According to recent guidelines, if a facial bony plate is lost during extraction socket grafting, the clinician should:

The correct answer is to place a barrier membrane and graft the socket when a facial bony plate is lost during extraction socket grafting. This approach is important because the barrier membrane serves several critical functions.

Firstly, it helps to prevent soft tissue from invading the grafted area, which is essential for allowing the bone to regenerate properly. The barrier membrane acts as a physical separator, maintaining the space necessary for the osteogenic cells (bone-forming cells) to populate the grafted area without interference from soft tissue.

Secondly, when a facial bony plate is compromised, the structural integrity of the socket is affected, and grafting alone without any protective barrier could lead to complications such as graft failure or loss of the grafted material.

By utilizing a barrier membrane along with the graft material, it enhances the chances of successful bone healing and regeneration, thus preserving the graft and supporting future dental implant placement. This method is consistent with established best practices in implant dentistry that emphasize the importance of protecting the graft area from potential complications involving soft tissue infiltration.