Feb 22, 2021
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In episode 56 of the Dental Digest Podcast Dr. Mark Bishara will discuss partial extraction therapy (PET) or the socket-shield technique. This is a technique in implant dentistry in which the anterior portion of the root is left in the socket. This root becomes part of the osteotomy site (the site where you place the implant). This enables the final implant to achieve a more esthetic outcome.
Typically when the tooth is lost through extraction, the buccal bone resorbs away. This resorption occurs because once the root is extracted, the associated PDL and blood supply leave with the tooth. Once this is lost, the bundle bone (and then eventually the buccal plate) are lost. However, if part of the tooth can be maintained, the associated bone which would normally be lost, is retained. This "tricks" the body into thinking that the tooth is still there. Thus leaving some of the bone behind so a more esthetic outcome can be achieved.
Bone grafting is of course costly, time consuming and inconvenient for the patient. What's more, grafts come with a risk of infection or failing to integrate. At times, their outcome can be unpredictable which can be especially problematic if the patient is esthetic-conscious. To complicate matters further, grafting the buccal plate can be challenging when there isn't a pronounced defect to graft to. The benefit of PET is that it may make it so that a bone graft isn't necessary.