Socket shield technique vs conventional immediate implant placement with immediate temporization. Randomized clinical trial

Abstract

Background: Alveolar bone resorption and labial bone plate reduction follow teeth extraction due to the deficiency of blood supply, derived from the loss of periodontal ligaments, and hence the socket shield technique was introduced to preserve the periodontal ligaments related perfusion. Purpose: The study aimed to compare the vertical and horizontal changes of the buccal cortical bone plates, encountered after utilizing the socket shield technique with immediate temporization vs an immediate implant placement with immediate temporization, and analyzing the differences of the implant stability and pink esthetic score evaluation between both techniques. Materials and Methods: A total of 40 dental implants were placed in the maxillary esthetic zone, 20 implants were placed using the socket shield technique with immediate temporization; the study group and 20 implants were placed immediately with immediate temporization; the control group. All patients received immediate and 6 months postoperative CBCT to assess the dimensional changes in the labial bone plates. Implant stability quotients (ISQs) and pink esthetic scores were measured at the time of implant placement and 6 months postoperatively. Results: The horizontal bone loss; ranged from 0 to0.26 (0.15) mm and 0.03 to0.44 (0.32) mm for the study and control groups, respectively. The vertical bone loss; ranged from 0.11 to 0.55 (0.31) mm and 0.25 to 1.51 (0.7) mm for the study and control groups, respectively. The ISQ for the study group increased from 68.6 ± 3.81 to 76.7 ± 3.49, while in the control group it increased from 66.4 ± 5.64 to 75 ± 4.4. PES for the study group increased from 11 to 12, while in the control group it decreased from 13 to 9. Conclusion: The socket shield technique with immediate temporization is a reliable method to reduce the labial bone loss following teeth extraction. However, further studies are required to investigate the effect of grafting the jumping gaps, to evaluate the graft contribution in further reduction of the bone loss.

Socket shield technique: A systemic review and meta-analysis

“…Ahmed 2020 [19] RCT The majority of studies included only the maxillary anterior region; however, three [26,[30][31] also included mandibular anterior sites. Eleven of 16 studies did not report gingiva biotype, while three did not limit the biotype [19,[26][27], and two recruited cases with a thick biotype [18,21]. Eight studies [18,19,20,22,24,26,28,30] accepted light smokers (≤ 10 cigarettes/day).…”

“…A review of the remaining titles, abstracts, and full-texts resulted 16 articles that were analyzed in the present study. There were four RCTs [17][18][19][20], four casecontrol studies (CCSs) [21][22][23][24], and eight retrospective studies (RSs) [25][26][27][28][29][30][31][32].…”

“…A summary of the Cochrane Collaboration assessment of the four human RCTs is presented in Table 2. One study [17] was considered to have a lower risk of bias than the other three [18][19][20]. Among non-RCTs, one CCS [23] and one RS [29] were considered to have a moderate risk of bias, while the other nine were considered to have a low risk of bias (Table 3).…”

“…For studies that only provided the clinical outcome of the SST group, a total of 511 implants (428 patients) were examined, with a maximum follow-up period of 10 years. Eight studies [17][18][19][20][21][22][23][24] that provided comparable clinical data for the SST group and conventional IIP group were included in the meta-analysis: 115 implants (111 patients) in the SST group; and 119 implants (117 patients) in the IIP group.…”

Failure Rate, Marginal Bone Loss, and Pink Esthetic with Socket-Shield Technique for Immediate Dental Implant Placement in the Esthetic Zone. A Systematic Review and Meta-Analysis

“…Dental extractions can cause volumetric changes in bone tissues characterized by the resorption of alveolar bone, especially the buccal bone wall, with a consequent retraction of the related soft tissues. Additionally, multiple-tooth extractions can lead to the loss of the dental papilla [ 1 , 2 ]. Biological mechanisms involved in the healing of the periodontal tissues after tooth extraction can cause the loss of the periodontal ligament and its vascular support [ 3 , 4 ].…”