SOCKET-SHIELD TECHNIQUE VERSUS CONVENTIONAL IMMEDIATE IMPLANT PLACEMENT IN THE MAXILLARY ESTHETIC ZONE: A RANDOMIZED CONTROLLED CLINICAL TRIAL

Abstract

Some changes in facial bone and soft tissue contour, and reduced esthetic outcomes, can be associated with immediate implant placement in the esthetic zone. This randomized clinical trial involved 100 patients who needed to replace a single tooth in the maxillary esthetic zone (METZ), and the socket-shield technique was compared to conventional immediate implant placement. A total of 50 participants were randomly divided into the socket-shield group and conventional immediate implant placement group, and followed for 12 months. The main outcome was the presence of horizontal bone loss, and secondary outcomes were vertical bone loss, midfacial recession, Pink Esthetic Score, implant stability, probing depth, patient satisfaction, postoperative complications, implant survival, and clinical success. The horizontal bone loss was significantly less in the socket-shield group compared to the conventional group at 12 months (0.26 ± 0.11 mm vs 0.69 ± 0.16 mm; p < 0.001). Also significantly reduced were vertical bone loss and midfacial recession. The socket-shield group reported higher Pink Esthetic Scores and patients' higher satisfaction level, while no difference was found in implant stability, probing depth or implant survival between groups. The implant survival rates were 98% and 98% for the two groups, with clinical success rates of 96% and 88%, respectively. There were 6% socket-shield cases that were shield exposed. The socket-shield technique resulted in better preservation of peri-implant hard and soft tissues, better esthetic outcomes and did not affect implant survival.