Comparing conventional flap‐less immediate implantation and socket‐shield technique for esthetic and clinical outcomes: A randomized clinical study

Abstract

Objective:The aim of this study was to assess the esthetic and clinical outcomes of immediate implantation using the conventional flap-less approach and the socketshield technique (SST).Methods: This study included 30 adult patients who underwent anterior teeth replacement and fulfilled the pre-defined criteria. Patients were randomly allocated to the SST (n = 15) and conventional flap-less (control, n = 15) groups. The esthetic outcomes were evaluated by assessing the degree of soft-tissue recession and the pink esthetic scores (PESs). Clinical parameters, including the modified plaque index, modified sulcus bleeding index (mSBI), probing depth (PD), and implant stability quotient (ISQ), were assessed. The buccal plate width (BPW) and height (BPH) were also measured.Results: Implantation was clinically successful for all subjects in both groups. With a similar baseline, the SST group exhibited less reduction in the midfacial mucosal margins and the height of the mesial and distal papillae as well as higher BPW and BPH values compared with the control group (p < .001). The ISQ values were 76.01 ± 1.31 for the SST group and 75.56 ± 1.07 for the control group (p > .05), suggesting sufficient initial stability in both groups. At the 24-month follow-up, SST group patients had statistically significant lower values of PD, mSBI, and mPLI compared with the control group. There were no significant differences in the overall and individual PES values for both groups.Conclusion: SST may improve functional and esthetic outcomes by maintaining alveolar bone volume and peri-implant tissues. SST seems to be a promising treatment approach for implants in the esthetic zone. K E Y W O R D S alveolar bone, esthetic outcome, immediate implant, pink esthetic score, restoration S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section. How to cite this article: Sun C, Zhao J, Liu Z, et al. Comparing conventional flap-less immediate implantation and socketshield technique for esthetic and clinical outcomes: A randomized clinical study. Clin Oral Impl Res. 2020;31:181-191. https ://doi.

Comparison of the soft and hard peri‐implant tissue dimensional changes around single immediate implants in the esthetic zone with socket shield technique versus using xenograft: A randomized controlled clinical trial

“…Similarly, Bramanti and colleagues 18 reported a mean PES of 12.15 in a randomized clinical trial after a 3‐year follow‐up period. This was also confirmed by Sun and colleagues 29 who reported mean PES of 12.2 after 12 months following immediate implant placement with the socket shield technique. The xenograft group yielded a mean PES of 11.86 in the present study.…”

“…The xenograft group yielded a mean PES of 11.86 in the present study. Similarly, Sun and colleagues 29 reported a mean PES of 11.5 after 12 months following immediate implant placement and grafting the jumping gap with xenograft. Moreover, Bramanti and colleagues 18 reported a mean PES of 11.05 6 months following conventional immediate implant placement with simultaneous grafting of the buccal gap with allograft.…”

“…Correspondingly, Huynh‐Ba and colleagues 32 found a mean of midfacial mucosal recession 1 year following immediate implant placement of 0.44 mm. Recently, Sun and colleagues 29 found 1.09 mm midfacial mucosal recession in the xenograft group 6 months following immediate implant placement and provisionalization. The greater amount of midfacial mucosal recession could be attributed to the inclusion of implant sites with a thin gingival biotype with a greater amount of midfacial mucosal recession.…”

“…Also, Nguyen and colleagues 36 observed minimal horizontal ridge alterations of 0.1 mm in a case series of 3 patients after 2–6 years following immediate implant placement with the socket shield technique. Moreover, Sun and colleagues 29 demonstrated buccal vertical and horizontal bone resorption of 0.28 mm and 0.22 mm respectively 6 months following implant placement. While the xenograft group showed a mean change in the buccal (I‐C) and (I‐OS) distance of 1.71 mm and 1.45 mm (46.24%), respectively, 6 months following implant placement.…”

“…On the other hand, Bäumer and colleagues 28 observed midfacial mucosal recession of 0.33 mm in a 5‐year retrospective case series of 10 patients. Also, Sun and colleagues 29 found that the socket shield group yielded a mean midfacial mucosal recession of 0.59 mm 12 months after immediate implant placement with the socket shield technique. These higher rates of the midfacial mucosal recession could be related to the inclusion of implant sites with thin gingival biotype in these studies.…”