How to: Graft an extraction socket

Grafting extraction sockets is essential for successful regeneration of bone. Research has shown that only 30% bone growth occurs in sockets that aren’t grafted compared to up to 60% bone growth in sockets that are grafted. While older bone grafts replaced the lost tissue, the new generation of grafts is resorbable and stimulate bone formation.

Bone grafting material

Orthogen’s NanoGen is a nanotechnology-based bone graft material that can be used as a graft by itself, a mixing agent with other bone grafts and a barrier membrane.

A box of NanoGen comes with two patient specific kits. Each patient specific kit has 1 gram of NanoGen in it. It also comes with saline. Saline is added to NanoGen drop by drop to form the material into a putty consistency. This consistency is moldable and very easy to handle. After placement, NanoGen undergoes controlled degradation over 3-4 months. It leads to deposition of calcium phosphate, which further stimulates bone formation.

Case presentation

A 39-year-old male presented with a large perio-endo lesion that caused bone resorption around tooth No. 7. The tooth required an extraction. Placement of bone graft was planned in the extraction socket (Fig. 1).

1. NanoGen bone grafting material is placed into a cup (Fig. 2).

2. Saline is added to the material. The material absorbs the saline and begins to form into a putty consistency (Fig. 3).

3. The putty is delivered into the extraction socket (Fig. 4).

4. The extraction socket is completely grafted with the NanoGen putty (Fig. 5).

5. A bone graft packer is used to press the grafted material to ensure no voids are left behind (Fig. 6).

6. A barrier is placed to cover the putty and the site is closed with sutures (Fig. 7).

This grafting product and the technique offer an effective, synthetic, easy and inexpensive alternative to xenografts and allografts. It’s used extensively in our practice for grafting extraction sockets as well as infra-bony defects.

NanoGen undergoes controlled degradation in the body and leads to formation of calcium phosphate, which further stimulates bone regeneration. Defects were found to be completely filled with regenerated vital bone 4 months after grafting.