Partial Extraction Therapy for Implant Placement: A Newer Approach in Implantology Practice

Abstract

One of the most popular treatment modalities in routine implantology practice is extraction followed by immediate or delayed implant insertion. Teeth removal alone is insufficient, particularly in the maxillary anterior region of the jaw. Patients may experience several issues after tooth extractions. Due to trauma and the loss of periodontal ligaments, post-extraction alveolar ridge resorption cannot be prevented. Atraumatic extraction, socket preservation, grafting, and implant placement immediately after the extraction are some of the procedures that are carried out to minimize or prevent the resorption of alveolar bone. Osseointegration is essential for keeping the clinical effectiveness of dental implants. If the supporting tissues at an implant site resorb and are worsened by risk factors for recession, there may be considerable esthetic and functional failure. Implant placement at the retained root structure preserves the buccal bone resulting in an excellent emergence profile. Resorption in the posterior alveolar ridge may result in a decrease in attached keratinized tissue and a decrease in vestibular depth. This might have a negative impact on the stability of the implant and leads to peri-implantitis resulting in the failure of the implant. Without papilla loss or arch collapse, partial extraction therapy has resulted in effective esthetic outcomes. The socket shield technique is a minimally invasive surgical procedure that helps to maintain both soft and hard tissues by preserving a small section of the root. It lessens the necessity for surgeries on bone and mucogingival grafts, cutting the length of the overall recovery process and reducing the treatment time. When soft and hard tissue grafts are used to fill the socket before applying pressure with pontics, it is known as the pontic shield procedure. However, there is no published study that explains partial extraction therapy in a straightforward and clear manner that can guide a practitioner in determining a shield design with a proven track record of success. This review article focuses on the partial extraction procedure which is very helpful for preserving soft and hard tissues in cases involving immediate implant insertion postextraction. It has long-term therapeutic success with implant and pontic therapy. This review article will also be helpful for clinicians to understand shield design in different case scenarios and help to learn stepwise procedures carried out in partial extraction therapy.

Immediate Loaded Post Extraction Implant and Connective Graft-Guided Bone Regeneration: A Case Report

“…Various investigations have revealed a loss of up to 50% in bone resorption width, as well as a decrease in height of 2-4mm, or an average of 1.24mm. However, this resorption process is highly unpredictable (2).…”

Aesthetic and Functional Objectives and Surgical Techniques of Soft Tissue Augmentation Around Dental Implants

“…Vestibular gingival recession 1 year after implant placement 2.1Для решения проблем с объемом мягких тканей вокруг имплантатов используются лоскуты на ножке и свободные трансплантаты.Лоскуты на ножке: 1) вращающиеся лоскуты: a) латеральный скользящий лоскут; b) косой вращающийся лоскут; c) перемещенный лоскут; 2) смещенные лоскуты: a) коронально смещенный лоскут; b) полулунный коронально смещенный лоскут. Свободные трансплантаты: 1) СДТ (эпителизированный); 2) ССТ (деэпителизированный).Сохранение мягких и твердых тканей для последующей установки имплантатаДля минимизации резорбции твердых и мягких тканей после удаления зуба применяются следующие методы лечения[13,11]:  сохранение гребня;  консервация лунки;  непосредственная имплантация;  ортодонтическая экструзия перед удалением зуба. На каждом этапе лечения работа с мягкими тканями направлена:  на модификацию дизайна лоскутов и методов наложения швов;  аугментацию КД: a) увеличение ширины КД; b) увеличение толщины десны (биотипа).…”