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Case by Dr Minas Leventis DDS, MSc, PhD (Researcher and Clinical Assistant, Dental School, National and Kapodistrian University of Athens, Athens, Greece) Case originally featured in European Journal for Dental Implantologists, Issue 1/18. Full copy of Case Report available here: https://ethoss.dental/wp-content/uplo.... The thickness of the buccal plate seems to have a significant influence on the amount of horizontal and vertical crestal resorption in human sockets, while the placement of an implant into the extraction socket with simultaneous implementation of bone regeneration procedures is routinely followed in an attempt to limit the resorption process and preserve the architecture of the alveolar ridge. This case highlights the management of an upper central incisor post-extraction site with a defective thin residual buccal plate, where an early implant placement procedure, with simultaneous intentional removal of the residual buccal bone and bone augmentation, was performed. The presence of the defective thin buccal plate will trigger locally an osteoclastic activity in order to be resorbed and removed from the body, as this residual bundle bone has lost its functional support from the root, and its nutrition from the periodontal ligament. So, it can be assumed that this osteoclastic activity will interfere and probably slow down the bone regeneration in the site which is the goal of our treatment. Moreover, this resorbing thin buccal plate will isolate the periosteum from the surface of the bioactive grafting material (EthOss) during the first important stages of healing. An in situ hardening synthetic bone substitute (EthOss) was used successfully according to our research (http://dx.doi.org/10.1155/2015/589135, https://doi.org/10.3390/ma11102004) in order to regenerate high quality stable vital bone on the buccal aspect of the implant and to successfully maintain the architecture of the alveolar ridge. More case studies available at: http://ethoss.dental/case-studies/ For a PDF of EthOss® guidelines go to: http://ethoss.dental/how-to-use/ The views and opinions expressed in this Post are those of the clinician in question and may not reflect the views and opinions of Ethoss Regeneration Ltd. Any claims or messages surrounding the use of EthOss® in this post are strictly in the opinion of the clinician in question.