Socket shield technique: A systemic review and meta-analysis

Abstract

The aim of the present study was to evaluate the clinical feasibility of the socket shield technique (SST). Study selection: An electronic search of the PubMed, Cochrane Central Register of Controlled Trials, and Wiley Online Library databases, and a manual reference search for articles published up to September 2020 was conducted. Meta-analysis was performed to estimate marginal bone loss (MBL), changes in buccal bone width (cBBW), pink esthetic score (PES), implant stability quotient (ISQ), implant failure rate, and complication rate between SST and conventional immediate implant placement (IIP). All pooled analyses were based on random effects models. Results: Sixteen relevant studies were ultimately selected by two independent reviewers: four randomized clinical trials (RCTs), four case-control studies, and eight retrospective studies. Meta-analysis revealed a trend toward lower MBL and cBBW and higher PES in the SST group. ISQ, implant failure rate, and complication rate were similar between the groups. Conclusions: The included studies provided evidence that SST may be a feasible treatment option. However, this technique should not be used as a routine clinical protocol due to the lack of evidence-based consensus guidelines, large-scale RCTs, and long-term follow-up data. Therefore, there is an urgent need for well-conducted RCTs in this field.

Application of Biodegradable Magnesium Membrane Shield Technique for Immediate Dentoalveolar Bone Regeneration

“…The socket shield technique (SST) suggests partial root retention on the buccal aspect during tooth extraction with subsequent immediate implant placement [ 3 ]. This technique is technically demanding and time intensive, and the feasibility of SST had yet to established as the potential clinical benefits of SST lack strong scientific evidence [ 4 ].…”

Navigation guided socket‐shield technique for implant and pontic sites in the esthetic zone: A proof‐of‐concept 1‐year prospective study with immediate implant placement and loading

“…19 Nevertheless, it should not be used as a daily-routine clinical procedure due to its technical sensitivity and lack of evidence-based consensus guidelines, and long-term follow-up data. [20][21] Moreover, the socket-shield technique, as all the minimally invasive surgical procedures, due to limited access and view of the operative field, required substantial surgical skills, to carve the buccal and remove the palatal and apical portions of the root, positioning at the same time an implant in the alveolar socket in respect of the surgical and prosthetic requirements. To reduce the risk of root exposure, a socket-shield with smooth margin, free of sharp edges, connected to the bundle bone with a sound periodontal attachment with its vascularization properly maintained, is needed.…”

“…Eighteen patients (6 males and 12 females; mean age 52.54 ± 4.92 years; range 33-72 years) were consecutively enrolled, treated, followed up for at least 1 year after the definitive prosthesis Recently, two systematic reviews with meta-analysis reported on the socket-shield technique. [20][21] Short-term favorable outcomes can be expected in terms of buccal bone plate width and height changes, MBL and esthetic outcomes. Comparable complication and implant failure rates following immediate implant placement with or without socket-shield were reported.…”

“…Comparable complication and implant failure rates following immediate implant placement with or without socket‐shield were reported 19 . Nevertheless, it should not be used as a daily‐routine clinical procedure due to its technical sensitivity and lack of evidence‐based consensus guidelines, and long‐term follow‐up data 20–21 . Moreover, the socket‐shield technique, as all the minimally invasive surgical procedures, due to limited access and view of the operative field, required substantial surgical skills, to carve the buccal and remove the palatal and apical portions of the root, positioning at the same time an implant in the alveolar socket in respect of the surgical and prosthetic requirements.…”

“…11,12 Despite several studies reported acceptable survival rates, a considerable level of technical difficulties were experienced. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] One such difficulty is the attempt to identify tooth root apex while preparing root shield without damaging surrounding socket anatomy by free hand. 32 Furthermore, flap reflection to improve visibility is not advisable to minimize bone resorption.…”