GBR vs PET

225 Rating(s).


Posted on By Isaac Tawil In Implants

43 Year old female fractured upper right central.
GBR with Igen membrane, fuse abutment, and immediate temp followed.

6 months later upper left central was deemed non restorable. PET/SS technique was employed. Note at the time of 2nd surgery recession of soft tissue around upper right central.

Patient was much happier with SS cosmetic. CTG was needed on area of deficiency utilizing VISTA technique.

4 year post op reveals steady outcome. Pt still members trauma of GBR and CTG compared to simplicity of PET/SS technique.




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26 Comments

Post op


Reply

Just great documentation and comparison! Thanks for sharing. Maurice


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Thank you DR S. I'm grounded with the new baby at home. I'll have more posts soon.


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Isaac
Very nice in both sites.
I think difficult to compare a labial defect which needed repair with a site that had no defect---unless you are saying the removal of the tooth caused the defect ?
With the socket shield approach you are eliminating the chance of causing a defect .

Thanks for sharing!

Emil


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Isaac. Fantastic case! Clearly demonstrates the value of PET. My experience with patients who have previously placed implants is similar to yours. They see, feel and truly appreciate the advantage of PET vs traditional extraction / GBR implant therapy. In addition, the PET for implant #9 not only helped avoid a potential disaster for #8, but also contributed to the augmentation process. Thank you for sharing such a significant case for discussion. Best regards. Chuck


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Thank you Chuck. I couldn't agree more. I know just how much fan of this technique you are. I've started using it in molars with great success when I saw your post.
Regards
-isaac


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Emil good question. The buccal bone on #8 was extremely thin and removal of the tooth created the defect. We were able to rebuild to more than 2mm of buccal bone and the initial gingival result was acceptable but demised over time as often does in these cases. We avoided the same scenario on #9 by employing the PET/SS technique. The case is now 4 years old. My only regret was not using the PET/SS technique on #8 initially but 4 years ago I was not so confident that the technique would be successful in my hands. Currently I am treating most cases with the PET/SS technique.
best wishes
-isaac


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Super case . I think more and more of us are seeing the same outcomes over time and the benefits of the SS technique are becoming more evident. Its time for a structured multicentre study to add validation to clinical findings.


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Great case. Do you perhaps have a post op CBCT. I think that would be invaluable in this case. to push the point home.

well done


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Thabk you Howie. I do have CBCT Ppst op I'll post whenI get home from work today.


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Taken at 2 separate post ops. Ill send then updated 4 yr post shortly.


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Isaac,
it is a great and very didactive case!
An observation add can be made here:
patient went through 3 surgical procedures and a long period of therapy time and appointements on tooth #11
On PET #12 case, just one single step procedure, conservative and predictable in terms of healing.
I believe we should all work to change the paradigm shift.
Thanks for sharing.
Armando


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Thank you Armando. I couldn't agree more.


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Isaac great case, great comparison and experience of your patient! All in one. A case that really compares the evolution of a regular GBR and the neighbor PET-.
I would like to share at MADRID JTI2016 this case, of course addresing is yours. Wouldn´t you mind?
Regards.
Jorge


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Jorge- Of course my friend. I will send you the keynote copy. email me at iketawil@mac.com. I will be showing this case as well in rominai SSER/ECAD.


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Thanks my friend. I´ll write you now!
Jorge


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Isaac:

The best aspect of this post is the fact that it does bring in the patient perspective. We all tend to look pass it sometimes. PET has allowed you to create more with less for your patient. Great case documentation.
We should all collect our PET cases as well as our osseodensification cases and organize them for a case series publications under the XP umbrella.
Salah


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Salah - thats a great idea. I will be happy to assist.


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Salah, Isaac, Jorge, Allesandro, Chuck, Howie and others....a Organized Clinical paper by those who frequent this BOARD would be well received and probably the 1st of it's kind in Implant Dentistry. It would take a group of dedicated individuals and I believe we have those on XP.
Dr. S


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Maurice:
I will circulate protocol drafts with a spread sheet to be filled by all in this posts and others. IMO, we should include cases with restoration completed and a minimum of 6 months to 48 months follow up. I would respectfully would lead the OD documentation and would need a volunteer to lead the PET documentation. This can be the first international multicenter documentation of this magnitude. Chuck and Jorge, please let me know your thoughts.
Anyone who would like to participate in Osseodensification and/ or PET case series documentation, please email me to shuwais@versah.com.

Salah


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I would like to be a part of this global study! Great idea!
Snjezana


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Mo. As you mentioned previously, this could be a future avenue for clinical study. In some ways this could be more relevant than controlled studies, because it will give insight of what can be expected on a daily basis in the "real world". Count me IN! Chuck


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I would be happy to contribute. I did this yesterday!

Before and after ct's should be part of the study.

Emil


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PET & Oseodensification gentlemen. I think it´s a good idea to gather together our clinical expirience on this fields.
I want to be in in this party.
We´re doing something new that it´ll become relevant for our Implantology comunity.
Jorge


Reply

Great case documentation and outcome for both techniques. You can not consider comparing these two cases they do not start from the same point. The labial wall defect changes the calculus of the comparison. Ultimately, if the labial wall was intact, you may still have needed the CTG. But that is the reason we are all looking into PET as anew standard of care. NICE WORK


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How is the Fuse abutment different than other plastic abutments. What do you cement your immediate temporary crowns with? Thanks.


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