Australasian Dentist Magazine Nov Dec 2021

Category 86 AustrAlAsiAn Dentist D ental implants have proved to be a reliable dental treatment to replace failing or missing teeth. Although the survival of dental implants is high, the esthetic results in the anterior zone are challenging due to resorption of the bundle bone after extraction. this can lead to bone loss and thus soft tissue resorption, thereby leading to improper esthetics. One technique to counteract this resorption is partial extraction therapy, also known as socket shield or the root membrane technique. in this case, the root is not fully extracted. instead, the palatal part of the root is sectioned from the labial part and removed, while the labial part of the root remains in the alveolar bone. Follow-up research up to 10 years shows high survival rates that are similar to single tooth replacement. However, the technique is quite difficult to perform. When incorrectly sectioned, the labial part of the root can also be luxated, in which case the technique will fail. therefore, with this surgical case, the author aims to confirm the value of using a guide for sectioning the root. A 62-year-old male patient (healthy, non-smoker, no history of periodontitis) is referred to the practice of the author because the crown of tooth 12 is fractured at the gingival level. Due to a lack of ferrule, the root is failing and the patient requests a dental implant and single crown. in anterior cases, the author always starts with information gathering for a treatment plan. in this case, intra-oral pictures, a CBCt-scan, and intraoral scan. this information is then uploaded into the r2Gate program by MegaGen implant Company for a correct diagnosis. this case is suitable for partial extraction therapy since the root has no signs of infection. to section the root up to the apex, a guide is made. Also, a normal surgical guide and temporary PMMA crown cemented on a titanium base are manufactured before surgery. the patient receives pre-operative amoxicillin 2 grams and analgesia Root Membrane Technique liniCal Dr Irfan Abas By Dr Irfan Abas Fig 1. Initial situation Fig 3. Fractured root visible Fig 5. Root guide in place Fig 7. Small opening up to the apex Fig 9. Palatal part of the root is elevated Fig 2. Planning in R2GATE Fig 4. Two guides Fig 6. Narrow straight diamond drill to the apex Fig 8. Root sectioned in mesial distal direction Fig 10. Palatal part of the root removed