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

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.