P.E.T for Molars = YES or NO ?

25 Rating(s).


Posted on By ashok gowda In Implants

Dear XP Clinicians, its a 3 months old healing of a molar site P.E.T ( upper second molar) after Densah sinus lift. Even after considering the challenges of P.E.T surgical procedure in molar area, this kind of result is always promising. So i always says YES, whenever its possible and required. Regards, Ashok.




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18 Comments

4 wks healing


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Mini flap


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Endo ultrasonic tip


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Countouring of the shield
Densah lift


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Post OP 3 months


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Hi Ashok,

It's looking good, but with the amount of buccal bone, thick biotype, and having the mesial and distal adjacent teeth intact, I would have gone for a simpler full extraction protocol.

Can't see the benefits of a PET in a molar site when you have this anatomy.

Besides you have 7mm to the sinus only, and if the mesial aspect of the implant is against the root, perhaps with no bone attachment, that leaves you with less integrated titanium surface.

I think a classic approach here would work phenomenally well.

But keep us updated on this one!

Thanks


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Hi Andoni, thanks for your valuable comment, i agree. I had the same opinion like you few years back, and even now for few cases.

Some times i used to create a crack line or fracture the buccal bone of grossly decayed or R.C. treated molars during extraction, and that used to create a decent amount of buccal bone collapse. Hence i started practicing this technique, and its working. Now with in limits i always take a chance to retain the buccal shield of teeth irrespective of the existing buccal bone and tissue biotype. If i cannot succeed, then as you said i will extract the tooth and go conventional. Regards. Ashok.

(Hope Jorge and Chuck will come to my rescue, lol )


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Ashok. I love it! I don't understand the rational to electively remove any healthy viable tissue just because "you may get away with it" or because it has been done that way mindlessly for decades. You never know what the future holds regarding the adjacent teeth. One thing we know for sure is removal of PDL = loss of bone. Not to mention possible sinus exposure or loss of large buccal plates along with the extracted tooth. I can and dose happen occasionally. Why risk extraction or go out of your way to remove perfectly healthy tissues? Best regards. Chuck


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Thanks Chuck, i really appreciate your advise. Regards, Ashok.


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very nice, couldn't tell was grafting used in the gap or just PRF


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Thanks James, its just P.R.F. Regards. Ashok


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I say YES but skill level and experience needed here. Well done. Dr. S


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I Totally agree. Regards. Ashok


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