Partial Extraction Therapy in Implant Dentistry

✍ Scribed by Udatta Kher (editor), Ali Tunkiwala (editor)

• Publisher: Springer
• Year: 2020
• Tongue: English
• Leaves: 416
• Category: Library

✦ Synopsis

This book covers all clinical aspects of partial extraction therapy (PET), a revolutionary technique that offers long-term stability of soft and hard tissue around implants. Readers will find step-by-step protocols, valuable insights, and helpful tips, backed by the best available scientific evidence. After explanation of the biological rationale for PET, the socket shield technique, which entails partial extraction of the tooth root prior to implant placement, is clearly described and illustrated. Guidance is then provided on case selection, contraindications, and fabrication and design of the provisional restoration. Variations in the PET procedure are explained, and techniques presented for the management of multirooted teeth, pontic sites, and full mouth rehabilitation. Advice is also offered on how to deal with complications and treatment failures. Finally, the current evidence for PET and the scope for extending its use are reviewed. PET has gained immense popularity in recent years, and this book will be of value for clinicians, students, and academicians.

✦ Table of Contents

Foreword
Foreword
Preface
Contents
1: Biologic Rationale for Partial Extraction Therapies
1.1 Introduction
1.1.1 Alveolar Bone
1.1.2 Development of the Alveolar Bone
1.1.3 Alveolar Bone Proper
1.1.4 Bundle Bone
1.2 Partial Extraction Therapies
1.3 Histological Evidence in PET Describing the Fate of the Root Fragment
1.4 Conclusion
References
Suggested Reading
2: Surgical Technique for Socket Shield Procedure
2.1 Introduction
2.2 Diagnostic Tools
2.3 Guidelines for Shield Preparation
2.3.1 Armamentarium
2.3.2 The Step by Step Procedure
Step 1: Sectioning of the Root
Step 2: Preparation of the Shield
Step 3: Implant Placement
Step 4: Management of the Gap
Step 5: Closure
2.3.3 Step by Step Protocol
2.4 Troubleshooting
2.5 Conclusion
References
3: Case Selection and Risk Assessment for PET
3.1 Introduction
3.2 Case Selection
3.2.1 Clinical Assessment
Lip Line
Tooth Position and Free Gingival Margin
Gingival Biotype
Scallop of Gingival Margin and Tooth Shape
Interproximal Height of Bone
Infection at Implant Site
Available Restorative Space
3.2.2 Radiological Assessment
3.3 Indications
3.4 Contraindications
3.5 Relative Contraindications
3.6 Conclusion
References
4: Provisional Restorations in Partial Extraction Therapy
4.1 Introduction
4.1.1 Designing Provisional Restorations
4.2 Principles of Design
4.2.1 Socket Shield Cases
4.2.2 Pontic Shield/Root Submergence Cases
4.2.3 Techniques for Making a Provisional Restoration
4.3 Technical Considerations for Cement-Retained Provisionals
4.3.1 Technique
4.4 Provisional Restorations for Adjacent Implant Sites
4.5 Technical Considerations for Screw-Retained Provisional Restorations
4.5.1 Direct Method
Temporary Cylinder with Resin Build Up
Temporary Cylinder with Patients Own Tooth/Existing Restoration
4.5.2 Indirect Method for Making Screw-Retained Provisional Restorations
4.6 Conclusion
References
5: PET for Multirooted Teeth
5.1 Introduction
5.2 PET for the Maxillary First Molar
5.2.1 Case Selection
Indications
Contraindications
5.2.2 Step by Step Procedure
5.3 PET Case for the Maxillary First Molar
5.4 PET for the Mandibular Molar
5.5 PET for the  Maxillary First Premolar
5.6 PET Case for Two Maxillary Premolars
5.7 Conclusion
References
6: Variations of the Socket Shield Procedure
6.1 Introduction
6.2 Socket Shield Procedure for Maxillary Canines
6.2.1 Case 1
6.2.2 Case 2
6.3 Socket Shield for a Fenestration Defect
6.3.1 Case 3
6.4 Adjacent Teeth Socket Shields
6.4.1 Case 4
6.4.2 Case 5
6.5 C-Shaped Shield
6.5.1 Case 6
6.6 Staged Socket Shield Procedure (GLOCKER’S Technique)
6.6.1 Surgical Technique
6.6.2 Case 7
6.7 Conclusion
References
7: Pontic Site Management
7.1 Introduction
7.2 Root Submergence Technique
7.3 RST Timeline
7.3.1 Indications
7.3.2 Contraindications
7.3.3 Clinical Considerations
Armamentarium
7.4 Surgical Technique
7.5 Cases
7.5.1 Case 1
7.5.2 Case 2
7.5.3 Case 3
7.6 RST Complications and Management
7.6.1 Root Exposure
Cause
Prevention
Management
7.6.2 Infection
Cause
Prevention
Management
7.6.3 Migration of the Root
Cause
Prevention
Management
7.7 Case
7.8 Pontic Shield
7.8.1 Evolution of Pontic Shield Technique
7.8.2 Indications for Pontic Shield Technique
7.9 Pontic Shield: Surgical Technique
7.10 Cases
7.10.1 Case 1
7.10.2 Case 2
7.10.3 Case 3
7.10.4 Case 4
7.10.5 Case 5
7.11 Conclusion
References
8: PET for Multiple Teeth and Full-Arch Implant-Supported Reconstructions
8.1 Introduction
8.2 Challenges in Multiple Sites Treated with PET
8.3 Case 1
8.3.1 Phase 1: Socket Shields and Tooth-Supported Provisional Restorations
8.3.2 Phase 2: Pontic Shield, Root Submergence Technique, and Implant-Supported Provisional Restorations
8.3.3 Phase 3: Definitive Restoration
8.4 Case 2
8.5 Case 3
8.6 Conclusion
References
9: Definitive Restorations in Partial Extraction Therapy
9.1 Introduction
9.2 Technical Considerations
9.2.1 Cement-Retained Restorations
Abutments
9.2.2 Screw-Retained Restorations
Material Considerations
9.3 Clinical Considerations for Implant Impressions
9.3.1 Conventional Impression Techniques
9.3.2 Digital Impressions
9.3.3 Direct Impressions with ‘One–Time’ Abutment Concept
9.4 Fast Tracking Protocol for Implants in the Aesthetic Zone
9.5 Conclusion
References
10: Errors and Complications in Partial Extraction Therapy
10.1 Introduction
10.2 Diagnostic Errors
10.2.1 Errors in Assessment of Root Condition
Root Length
Caries Status
Periodontal Status
Infection in Existing Teeth
External Resorption
Vertical/Oblique Fracture
10.2.2 Errors in Assessment of the Radial Position of the Tooth
10.2.3 Errors in Assessment of Buccal Bone Morphology
10.3 Surgical Errors/Complications
10.3.1 Errors in Shield Preparation
Shield Thickness
Inadequate Length of the Shield
Root Apex Left Behind
Incorrect Shield Shape
Damage to Proximal Bone Walls During Shield Preparation
10.3.2 Shield Mobility
10.3.3 Apical Fenestration
10.3.4 Palatal Wall fracture
Management of the Perforated Palatal Wall
10.3.5 Shield-Implant Proximity
Shield and Implant are in Physical Contact
There is a Very Large Gap Between the Shield and the Implant
10.3.6 Lack of Implant Stability
Soft Tissue Invagination into a Staged Socket Shield Site
10.4 Complications in Restorative Phase
10.4.1 Shield Mobility
10.4.2 Shield Migration
10.4.3 Shield Exposure
Internal Shield Exposure Management with Connective Tissue Graft (CTG)
Management of External Shield Exposure
Management of External Shield Exposure in Lower Cuspid and Bicuspid
10.4.4 Infection
Implant Failures in SS
Implant Failure and Shield Removal
10.5 Conclusion
References
11: Visual Essays of Clinical Cases
11.1 Introduction
11.2 Case 1: Single Upper Incisor with Socket Shield and Immediate Placement
11.3 Case 2: Single Lower Incisor with Socket Shield and Immediate Implant Placement
11.4 Case 3: Single Implant with Mid Treatment Complication and its Management
11.5 Case 4: Single Canine in Maxillary Arch. Socket Shield with Immediate Placement
11.6 Case 5: Single Implant with Socket Shield in Upper Incisor Along with Esthetic Buccal Flap to Remove the Apical Infection
11.7 Adjacent Implants in Aesthetic Zone with Socket Shield
11.7.1 Case 6: Adjacent Incisors PET with Overall Enhancement of Smile
11.7.2 Case 7: Adjacent Lower Incisors
11.7.3 Case 8: Adjacent Implants in Maxillary Anterior Region
11.7.4 Case 9: Multiple PET and Implants with Smile Design in Maxillary Anterior Region
11.8 Socket Shield/Pontic Shield/Root Submergence in Maxillary Anterior Region
11.8.1 Case 10: Socket Shield in #12 and #21 and Pontic Shield in #11
11.8.2 Case 11: Socket Shield and Root Submergence in Maxillary Posterior Quadrant
11.8.3 CASE 12: Pontic Shield with Multiple Adjacent Socket Shield in Aesthetic Zone
11.8.4 CASE 13