Any advice on the best way to secure socket grafts in mandibular molar sites during socket preservation? I plan on placing a Collaplug to cover the socket graft along with a removable flipper covering the graft site.
This worked well for me before with a graft in the maxillary anterior area. It seems more difficult to adequately seal and contain the socket graft for mandibular molars because of their size and location in the mouth, where saliva tends to pool. What are you doing to secure these graft sites?
I use a membrane under the buccal and lingual flap and use papilla sparing incisions and advance the tissue to close it primarily without tension. However you alter the position of the attached tissue which is managed at the time of implant placement and/or uncovering to reposition the attached tissue.
If on extractoin you will end up with an intact socket and if you are going to place an implant in three months time the best thing to do is to leave it to heal naturally or at the most place a collagen plug. In three months time the bone is ususally fully formed though a little soft but this makes no difference in the long term. If you re-enter a grafted site in three months it is just mush, so for grafted sites you have to wait for at least six months before you have anything that you can work with.
The only time I would graft a socket was if one of the walls was missing and the reason for the graft was to rebuild this part of the socket.