EC Dental Science

With the revolution in implant dentistry, an increasingly high esthetic demand has produced a challenge when replacing missing teeth in the esthetic zone. Dimensional changes after tooth extraction are compensated for with different socket preservation techniques, and, sometimes, hard and soft tissue augmentations are needed to minimize these hard and soft tissue dimensional changes. A new innovative technique, called the socket shield (SS) technique, was developed to overcome the soft and hard tissue alterations that occur following tooth extraction. In this technique, a buccal root fragment is retained to preserve the blood supply provided from the periodontal ligament to the buccal alveolar bone. This case report will present the clinical and radiographic outcomes of the SS technique with immediate implant placement.

Keywords: Immediate Implant; Partial Extraction Therapy; Socket Preservation; Socket Shield

1. Araújo Mauricio G and Jan Lindhe. “Dimensional Ridge Alterations Following Tooth Extraction. An Experimental Study in the Dog”. Journal of Clinical Periodontology 2 (2005): 212-218.
2. Mauricio G Araújo and Jan Lindhe. “Ridge Alterations Following Tooth Extraction with and without Flap Elevation: An Experimental Study in the Dog”. Clinical Oral Implants Research 6 (2009): 545-549.
3. Belser UC., et al. “Aesthetic Implant Restorations in Partially Edentulous Patients--a Critical Appraisal”. Periodontology 2000 17 (1998): 132-150.
4. Bramanti Ennio., et al. “Postextraction Dental Implant in the Aesthetic Zone, Socket Shield Technique Versus Conventional Protocol”. The Journal of Craniofacial Surgery 4 (2018): 1037-141.
5. Chappuis V., et al. “Ridge Alterations Post-Extraction in the Esthetic Zone: A 3D Analysis with CBCT”. Journal of Dental Research 12 (2013): 195S-201S.
6. Chappuis Vivianne., et al. “Clinical Relevance of Dimensional Bone and Soft Tissue Alterations Post-Extraction in Esthetic Sites”. Periodontology 2000 1 (2017): 73-83.
7. Chen Stephen T and Daniel Buser. “Clinical and Esthetic Outcomes of Implants Placed in Postextraction Sites”. The International Journal of Oral and Maxillofacial Implants 24 (2009): 186-217.
8. Cooper Lyndon F. “Objective Criteria: Guiding and Evaluating Dental Implant Esthetics”. Journal of Esthetic and Restorative Dentistry: Official Publication of the American Academy of Esthetic Dentistry 3 (2008): 195-205.
9. Cutright DE. “The Proliferation of Blood Vessels in Gingival Wounds”. Journal of Periodontology 3 (1969): 137-141.
10. Gluckman Howard., et al. “A Retrospective Evaluation of 128 Socket-Shield Cases in the Esthetic Zone and Posterior Sites: Partial Extraction Therapy with up to 4 Years Follow-Up”. Clinical Implant Dentistry and Related Research 2 (2018): 122-129.
11. Hürzeler Markus B., et al. “The Socket-Shield Technique: A Proof-of-Principle Report: The Socket Shield Technique”. Journal of Clinical Periodontology 9 (2010): 855-862.
12. Huynh-Ba Guy., et al. “Analysis of the Socket Bone Wall Dimensions in the Upper Maxilla in Relation to Immediate Implant Placement”. Clinical Oral Implants Research 1 (2010): 37-42.
13. Januário Alessandro Lourenço., et al. “Dimension of the Facial Bone Wall in the Anterior Maxilla: A Cone-Beam Computed Tomography Study”. Clinical Oral Implants Research 10 (2011): 1168-1171.
14. Lekovic V., et al. “A Bone Regenerative Approach to Alveolar Ridge Maintenance Following Tooth Extraction. Report of 10 Cases”. Journal of Periodontology 6 (1997): 563-570.
15. Lekovic V., et al. “Preservation of Alveolar Bone in Extraction Sockets Using Bioabsorbable Membranes”. Journal of Periodontology 9 (1998): 1044-1049.
16. Mourya Akanksha., et al. “Socket-Shield Technique for Implant Placement to Stabilize the Facial Gingival and Osseous Architecture: A Systematic Review”. Journal of Investigative and Clinical Dentistry4 (2019): e12449.
17. Sáez-Alcaide Luis Miguel., et al. “Socket Shield Technique: A Systematic Review of Human Studies”. Annals of Anatomy = Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft 238 (2021): 151779.
18. Sun Cong., et al. “Comparing Conventional Flap-Less Immediate Implantation and Socket-Shield Technique for Esthetic and Clinical Outcomes: A Randomized Clinical Study”. Clinical Oral Implants Research 2 (2020): 181-191.
19. Tarnow Dennis P., et al. “Flapless Postextraction Socket Implant Placement in the Esthetic Zone: Part 1. The Effect of Bone Grafting and/or Provisional Restoration on Facial-Palatal Ridge Dimensional Change-a Retrospective Cohort Study”. The International Journal of Periodontics and Restorative Dentistry 3 (2014): 323-331.
20. Vera Carolina., et al. “Evaluation of Buccal Alveolar Bone Dimension of Maxillary Anterior and Premolar Teeth: A Cone Beam Computed Tomography Investigation”. The International Journal of Oral and Maxillofacial Implants6 (2012): 1514-1519.