Allograft with Calcium Sulfate or the Socket Shield technique: Which is the Best Socket Technique?

Sun, 06/13/2010 - 09:44 — Misch Follower

I just got back from the Boston IJPRD meeting and have more questions then answers. It seems like there is a trend of leaving behind root tips for pontic sites as David Garber presented or now there is the Socket Shield that the Swiss are doing. The socket shield consists of leaving behing the facial aspect of the tooth being extracted and placing the implant in the bone behind it. They claim that the implant withh get bone and cementum on the surface and you will loss less bone in the socket. Anyone doing this? As for my socket technique, I am currently placing allograft material in my extraction sites. I use mineralized cortical bone from CK dental or 3i with Calcium Sulfate (dentogen or calmatrix) mixed in. I place calium sulfate on top of the socket as well. I am getting very good results. What is the best technique to graft a socket? Are there any other potential methods that are better than this technique? What are the thoughts of the socket shield vs calcium sulfate for socket grafts? TY

Comments

Sat, 06/19/2010 - 16:03 — Dr. X

Socket grafting with Calium sulfate

I use calcium sulfate as an enhancer to bind my graft material. I also place on top of the socket as the soft tissue loves it and it grows right over it.

Sat, 06/19/2010 - 16:04 — Dr. X

What is a socket shield?

I am unfamiliar with it and cant find anything in pubmed. Can anyone explain?

Tue, 06/22/2010 - 06:29 — Steve Wilson

Socket Shield: Not much info

The way I understand it is you need the thin shell of the buccal aspect of the root to act as a shield to prevent resorption and place the implant in the bone behind it.

The theory is that you will get bone and cementum on the implant.

Int J Oral Maxillofac Implants. 1990 Summer;5(2):113-6.

Titanium implants with a true periodontal ligament: an alternative to osseointegrated implants?
Buser D, Warrer K, Karring T, Stich H.

Department of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts 02115.

Abstract
The purpose of the present study was to experimentally determine if cementum formation with inserting collagen fibers can be accomplished on dental implants. Titanium implants were placed in the mandible of monkeys, where apical root portions were retained. The histologic examination of undecalcified sections revealed that a cementum layer on the implant surface with inserting collagen fibers was achieved around implants placed in close relationship to retained roots; however, implants without contact to retained roots demonstrated the typical findings of osseointegration. These results demonstrate that dental implants with a true periodontal ligament can be accomplished.

PMID: 2133335 [PubMed - indexed for MEDLINE]

Fri, 06/25/2010 - 20:28 — Mental Foramen