Socket Preservation with Ivory Graft and Free Gingival Graft (Tooth 11)

Clinical Case Report

Graft Material Used: 100% Ivory Dentin Graft
Application: Socket preservation after extraction of tooth 11, covered with Free Gingival Graft (FGG) from the tuberosity.
Performed by: Dr. Avi Kuperschlag

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Pre-operative condition

A frontal clinical image showing the anterior maxilla prior to treatment. Tooth 11 is present but non-restorable, with aesthetic and functional concerns. The surrounding gingival architecture appears healthy, making the case suitable for extraction and socket preservation in preparation for implant placement.

Pre-operative condition
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Tooth extraction

Tooth 11 was atraumatically extracted. Examination of the socket confirmed intact bony walls and adequate vascularity, making the site suitable for grafting.

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Socket grafting

Ivory Dentin Graft was placed into the socket to preserve alveolar ridge dimensions and promote natural bone regeneration.

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Free gingival graft (FGG) from the tuberosity

A soft tissue graft was harvested from the tuberosity area and used to cover the grafted socket, providing stability and soft tissue closure.

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Socket sealed and sutured

The site was sealed with the FGG and secured with sutures. A membrane could also be used as an alternative to soft tissue grafts for socket coverage.

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Reopening 4 months post-op

Re-entry at 4 months revealed mature, regenerated bone with excellent integration of the graft, supporting ideal conditions for implant placement.

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Implant Placement

A dental implant was placed with high primary stability, allowing immediate loading. The regenerated ridge fully supported the implant body.

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Temporary crown

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Pre-op CBCT

CBCT showing the compromised condition of the alveolar ridge and root of tooth 11 prior to extraction and grafting.

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Post-op CBCT – 4 Months

CBCT 4 months post operation - The excellent integration of Ivory graft allowed the implant to be placed with high primary stability allowing immediate loading.

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Case Outcome:

The combination of Ivory Dentin Graft and a free gingival graft from the tuberosity provided an effective socket preservation approach. At 4 months post-op, the regenerated site supported immediate implant loading with high primary stability — demonstrating a predictable, patient-friendly approach to anterior implant rehabilitation.