Immediate effects of tooth extraction on ridge integrity and dimensions



This study aims to assess possible immediate post-extraction changes in ridge integrity and width.


Tooth extractions (53 teeth in 30 adults) were performed following atraumatic techniques. Root trunk and ridge width were measured at the crest level in buccolingual direction. Similarly, socket width and buccal plate thickness were also determined. Pre- and post-extraction buccal plate dehiscence, fenestration, or fracture was recorded. Diameter and length of extracted tooth root were also measured. Multinomial logistic regression was used to reveal relationships between ridge outcome (expanded, stable, or collapsed groups) and assessed tooth/site parameters.


Post-extraction, buccal plate fracture developed in 5 (9 %), dehiscence in 15 (28 %), and complete buccal plate loss in 2 sites (4 %). Following extraction, ridge width was expanded in 30 (57 %), collapsed in 12 (23 %), and remained unchanged in 11 (21 %) sites. In most sites (72 %), post-extraction socket size was wider than pre-extraction root trunk width (p < 0.0001). Socket size was a statistically significant predictor for ridge outcome (expansion or collapse compared to stable) (p < 0.01).


Loss of ridge integrity is uncommon, while ridge width expansion is a common finding immediately following tooth extraction. The significance of such expansion compared to integrity of socket walls remains to be established.

Clinical relevance

Tooth extraction approaches that preserve ridge integrity are accompanied by mainly ridge expansion in ridge width. The significance of such immediate changes for the long-term ridge outcomes (i.e., effect on bone remodeling especially in relation to buccal bone integrity) needs further investigation.

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This study was supported by the Division of Periodontology, The Ohio State University. The authors report no conflict of interest.

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Corresponding author

Correspondence to Binnaz Leblebicioglu.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Table A

Initial findings, reason for extraction, and techniques used for extraction. (DOC 1365 kb)

Figure A

Distribution of cases based on ridge width changes (collapse or expansion). (DOC 1368 kb)

Figure B

Distribution of cases based on post-extraction socket size. (DOC 1368 kb)

Figure C

Distribution of cases based on pre-extraction root trunk. (DOC 1368 kb)

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Leblebicioglu, B., Hegde, R., Yildiz, V.O. et al. Immediate effects of tooth extraction on ridge integrity and dimensions. Clin Oral Invest 19, 1777–1784 (2015).

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  • Tooth root
  • Tooth extraction
  • Tooth socket
  • Alveolar process
  • Treatment outcome