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Volume 34 , Issue 3
May/June 2014
Pages 399-403

Analysis of Buccolingual Dimensional Changes of the Extraction Socket Using the “Ice Cream Cone” Flapless Grafting Technique

Jocelyn H.P. Tan-Chu, DDS/Frank J. Tuminelli, DMD/Kenneth S. Kurtz, DDS/Dennis P. Tarnow, DDS

PMID: 24804291
DOI: 10.11607/prd.1605

The socket or ridge preservation approach known as the “ice cream cone” technique was used in type 2 sockets in this retrospective analysis of 11 extraction sites. A type 2 extraction socket is defined as having the presence of facial soft tissue with a partial or complete dehiscence of the buccal bone plate. All teeth were extracted atraumatically without flap elevation. A resorbable collagen membrane was contoured into an ice cream cone– shape, placed into the socket defect, and grafted with human freeze-dried bone allograft. Buccolingual dimensional changes were measured manually with a digital caliper sensitive to 0.01 mm on pre- and posttreatment casts using an acrylic template and a three-dimensional (3D) digital scanner, as well as radiographically with pre- and post-cone beam computed tomography (CBCT) scans. All implants were placed 6 months after socket preservation and achieved primary stability with a minimum torque value of 35 Ncm with a mean buccal-lingual dimensional loss of 1.32 mm. The dimensional change of the ridge from pre- to postextraction reflective of the healed grafted site ranged from a loss of 0.46 to 2.25 mm with a mean of 1.28 mm (CBCT), 0.31 to 2.71 mm with a mean of 1.36 mm (digital calipers), and 0.21 to 2.80 mm with a mean of 1.32 mm (3D digital scanner). All 11 implants were immobile and clinically osseointegrated. The so-called ice cream cone technique allows for the reconstruction of a buccal plate dehiscence to enable the placement of an implant; however, the ridge dimension was diminished by 1.32 mm compared with the width of the extraction socket prior to tooth removal. (Int J Periodontics Restorative Dent 2014;34:399–403. doi: 10.11607/prd.1605

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