Mukesh Soni

Mukesh Soni

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Mukesh Soni
Mukesh Soni
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Can someone help me identify these dental implants. Completed in Sri Lanka two years ago TIA

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Mukesh Soni
Mukesh Soni
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Socket Shield Complication: This is one of my first Socket Shield cases back in 2011. I did not use CBCT scan for this case and this was a big mistake, because I could not make good measurements and I was not able to notice that the root had much more prominence than I thought. So I forgot/ was not able to remove all the rootfilling material. The problem was that clinical symptoms of infection started 1 year after insertion of the definitive crown! The patient came for her regular checkup in 2013 and suddenly I could probe a 10mm deep pocket at the mid-buccal, also I could notice some loss of papillary height and swelling of the cervical tissue at the buccal. The patient did not feel any pain and was not aware of the changes. I could also feel some mobility of the shield, so I had to remove it. I performed a flap, removed the shield. There was a 3-wall defect. ( I was lucky that there was a tiny thin buccal plate left. Notably: it was not a circumferential defect like a peri-implantittis.So I could try a regenerative procedure and keep the implant. I cleaned the implant surface as good as possible with Airflow and H2O2 + saline and filled the gap with BioOss granules. I used a CTG ( Zucchelli style) and closed the flap with 6-0 monofilament. The healing went uneventful, but the result after 4 weeks was a distaster. I instructed the patient to clean with a apico-coronal brushtechnique and told her to have patiënce. Every 3 months I saw her back and I noticed changes in the tissue ; It was creeping coronally! It took some years, but the situation is now accaptable again The lessons I learned from this case: -never ever again do a socket shield without CBCT diagnostics. -Soft tissue has the potential to improve and grow over time, so always use CTG in a resque treatment

What great honesty. And yes while i agree PET/socket shield is an option, but it is not for the faint hearted me thinks. Be careful very careful and p... Read more

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