A vast number of factors influence the success of implant treatment. Case selection, assessment and diagnosis, treatment planning and execution must all be optimised if patients are to enjoy functional, aesthetic, and long-lasting results. In more complex cases, clinicians often have to manage unfavourable hard or soft tissue conditions before an implant can be safely and effectively placed. The application of appropriate techniques can accelerate healing, enhance implant stability, and ensure predictable and durable outcomes. With adequate training and experience, clinicians have several procedures to call upon.
Partial extraction therapy
Partial extraction therapy combines a number of surgical techniques to enhance the post-extraction socket environment for successful implant placement. It aims to preserve a slice of the tooth in the bone in order to minimise loss of bone and ligament attachment and reduce the remodelling and resorption of hard and soft tissue after extraction. It often combines versions of the socket shield technique, radicular burial technique, pontic shield technique, and proximal socket shield technique.[i]
When utilised by experienced hands, this approach delivers excellent mechanical, biological, and aesthetic outcomes.[ii] Research has demonstrated that 91% of implants survive without complications, and that good aesthetic results are achieved at least 1 year post-operatively. A low failure rate has also been recorded after 10 years.[iii] The key is detailed assessment and meticulous planning, ensuring any potential complications are mitigated from the very beginning.
PRF / PRGF
Platelet-Rich Fibrin (PRF) has been used in implant surgery for some time as a way to improve secondary implant stability for increased longevity and survival.[iv] It is an autologous material, derived from the patient’s own blood at the time of surgery, which contains a combination of fibrin matrix, platelets, leukocytes, and more to support tissue regeneration. The technique has been shown to support healing of the surgical site post tooth extraction,[v] as well as enhancing the amount of keratinised tissue present for greater soft tissue health and thickness.[vi]
Plasma-Rich Growth Factors (PRGF) are an alternative solution, also shown to promote soft tissue health and reduce post-operative symptoms.[vii] Another autogenous blood-derived solution, PRGF differs from PRF in how it is prepared, meaning it releases growth factors more rapidly after placement.
Both techniques improve outcomes by accelerating healing, so it’s important that clinicians understand the indications for each to ensure appropriate case selection.[viii]
Augmentation procedures
A growing body of literature evidences the benefits of augmentation procedures when treating edentulous patients. For example, research supports that dehiscence and fenestrations can be effectively addressed with guided bone regeneration (GBR) at the time of implant placement, resulting in high survival rates. It also shows good outcomes when a staged GBR approach is taken to treat horizontal and vertical bony defects.[ix]
Soft tissue grafting is also associated with improved surgical results as it is found to significantly reduce marginal bone loss and vestibular recession, in addition to increasing periodontal tissue volume around an implant.[x] Aesthetic outcomes are also improved, with a 2.2mm reduction in peri-implant soft tissue dehiscence reported following soft tissue augmentation with a coronally advanced flap.[xi]
Building a solid armamentarium
This is not an exhaustive list of the clinical skills required, but it does demonstrate some of the techniques that need to be understood when approaching more complex implant cases. To offer them to patients, clinicians must first undergo comprehensive training in the field, acquiring the relevant knowledge and practical abilities to effectively manage treatment from start to finish.
Finding the right programme that covers a wide enough range of topics is important for those wanting to advance their skills in a meaningful way. A combination of hands-on and theoretical teaching is vital, as is the availability of mentorship and ongoing support from a faculty of highly experienced clinicians. One to One Implant Education provides a number of courses, including the PG Diploma in Advanced Techniques in Implant Dentistry, led by expert practitioners in implant dentistry and oral surgery. Across nine modules, attendees cover everything from the science of regeneration to GBR techniques, soft tissue augmentation procedures, sinus lifts, full-arch reconstruction, and so much more. The evidence-based teaching is supported by invaluable one-to-one mentorship, affording confidence that clinicians receive a truly comprehensive education.
Refining implant success
Predictable and long-lasting implant outcomes rely on many factors. The clinician can optimise the chance of success with careful case selection, assessment, and planning, utilising the vast, evidence-based surgical techniques available to minimise the risk of complications and optimise implant stability, function, and aesthetics. The result is longer-lasting implants and happy patients – which is the ultimate objective for any dental treatment.
To reserve your place or to find out more, please visit
https://121implanteducation.co.uk or call 020 7486 0000.
Author: Dr Fazeela Khan-Osborne
[i] Carvalho BM, Oliveira HSFS, Pereira OS, Viana SFA. Partial extraction therapies (PET): a review of the literature. RGO, Rev Gaúch Odontol. 2024;72:e20240001. http://dx.doi.org/10.1590/1981-86372024000120200113
[ii] Shaheen, Rakan Saifuddin1,. Partial extraction therapy: A review of the clinical and histological human studies. International Journal of Preventive and Clinical Dental Research 8(1):p 16-19, Jan–Mar 2021. | DOI: 10.4103/ijpcdr.ijpcdr_2_21
[iii] Al Moaleem MM, Abdulrab AMM. Khan HK, Khawaji AH, Mawkili LK, Faris SH, Alsam SM, Alalmaie NI, Eschwi HIA. On the ten-year success in the application of partial extraction therapy; A systematic review. Bioscience Biotechnology Research Communications. 14(4); Oct-Dec 2021. doi: http://dx.doi.org/10.21786/bbrc/14.4.10
[iv] Tabassum S, Raj SC, Rath H, Mishra AK, Mohapatra A, Patnaik K. Effect of platelet rich fibrin on stability of dental implants: A systematic review and meta-analysis. Int J Health Sci (Qassim). 2022 Sep-Oct;16(5):58-68. PMID: 36101844; PMCID: PMC9441650.
[v] Al-Maawi S, Becker K, Schwarz F, Sader R, Ghanaati S. Efficacy of platelet-rich fibrin in promoting the healing of extraction sockets: a systematic review. Int J Implant Dent. 2021 Dec 19;7(1):117. doi: 10.1186/s40729-021-00393-0. PMID: 34923613; PMCID: PMC8684569.
[vi] Giammarinaro E, Baldini N, Covani U, Menini M, Pesce P, Marconcini S. Does platelet-rich fibrin enhance the outcomes of peri-implant soft tissues? A systematic review. BMC Oral Health. 2025 Apr 22;25(1):615. doi: 10.1186/s12903-025-05922-6. PMID: 40264081; PMCID: PMC12016366.
[vii] Dragonas P, Schiavo JH, Avila-Ortiz G, Palaiologou A, Katsaros T. Plasma rich in growth factors (PRGF) in intraoral bone grafting procedures: A systematic review. J Craniomaxillofac Surg. 2019 Mar;47(3):443-453. doi: 10.1016/j.jcms.2019.01.012. Epub 2019 Jan 17. PMID: 30711470.
[viii] Acerra A, Caggiano M, Chiacchio A, Scognamiglio B, D’Ambrosio F. PRF and PRP in Dentistry: An Umbrella Review. J Clin Med. 2025 May 6;14(9):3224. doi: 10.3390/jcm14093224. PMID: 40364255; PMCID: PMC12072518.
[ix] Milinkovic I, Cordaro L. Are there specific indications for the different alveolar bone augmentation procedures for implant placement? A systematic review. Int J Oral Maxillofac Surg. 2014 May;43(5):606-25. doi: 10.1016/j.ijom.2013.12.004. Epub 2014 Jan 19. PMID: 24451333.
[x] De Angelis P, Manicone PF, Rella E, Liguori MG, De Angelis S, Tancredi S, D’Addona A. The effect of soft tissue augmentation on the clinical and radiographical outcomes following immediate implant placement and provisionalization: a systematic review and meta-analysis. Int J Implant Dent. 2021 Aug 26;7(1):86. doi: 10.1186/s40729-021-00365-4. PMID: 34435229; PMCID: PMC8387538.
[xi] Nart J, Valles C, Vilarrasa J, Romano F, Baima G, Aimetti M. Impact of soft tissue augmentation procedures on esthetics and patient satisfaction in the treatment of peri-implant buccal soft tissue dehiscences: A systematic review and meta-analysis. Periodontology 2000. 2025;00:1-19. doi:10.1111/prd.12633
