Socket Shield Technique and Immediate Implant Placement – A Systematic Review

Abstract

Purpose: A novel method, socket shield technique (SST), preserving the peri-implant tissue dimensions by retaining the buccal aspect of root was published by Hurzeler et al in 2010. Our study aims to compare the clinical and radiographic outcomes between conventional immediate implantation and socket shield technique (SST) based on prospective clinical trials. Also, we will discuss the different protocols and modifications of the socket shield technique. Material and methods: A PubMed, Cochrane Library, Embase database search was conducted to identify relevant publication up to March 2022. Result: 7 articles were included in our systemic review. The follow-up periods of the included literature ranged from 6 months to 4 years and contained 106 cases of socket shield technique (Test group) and 112 cases of conventional immediate implantation technique (Control group). None of the implants failed to have osseointegration. The horizontal bone loss at the crestal area in test group and control group ranged from 0.12~0.29mm and 0.29~1.45mm half a year post-operatively on CBCT, respectively. On the other hand, the vertical bone loss in test group and control group ranged from 0.28~0.36mm and 0.77~1.71mm half a year after operation on CBCT. All the results showed the socket shield techniques had less tissue alterations compared to the conventional immediate implantation with statistical significance. The overall Pink Esthetic Score (PES) of the test group (Socket shield technique) in the included studies ranged from 12.0 to 13.25 postoperatively, comparing to those ranging from 8.85 to 12.60 for the control group. Conclusion: All the included clinical trials showed promising results of socket shield technique in respect of less bone and soft tissue volume changes than the conventional immediate implantation. However, it is still unclear whether the socket shield technique will provide a stable long-term outcome in this stage.