Comparison of socket-shield technique and routine immediate implantation in anterior maxillary region

doi:10.19438/j.cjoms.2021.06.006

Abstract

Abstract: PURPOSE: To compare the changes in the thickness of labial bone mass and clinical effects between socket-shield technique and routine immediate implant placement in the aesthetic area of anterior maxillary region, and discuss operation details of the socket-shield technique. METHODS: Forty-eight patients were included for immediate implantation between September 2017 to March 2019 in the Affiliated Hospital of Qingdao University. Of them, twenty-six patients underwent routine immediate implantation(RI group), while 22 patients received socket-shield technique(SS group). The follow-up periods were 18-36 months, and the following parameters were employed for comparison: implant success rate, the changes of labial bone plate at 0 mm (I0), 3 mm (I3) and 6 mm (I6) below the shoulder of the implant, the pink aesthetics index(PES) at the last follow-up, gingival sulcus bleeding index and clinical satisfaction. SPSS 25. 0 software package was used for data analysis. RESULTS: The success rate in both groups was 100%. At 6 months and 18 months after operation , the changes of labial bone plate in SS group were lower than those in RI group, with significant difference at I0 and I3. PES score in SS group was higher than that in RI group, but with no significant difference. There was no significant difference in the modified sulcus bleeding index between these two techniques, and both groups obtained high patient satisfaction. CONCLUSIONS: Compared with routine immediate implantation, socket-shield technique maintains bone mass in the labial side of the neck of the implant and soft tissue profile in a short period of time, but has no obvious effect on the success rate. However, these two methods still need long-term clinical observation. It is recommended to prepare root film to the level of the bone surface, with a thickness of about 1 mm,keep a gap of about 1-2 mm on the labial side of the implant and then fill the bone graft material into the defect site. Pitifully, this technique needs highly difficult requirement of clinical procedure.

Key words: Socket-shield technique, Immediate implant, Anterior teeth restoration

CLC Number:

R782.1

YAO Chen-yang, MEI Dong-mei, TENG Min-hua, Xu Hao, WANG Wen-xue, LI Jing, ZHOU Chen, ZHAO Bao-dong. Comparison of socket-shield technique and routine immediate implantation in anterior maxillary region[J]. China Journal of Oral and Maxillofacial Surgery, 2021, 19(6): 511-516.

References

[1] Schropp L, Wenzel A, Kostopoulos L, et al.Bone healing and soft tissue contour changes following single-tooth extraction: a clinical and radiographic 12-month prospective study[J]. Int J Periodontics Restorative Dent, 2003, 23(4): 313-323.
[2] Pietrokovski J, Massler M.Alveolar ridge resorption following tooth extraction[J]. J Prosthet Dent, 1967, 17(1): 21-27.
[3] Araújo MG, Lindhe J.Ridge alterations following tooth extraction with and without flap elevation: an experimental study in the dog[J]. Clin Oral Implants Res, 2009, 20(6): 545-549.
[4] Tortamano P, Camargo LO, Bello-Silva MS, et al.Immediate implant placement and restoration in the esthetic zone: a prospective study with 18 months of follow-up[J]. Int J Oral Maxillofac Implants, 2010, 25(2): 345-350.
[5] Rosenquist B, Grenthe B.Immediate placement of implants into extraction sockets: implant survival[J]. Int J Oral Maxillofac Implants, 1996, 11(2): 205-209.
[6] 王莺, 林野, 陈波, 等. 即刻种植术后牙槽突骨板改建及美学效果评价[J]. 北京大学学报(医学版), 2016, 48(1): 121-125.
[7] Hürzeler MB, Zuhr O, Schupbach P, et al.The socket-shield technique: a proof-of-principle report[J]. J Clin Periodontol, 2010, 37(9): 855-862.
[8] 陈慧鸿, 韦颂观, 庞博, 等. 牙根盾技术在保存前牙区种植体周围软硬组织的研究进展[J]. 中国组织工程研究, 2018, 22(10): 1605-1610.
[9] Fürhauser R, Florescu D, Benesch T, et al.Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score[J]. Clin Oral Implants Res, 2005, 16(6): 639-644.
[10] Bäumer D, Zuhr O, Rebele S, et al.Socket shield technique for immediate implant placement - clinical, radiographic and volumetric data after 5 years[J]. Clin Oral Implants Res, 2017, 28(11): 1450-1458.
[11] Calvo-Guirado JL, Benítez-García JA, Maté Sánchez de Val JE, et al. Socket-shield technique: the influence of the length of the remaining buccal segment of healthy tooth structure on peri-implant bone and socket preservation. a study in dogs[J]. Ann Anat, 2019, 221: 84-92.
[12] Bäumer D, Zuhr O, Rebele S, et al.The socket-shield technique: first histological, clinical, and volumetrical observations after separation of the buccal tooth segment-a pilot study[J]. Clin Implant Dent Relat Res, 2015, 17(1): 71-82.
[13] Nevins ML, Langer L, Schupbach P.Late dental implant failures associated with retained root fragments: case reports with histologic and SEM analysis[J]. Int J Periodontics Restorative Dent, 2018, 38(1): 9-15.
[14] Gluckman H, Salama M, Du Toit J.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[J]. Clin Implant Dent Relat Res, 2018, 20(2): 122-129.
[15] Gluckman H, Du Toit J, Salama M, et al.A decade of the socket-shield technique: a step-by-step partial extraction therapy protocol[J]. Int J Esthet Dent, 2020, 15(2): 212-225.
[16] Du Toit J, Gluckman H.The modified socket-shield technique[J]. J Craniofac Surg, 2018, 29(7): 2005-2006.
[17] Araújo MG, Sukekava F, Wennström JL, et al.Ridge alterations following implant placement in fresh extraction sockets: an experimental study in the dog[J]. J Clin Periodontol, 2005, 32(6): 645-652.
[18] Sun C, Zhao J, Liu Z, et al.Comparing conventional flap-less immediate implantation and socket-shield technique for esthetic and clinical outcomes: a randomized clinical study[J]. Clin Oral Implants Res, 2020, 31(2): 181-191.
[19] 许亚梅, 黄弘, 王黎, 等. 改良盾构术与传统即刻种植术的临床效果对比研究[J]. 华西口腔医学杂志, 2019, 37(5): 490-495.
[20] Chow YC, Eber RM, Tsao YP, et al.Factors associated with the appearance of gingival papillae[J]. J Clin Periodontol, 2010, 37(8): 719-727.
[21] Waki T, Kan JY.Immediate placement and provisionalization of maxillary anterior single implant with guided bone regeneration, connective tissue graft, and coronally positioned flap procedures[J]. Int J Esthet Dent, 2016, 11(2): 174-185.
[22] Smeets R, Henningsen A, Jung O, et al.Definition, etiology, prevention and treatment of peri-implantitis-a review[J]. Head Face Med, 2014, 10: 34-47.
[23] Tan Z, Kang J, Liu W, et al.The effect of the heights and thicknesses of the remaining root segments on buccal bone resorption in the socket-shield technique: an experimental study in dogs[J]. Clin Implant Dent Relat Res, 2018, 20(3): 352-359.
[24] 郑吉驷, 张善勇, 杨驰, 等. 超声骨刀在种植外科的应用效果评价[J]. 中国口腔颌面外科杂志, 2013, 11(2): 140-144.