Effectiveness of the socket shield technique in dental implant: A systematic review

Abstract

Purpose: Dental implant therapy is a common clinical treatment for missing teeth. However, the esthetic result is not as satisfactory as expected in some cases, especially in the anterior maxillary area. Poor esthetic results are caused by inadequate preparation of the hard and soft tissues in this area before treatment. The socket shield technique may be an alternative for a desirable esthetic outcome in dental implant treatments. Study selection: In the present systematic review, PubMed-Medline, Google Scholar, and ScienceDirect were searched for clinical studies published from January 2000 to December 2018. Results: Twenty studies were included, comprising one randomized controlled trial, two cohort studies, 14 clinical human case reports, and three retrospective case series. In total, 288 patients treated with the socket shield technique with immediate implant placement and follow-up between 3-60 months after placement were included. A quality assessment showed that 12 of the 20 included studies were of good quality. Twenty-six of the 274 (9.5%) cases developed complications or adverse effects related to the socket shield technique. Most studies reported implant survival without the complications (90.5%); most of the cases that were followed up for more than 12 months after implant placement achieved a good esthetic appearance. The failure rate was low without the complications, although there were some failures due to failed implant osseointegration, socket shield mobility and infection, socket shield exposure, socket shield migration, and apical root resorption. Conclusions: The socket shield technique can be used in dental implant treatment, but it remains difficult to predict the long-term success of this technique until high-quality evidence becomes available.

Failure Rate, Marginal Bone Loss, and Pink Esthetic with Socket-Shield Technique for Immediate Dental Implant Placement in the Esthetic Zone. A Systematic Review and Meta-Analysis

“…Blaschke and Schwass published a systematic review without meta-analysis and highlighted promising outcomes for the socket-shield technique; however, they also mentioned the limited data available related to well-designed prospective randomized controlled studies, which tend not to report the long-term outcomes for the socket-shield technique [ 27 ]. Ogawa et al also published a systematic review without meta-analysis and reported 90.5% implant survival and a low failure rate [ 28 ]; however, the present study only showed 1.37% implant failure.…”

Navigation guided socket‐shield technique for implant and pontic sites in the esthetic zone: A proof‐of‐concept 1‐year prospective study with immediate implant placement and loading

“…19 Nevertheless, it should not be used as a daily-routine clinical procedure due to its technical sensitivity and lack of evidence-based consensus guidelines, and long-term follow-up data. [20][21] Moreover, the socket-shield technique, as all the minimally invasive surgical procedures, due to limited access and view of the operative field, required substantial surgical skills, to carve the buccal and remove the palatal and apical portions of the root, positioning at the same time an implant in the alveolar socket in respect of the surgical and prosthetic requirements. To reduce the risk of root exposure, a socket-shield with smooth margin, free of sharp edges, connected to the bundle bone with a sound periodontal attachment with its vascularization properly maintained, is needed.…”

“…Comparable complication and implant failure rates following immediate implant placement with or without socket‐shield were reported 19 . Nevertheless, it should not be used as a daily‐routine clinical procedure due to its technical sensitivity and lack of evidence‐based consensus guidelines, and long‐term follow‐up data 20–21 . Moreover, the socket‐shield technique, as all the minimally invasive surgical procedures, due to limited access and view of the operative field, required substantial surgical skills, to carve the buccal and remove the palatal and apical portions of the root, positioning at the same time an implant in the alveolar socket in respect of the surgical and prosthetic requirements.…”

Dimensional Changes in the Alveolus after a Combination of Immediate Postextraction Implant and Connective Grafting and/or Socket Shield Technique

“…SST is relatively recent, and the current literature mainly presents articles about the performance of the technique and its modifications but little evidence of its long-term predictability [ 32 , 46 , 47 , 48 , 49 ].…”

“…However, this finding is deemed anecdotal by the authors since the expected reduction in crest height occurred one year after placement of the immediate implant (between −0.19 and −0.82 mm), irrespective of the type of technique employed (SST or CTG; p > 0.05). Nevertheless, a comparison of our results with those published in the literature is complicated due to the lack of published data and the existing disparity regarding methodology and results depending on with which other technique SST is compared [ 48 , 49 ]. According to some authors, SST has similar efficiency to immediate implants without a graft in the prevention of horizontal and vertical bone resorption [ 32 ].…”