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Video Details
"P.E.T." & Socket Shield - The Technique Beyond the Concept

Description:
This presentation will provide the viewer an in-depth review of a new innovative armamentarium and techniques utilized for "PET" (Partial Extraction Therapies) and specifically Socket Shield approaches for tooth replacement with dental implants. The actual step-by-step design and utilization of each bur and tool will be highlighted as well as a biological rationale supported by current literature and histology. The new Brasseler PET System will be thoroughly reviewed as well as to it's simplicity and effectiveness in contemporary dentistry today.

Date Added:
6/1/2016

Author(s):

David Garber, DMD David Garber, DMD
Dr. David Garber has a dual appointment at the Medical College of Georgia School of Dentistry, in Augusta Georgia, as Clinic...
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Questions & Comments
henry salama - (11/16/2017 3:54 PM)

Actually, the Baumer, publication referenced with the histology is in CIDRR 2013. Baumer et al. also recently published their 5 yr result: Socket Shield Technique for immediate implant placement – clinical, radiographic and volumetric data after 5 years in COIR 2017. There are two main components to the biologic elegance of the technique. One has to do with maintaining "bundle bone", and the other is associated with the maintenance of "supra-crestal fibers" to optimize tooth-like peri-implant tissue. Therefore, if you cut the "shield" down to the crest, you'll at least gain one benefit. If you maintain it 0.5-1 mm supra-crestal, you'll gain both benefits. However, as Paul stated, the supra-crystal placement is more technically challenging and is the reason we utilize a "gingival protector" to do it without raising a flap and maintain a more minimal invasive approach. Not only does it protect the tissue but also helps put a metal background behind the tooth fragment to better differentiate it. Hope that helps.

Paul Botha330 - (11/16/2017 6:07 AM)

Apologies: "The bone crest is a few mm subgingval..."

Paul Botha330 - (11/16/2017 6:06 AM)

Is the Blaumer et al article not 2015? How critical is it that the root segment be level with or below the bone margin? The Blaumer 2015 article histology photos shows the root segment above the crest. I have seen cases of root exposure through the gingiva when removing the healing abutment or crown. If the root segment should be subcrestal or equicrestal then the reflection of a small flap is indicated in order to gain this precision in root fragment reduction as in many instances the bone crest is a few mm subcrestal and the colour match of crestal bone and tooth fragment is very close and it becomes difficult/impossible to evaluate the position of the root fragment with relation to the crest.

Paul Botha330 - (11/16/2017 6:05 AM)

Is the Blaumer et al article not 2015? How critical is it that the root segment be level with or below the bone margin? The Blaumer 2015 article histology photos shows the root segment above the crest. I have seen cases of root exposure through the gingiva when removing the healing abutment or crown. If the root segment should be subcrestal or equicrestal then the reflection of a small flap is indicated in order to gain this precision in root fragment reduction as in many instances the bone crest is a few mm subcrestal and the colour match of crestal bone and tooth fragment is very close and it becomes difficult/impossible to evaluate the position of the root fragment with relation to the crest.

Maurice Salama - (11/12/2017 2:37 PM)

Tom Cassidy, thin tissue and thin labial bone are both perfect indications for PET therapy. Just need to make sure you utilize good techniques and armamentarium to avoid iatrogenic damage. We strongly suggest a hands-on course prior to implementation of this technique in clinical practice. regards Dr. Salama

Tom Cassidy - (11/10/2017 12:37 PM)

Hi Dr Garber I note that both cases shown had a good width and thickness of kertinised tissue. How does a thin gingival biotype respond to the PET technique.

Gary Chike - (9/4/2017 11:36 AM)

Very nice presentation Dr. Garber! And as a dentist who also has a Master's of Science in medical illustration, my compliments to the very clean dental illustrations.

Howard Gluckman - (8/16/2017 3:08 AM)

Great presentation of PET Dave. Love the animations and the fine detail you see and the way you describe everything. It is what makes you one of the best in the world. Lots of love from SA

Curtis Perry - (8/13/2017 10:54 PM)

Thanks for the presentation. This technique solves so many issues but is counter intuitive to the tradition of removing all of the tooth before placement. How do you handle the situation where there is a long root, where you can't remove the apex or most of the tooth? What I try to do is cut the root more buccally so there is 10-15mm of tooth against the buccal wall then splitting the lingual piece and removing that with the apex. It is difficult to do and I have modified what I did previously which is to leave the apex as hollowed out as possible which doesn't seem to have caused any issues. Thanks for your reply

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