Partial Extraction Therapy in Implant Dentistry

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