes after tooth loss

The bone that held a tooth shrinks after the tooth is removed, most in width and most in the first 3 to 6 months. The amount of remaining bone shapes implant planning and whether grafting is needed.

 Smiling senior woman in white shirt indoors Procedures

Bone grafting for implants

Bone grafting adds bone or bone substitute where the jaw is too thin or short for an implant. Grafts come from the patient, a human donor, an animal source, or synthetic material.

 Radiant senior woman smiling outdoors on a sunny d Procedures

Implant placed at tooth extraction

Immediate placement puts the implant into the socket on the day the tooth is removed. It can be combined with immediate, early or conventional loading; each combination has its own level of evidence.

 Smiling woman in white robe touches her face Procedures

Single-tooth implant

A single-tooth implant replaces one missing tooth with one implant and one crown. Neighboring teeth are not used for support.

 Elegant woman with gray hair and amber top Procedures

Implant bridge for several missing teeth

Several missing teeth in a row can be replaced by a bridge on two or more implants. The bridge does not rely on natural teeth for support.

 Smiling woman in bathrobe with short blonde hair Procedures

Full-arch fixed teeth: All-on-4 and All-on-X

A full-arch fixed bridge replaces all teeth in one jaw and is fixed to four or more implants. All-on-4 uses four implants, which may include tilted implants; in All-on-X the X stands for a variable number of implants, commonly four to six.

Featured

Featured doctor

Featured doctors advertise with the publisher. Featured placement does not change a score or a rank. Disclosure

Dr. Michael Pawlus
Featured

Dr. Michael Pawlus

Periodontist · Sarasota

ICOI Fellow, ICOI Diplomate · AAP member

Doctor page(941) 923-2288
Featured doctorDr. Michael Pawlus · Sarasota