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Zhang X, Zhao L, Li L, Wang J. Self-designed surgical guides for accurate socket shield preparation: An in vitro evaluation supported by a clinical report. J Prosthodont 2024; 33:436-442. [PMID: 37688431 DOI: 10.1111/jopr.13768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/27/2023] [Accepted: 09/06/2023] [Indexed: 09/10/2023] Open
Abstract
PURPOSE To achieve accurate socket shield preparation with newly proposed guides that are based on guiding rails and to investigate the effect of rail format (unilateral or bilateral) and rail height on the accuracy and efficiency of the guides. MATERIALS AND METHODS Two surgical guides based on grooved rails to guide the rotary instruments were produced. The first guide was used to cut the root into a labial shield with a pre-designed form and a lingual one, while the second guide was used to reduce the socket shield to the alveolar bone crest. The CBCT and intraoral scan data were first obtained and superimposed using the software. After isolating the root which would be used as a socket shield, grooved rails were designed on two separate guide templates according to the chosen rotary instruments to obtain a labial shield with a pre-designed form. An in vitro study was then conducted based on four cases in each group to determine the accuracy, efficiency, and optimal parameters of the guides, which was then verified with a clinical report. Comparisons between groups were performed with a one-way analysis of variance (ANOVA, for comparison between multiple groups) and the Student-Newman-Keuls test (for comparison between two groups). RESULTS With these two guides, the root can be divided into two pieces, including a palatal one and a labial one with a pre-designed form within a short time. Guide templates with bilateral rails more than 7 mm in height and those with unilateral rails 9 mm in height significantly increased the surgery accuracy, showing accurate shield preparation and decreased bone injury. Moreover, the guides with bilateral rails of more than 5 mm significantly decreased the surgery time for shield preparation. The presented case further verified the accuracy and efficiency of the guides. CONCLUSIONS The newly proposed guides can help to accurately prepare the socket shield, resulting in long-term stability of peri-implant tissues. Moreover, bilateral guiding rails with a height of 7-9 mm are recommended in such a guided socket shield surgery.
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Affiliation(s)
- Xin Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Linxiao Zhao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Lei Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Jian Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
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Lin X, Zhang Z, Huang Y, Deng F, Xu R. Unconventional Dental Implant Placement Through an Impacted Maxillary Central Incisor in Stable Contact With Enamel and Dentin: A Case Report. J ORAL IMPLANTOL 2024; 50:190-194. [PMID: 38660752 DOI: 10.1563/aaid-joi-d-24-00043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
When edentulism is accompanied by an impacted tooth, conventional treatment usually involves traumatic tooth extraction, which would inevitably destroy the surrounding alveolar bone and cause unfavorable esthetics, especially for anterior teeth. Recently, implant placement through the impacted tooth or residual root has been proposed as an alternative to invasive extraction. A particular type of integration has been observed between dentin/cementum and titanium implant, while enamel-implant contact has not been reported. In this article, an implant was placed through the impacted maxillary central incisor, thereby avoiding an invasive extraction surgery. The buccal section of the tooth, including crown enamel, was retained in situ for buccal alveolar ridge preservation. The follow-up results were satisfactory, and a stable enamel-implant contact was observed. Combining with previous similar studies, this technique opens intriguing possibilities and brings fresh insight for the concept of dentointegration. More histological and clinical studies with long-term follow-up are warranted before endorsing this technique in routine application.
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Affiliation(s)
- Xiaoxuan Lin
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Zhengchuan Zhang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Yaohong Huang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Feilong Deng
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Ruogu Xu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
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Shinde A, Madhav VNV, Saini RS, Gurumurthy V, Binduhayyim RIH, Mosaddad SA, Heboyan A. Finite element analysis of stress distribution on residual root structure in socket shield procedure following immediate dental implant placement: an in vitro study. BMC Oral Health 2024; 24:366. [PMID: 38515128 PMCID: PMC10958881 DOI: 10.1186/s12903-024-04133-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 03/11/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND The success of implants in the socket shield technique relies on stress experienced by root fragments within the socket. Although there is no consensus on optimal root fragment thickness, varying thicknesses and dynamic implant placement induce stress in various directions and degrees. This study aimed to assess biomechanical response and stress distribution across different root fragment thicknesses in the socket shield procedure. METHODS This in vitro study was conducted to assess and compare the stress distribution on residual root structures of varying thicknesses positioned within the labial aspect of the maxillary incisor socket during immediate implant placement of standard dimensions. The procedure involved applying an insertional torque of 40 Ncm, and the analysis was conducted using finite element analysis software. RESULTS Utilizing the Numerical Technique with Abaqus software for explicit dynamics, von Mises stress and principal strain were analyzed on the root structure and bone under nonlinear contact conditions during implant torque application. For Model A, a loading torque of 40 Ncm was applied vertically on the implant, along with a horizontal force of 20 N on the root structure and bone. Results indicated maximum stress of 12.68 MPa on the root structure with a thickness of 0.5 mm and 5.61 MPa on the bone, with principal strains of 6.82E-03 and 4.10E-03, respectively. In Model B, with a root structure thickness of 1.0 mm, the maximum stress increased to 19.70 MPa, while the bone stress rose to 9.51 MPa, with principal strains of 1.03E-02 and 6.09E-03. Model C, with a root structure thickness of 1.5 mm, exhibited a maximum stress of 21.58 MPa on the root and 10.12 MPa on the bone, with principal strains of 1.16E-02 and 6.10E-03. Lastly, in Model D, with a root structure thickness of 2.0 mm, the maximum stress on the root structure and bone escalated to 28.74 MPa and 11.38 MPa, respectively, with principal strains of 1.55E-02 and 8.31E-03. CONCLUSIONS As the thickness of the shield increases (ranging from 0.5 to 2 mm) in socket shield procedures with immediate implant placement, both stress on the root fragment and bone and principal micro-strain escalate. However, employing a shield thickness within the range of 0.5 to 2 mm does not lead to any adverse stress generation on the residual root fragment. However, for enhanced safety, it is recommended to restrict the maximum diameter and extension of the root fragment to 1.5 mm when considering implant sizes and socket diameter for the socket shield technique.
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Affiliation(s)
| | - V N V Madhav
- Department of Prosthodontics, YCMM and RDF's Dental College & Hospital, 166/1, Vadgaon Gupta, Opp MIDC, Ahmednagar, Maharashtra, 414003, India
| | - Ravinder S Saini
- Department of Dental Technology, COAMS, King Khalid University, Abha, Saudi Arabia
| | | | | | - Seyed Ali Mosaddad
- Department of Research Analytics, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospitals, Saveetha University, Chennai, India.
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Qasr-e-Dasht Street, Shiraz, Iran.
| | - Artak Heboyan
- Department of Research Analytics, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospitals, Saveetha University, Chennai, India.
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Str. Koryun 2, Yerevan, 0025, Armenia.
- Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
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Shadid RM. Comparing Dual-Zone Immediate Implant Placement and Socket Shield Technique for Ridge Width Changes in the Maxilla: A Prospective Cohort Study. Clin Cosmet Investig Dent 2022; 14:321-336. [PMID: 36439194 PMCID: PMC9699660 DOI: 10.2147/ccide.s390131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 11/16/2022] [Indexed: 09/07/2023] Open
Abstract
PURPOSE The aim of this prospective cohort study was to assess the facial-palatal ridge dimensional changes that occurred at 8-10 months following flapless dual-zone (DZ) immediate implant placement and socket-shield (SS) immediate placement in the maxilla. MATERIALS AND METHODS A total of 19 patients who received 20 implants were included, with 10 implants (MegaGen AnyRidge) placed for each treatment, DZ and SS. Cast models were made at 8-10 months after implant placement to assess the dimensional ridge changes by measuring the facial-palatal ridge width on implant sites (T) at six designated points starting from the gingival margin (0, 1, 2, 3, 5 and 7) and comparing it with the corresponding measurement on the contralateral tooth site (C). RESULTS All 20 implants demonstrated successful osseointegration at 8-10 months follow-up (survival rate 100%). Two out of ten cases of SS group presented with minor manageable complications of external shield exposure. DZ group showed an average of 0.3 mm facial-palatal ridge width reduction, while SS group revealed a mean gain in ridge width of approximately 0.2 mm at 8-10 months follow-up. CONCLUSION When comparing between two treatments, there was a significant difference in ridge width change at 8-10 months following implant placement, indicating better preservation of the ridge contour for socket shield technique.
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Affiliation(s)
- Rola Muhammad Shadid
- Department of Prosthodontics, Faculty of Dentistry, Arab American University, Jenin, Palestinian Territory
- Private Practice, Palestine, Palestinian Territory
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Verma V. Is socket shielding an option in esthetic region? J Oral Biol Craniofac Res 2022; 12:662-665. [PMID: 36052117 DOI: 10.1016/j.jobcr.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 10/05/2021] [Accepted: 08/10/2022] [Indexed: 11/28/2022] Open
Abstract
The implant cannot preserve the surrounding bone from resorption when placed in the extraction socket. After teeth extraction, a change in the bony architecture of the anterior region makes oral rehabilitation difficult by an implant. This leads us to explore such a critical issue and the relevant data were collected from Pubmed, Google Scholar, and Cochrane database and reviewed. Socket shielding technique is intentional retention of the buccal segment of root fragment during the implant placement in the extraction socket. Socket shielding is an effective procedure in minimizing the buccal bone resorption along with minimizing the buccal contour changes it is minimally invasive as the bone graft is optional thus reducing the cost of the treatment procedure. The limited studies were available to support the routine clinical use of the socket shielding technique. Socket shielding seems to become the non-invasive technique for the preservation of hard and soft tissue by dental implant especially in the esthetic zone in the future. Therefore studies should be carried out on a large population to obtained more précised results related to the socket shielding technique.
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Affiliation(s)
- Varsha Verma
- Department of Prosthodontics & Crown and Bridge, People's Dental Academy
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Immediate implant placement with socket shield technique in the maxilla: a prospective case series evaluation at 1-year follow-up. Head Face Med 2022; 18:17. [PMID: 35689246 PMCID: PMC9185963 DOI: 10.1186/s13005-022-00324-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 05/23/2022] [Indexed: 11/20/2022] Open
Abstract
Background The aims of this case series were to investigate the clinical, radiographic, implant success, complication incidence, esthetic, and patient-reported outcomes of 10 immediately placed implants associated with the socket shield technique at 12 months post-loading and to assess the ridge width changes that occurred at 8 months following implant placement. Methods A total of 10 patients received 10 socket shield immediate implants (MegaGen AnyRidge). At 8 months postimplantation, casts were made to assess the ridge width changes by measuring the ridge width at the implant sites and comparing them with the corresponding measurements at the contralateral tooth site. At 12 months post-loading, clinical indices, marginal bone loss, pink esthetic score, and patient-assessed outcomes were evaluated. The mean, standard deviation and median were calculated for all continuous variables. Results All implants demonstrated a 100% success rate, while 2 implants presented with external shield exposure that was managed successfully. The mean marginal bone loss was 0.08 ± 0.14 mm mesially and 0.21 ± 0.23 mm distally. Esthetic evaluation yielded an average modified pink esthetic score of 8.65. A mean gain of 0.17 mm in the facial-palatal ridge width was recorded at 8 months postimplantation. Conclusions The socket shield technique enhanced the functional and esthetic results by preserving the alveolar bone and peri-implant soft tissues. However, this is a sensitive technique and still needs more robust evidence before it can be recommended for everyday clinical practice.
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Root Membrane Replantation as an Alternative Technique for the Socket Preservation. Case Rep Dent 2022; 2022:7455050. [PMID: 35548384 PMCID: PMC9085336 DOI: 10.1155/2022/7455050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/20/2022] [Accepted: 04/06/2022] [Indexed: 11/17/2022] Open
Abstract
Background and Overview. Socket shield is a technique that allows the maintenance of tissue volumes. In the reported clinical case, the replantation of the buccal root fragment mistakenly extracted during a socket shield surgery is performed. We present a follow-up to 5 years with an unexpected healing.Case Description. An 88-year-old patient underwent an immediate loading implant placement associated with the replantation of the mistakenly extracted root fragment. The shaping of the fragment was performed extraorally, and the replantation was done so that the fragment protruded above the crest margin.Conclusions and Practical Implications. The 5-year follow-up shows an uneventful healing of the implant. At 48 months, postoperative CBCT exam reports images compatible with the regeneration of the bone over the portion of root that protruded over the margin. The outcome suggests clinical implications, as the opportunity to easily shape the fragment extraorally and replant sound portion of the root (not necessary the buccal) in buccal socket with bone defect.
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8
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Shadid RM. Socket shield technique and delayed implant placement in maxilla: a series of five case reports. BMC Oral Health 2022; 22:110. [PMID: 35382808 PMCID: PMC8985256 DOI: 10.1186/s12903-022-02149-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background Tooth extraction is often followed by remodeling of hard and soft tissues, while socket shield technique has been proposed to prevent or minimize this remodeling. Socket shield accompanied with delayed implant placement is a novel technique that could be used when delayed implantation is selected; however, more scientific based evidence is required to recommend this technique as everyday clinical practice. Thus, the aim of this case series was to assess the clinical, radiographic, and esthetic outcomes of the delayed placed implants associated with previously prepared socket shield at 3–15 months follow-up after loading. The stability of the shield and the depth of soft tissue penetration palatal to the shield at reentry of 3–6 months were also assessed.
Cases presentation Five case reports of socket shield with delayed implant placement were described in the study. The facial shields were prepared and simultaneously the sockets were grafted with mineralized allograft particles, then the implants were placed 3–6 months later. Periodontal probe was used to measure the depth of soft tissue penetration palatal to the shield at reentry. Clinical indices of bleeding index, plaque index, and probing depths were recorded. Radiographic evaluation to record the amount of marginal bone loss post-loading, esthetic assessment using modified pink esthetic score, and patient assessed outcomes were also evaluated at 3–15 months follow-up after loading. At 3–6 months reentry, all shields were stable with maintenance of the facial bone and with extreme hard tissue formation in the sockets. All five implants were successful and functional without any pain or inflammation, with optimal soft tissue health and esthetics, and with minimal radiographic marginal bone loss at the last follow-up visit (3–15 months after loading). Conclusions Within the limits of this study, socket shield technique with delayed implant placement could be a predictable minimally invasive option for cases requiring delayed implant placement; however, a long-term well-designed clinical proof is warranted.
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Affiliation(s)
- Rola Muhammed Shadid
- Department of Prosthodontics, Faculty of Dentistry, Arab American University, Jenin, Palestinian Territory, 240 Jenin. .,Prosthodontist, and Implantologist at Private Practice, Tulkarm, Palestinian Territory.
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Dimensional Changes in the Alveolus after a Combination of Immediate Postextraction Implant and Connective Grafting and/or Socket Shield Technique. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052795. [PMID: 35270486 PMCID: PMC8910222 DOI: 10.3390/ijerph19052795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 02/20/2022] [Accepted: 02/23/2022] [Indexed: 12/10/2022]
Abstract
Immediate implant placement protocols after dental extraction have enabled a reduction in surgical phases. This procedure has increased patient satisfaction and similar survival rates to late implant placement procedures. However, placing an implant immediately after dental extraction does not counteract the physiological remodeling of alveolar bone. For this reason, additional surgical techniques have been developed, such as the placement of a connective tissue graft (CTG) or the socket shield technique (SST). Dimensional changes in the peri-implant tissues were observed after placement of immediate implants following the extraction and CTG and/or SST. A total of 26 surgical interventions were carried out in which dimensional change variables of peri-implant tissues were analyzed. The preoperative state and immediate postoperative situation were compared with the situation after one year. Measurements were taken at 3, 5, and 7 mm from the gingival margin and analyzed in this CBCT radiological study (Planmeca Promax 3D). The implant platform was used as a reference point for the measurement of changes in alveolar crest height. One year after performing either of the two techniques (CTG and/or SST), a significant increase in the gingiva thickness and vestibular cortex occurred at 5 mm (0.65 ± 1.16 mm) and 7 mm (0.95 ± 1.45 mm) from the gingival margin. Additionally, an increase in thickness of palatal bone was registered at 3 mm (0.48 ± 0.90 mm). The graft placement group showed an increase in thickness of peri-implant tissue in the vestibular area after one year, although CTG and SST groups were clinically similar. The implementation of SST revealed promising results regarding the buccal thickness of hard and soft tissues after one year. A significant increase in vestibular cortical bone thickness, as well as the overall mucosa thickness and buccal bone at 3 mm from the gingival margin, was observed. A significant reduction in the distance from the bone crest to the platform was detected in both techniques. Both techniques (CTG and SST) are appropriate to provide sufficient volume to peri-implant tissues in the vestibular area of anterior maxillary implants. Some limitations were detected, such as the lack of an aesthetic analysis or small sample size, so results should be interpreted with caution. Future studies are necessary to further evaluate the long-term predictability of these techniques.
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Wang Z, Liu J, Wang X, Wang N, Teng M. Effect of CAD/CAM Guide Plate Combined With Socket-Shield Technique in Immediate Implantation of Anterior Teeth Aesthetic Area and Its Influence on Aesthetics. Front Surg 2022; 8:833288. [PMID: 35145994 PMCID: PMC8821654 DOI: 10.3389/fsurg.2021.833288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 12/22/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study is to discuss the effect of computer-aided design or computer-aided manufacturing (CAD/CAM) guide plate combined with socket-shield technique (SST) in immediate implantation of anterior teeth aesthetic area and its influence on aesthetics. Methods A total of 102 patients with immediate implantation in our hospital from March 2017 to March 2020 were selected. According to different repair methods, patients were divided into conventional group (n = 51) and observation group (n = 51). Traditional immediate implantation was performed in conventional group. The observation group underwent immediate implantation with CAD/CAM guides combined with SST. Immediately after operation and 12 months after operation, the success rate, implant deviation, periodontal index, absorption of labial bone plate, complications, aesthetic effects, and satisfaction of the two groups were observed. Results There was no significant difference in the success rate between the two groups (p > 0.05). The implant deviation values in the observation group were all lower than those in the conventional group (p < 0.05). PD, PLI, and SBI in the observation group were all lower than those in the conventional group (p < 0.05). The absorption value of labial bone plate in the observation group were all lower than those in the conventional group (p < 0.05). The total incidence of complications in the observation group (5.88%) was lower than that in the conventional group (19.61%) (p < 0.05). The PES and WES in the observation group were higher than those in the conventional group (p < 0.05). The total satisfaction in the observation group (92.16%) was higher than that in the conventional group (76.47%) (p < 0.05). Conclusion : The application of CAD/CAM guide plate combined with SST in immediate implantation of anterior teeth aesthetic area has a good effect, which can improve the accuracy of implantation, improve the periodontal environment, reduce bone resorption, reduce complications, improve aesthetics, and have high patient's satisfaction.
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Affiliation(s)
- Zhigang Wang
- Department of Stomatology, Zibo Central Hospital, Zibo, China
| | - Jianwei Liu
- Department of Stomatology, People's Hospital of Changle County, Weifang, China
| | - Xinquan Wang
- Department of Stomatology, Rizhao Traditional Chinese Medicine Hospital, Rizhao, China
| | - Ning Wang
- Department of Stomatology, Zibo Central Hospital, Zibo, China
| | - Min Teng
- Department of Stomatology, Tengzhou Central People's Hospital, Zaozhuang, China
- *Correspondence: Min Teng
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Pozzi A, Arcuri L, Kan J, Londono J. 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. J ESTHET RESTOR DENT 2022; 34:203-214. [PMID: 34994995 DOI: 10.1111/jerd.12867] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 12/29/2021] [Accepted: 12/30/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess clinical, radiological performance of novel navigation guided socket-shield technique (NSS) with immediate implant placement and loading. MATERIALS AND METHODS Eighteen patients (12 females; age 52.54 ± 4.92; 33-72) treated between January 2018 and June 2019, were investigated, and followed for at least 1 year after definitive prosthesis placement (mean 20.1 months, 18-23). Primary outcomes: implant and prosthetic success rates, surgical, biologic, prosthetic complications. SECONDARY OUTCOMES marginal bone loss (MBL), implant stability quotient (ISQ), pink esthetic score (PES), plaque and bleeding indexes. RESULTS Sixty-nine navigation guided socket-shield procedures were performed (27 implant-sites and 42 pontic-sites) and 27 implants (NobelParallel, NobelBiocare AG) positioned and immediately loaded. Mean insertion torque and ISQ at implant positioning were 49 ± 5.34 Ncm (36-74), 73 ± 5.72 (68-81). No implant failure was experienced. Two root-shield exposures with mucositis, ulceration and bleeding were reported at two pontic-sites (2.9%) and successfully treated. No complications were experienced at implant-site leading to an overall NSS success-rate of 100%. No prosthetic complications occurred. Mean MBL was -0.72 ± 0.26 mm (-0.42 to -1.06 mm). PES final at the last follow-up 12.84 ± 0.92. The plaque and bleeding scores were 18.5 ± 6.12 and 3.15 ± 2.21. CONCLUSIONS Within study limitations, dynamic navigation was effective to streamline execution of socket-shield technique at implant and pontic sites, shortening treatment time and reducing complications. Navigation guided socket-shield technique was reliable to achieve digitally planned shield-to-implant distance, facilitate immediate implant placement and loading and establish the mucosal dimension needed for underlying bone-to-implant protection and esthetic integration. CLINICAL SIGNIFICANCE The investigated NSS technique overcomes the difficulties related to root preparation at implant and pontic-sites, facilitating immediate implant placement and loading. Dynamic guided surgery contributed to make socket-shield technique less technical-sensitive, shortening time for execution, reducing complication rate.
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Affiliation(s)
- Alessandro Pozzi
- Department of Restorative Sciences, Augusta University, Goldstein Center for Esthetic and Implant Dentistry, Augusta, Ga, USA
| | - Lorenzo Arcuri
- PhD Materials for Health, Environment and Energy, University of Tor Vergata, Rome, Italy
| | - Joseph Kan
- Advanced Dental Education Program in Implant Dentistry, School of Dentistry, Loma Linda University, Loma Linda, California, USA
| | - Jimmy Londono
- Goldstein Center for Esthetic and Implant Dentistry, Department of Restorative Sciences, The Dental College of Georgia at Augusta University, Augusta, Ga, USA
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Oliva S, Capogreco M, Murmura G, Lupi E, Mariachiara DC, D’Amario M. The socket shield technique and its complications, implant survival rate, and clinical outcomes: a systematic review. J Periodontal Implant Sci 2022; 53:99-109. [PMID: 36468475 PMCID: PMC10133821 DOI: 10.5051/jpis.2201780089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 06/23/2022] [Accepted: 07/26/2022] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The aim of this systematic review was to evaluate the effectiveness of the socket shield technique (SST), an innovative surgical method introduced in 2010, for reducing buccal bone plate resorption. METHODS The review was conducted following the PRISMA guidelines. Clinical studies conducted in humans and investigating the SST were searched on PubMed (MEDLINE), Embase, Web of Knowledge, and Google Scholar in November and December 2021. The implant survival rate, percentage of complications, and clinical parameters (marginal bone loss [MBL], pink esthetic score [PES], and buccal bone plate resorption [BBPR]) were analyzed using the collected data. RESULTS The initial search resulted in 132 articles. After article screening, the full texts of 19 studies were read and 17 articles were finally included in the review. In total, 656 implants were installed with the SST. Nine of the 656 implants experienced failure, resulting in an implant survival rate of 98.6%. The percentage of complications was about 3.81%. The analysis of clinical parameters (MBL, PES, and BBPR), showed favorable results for the SST. The mean MBL in implants placed with the SST was 0.39±0.28 mm versus 1.00±0.55 mm in those placed without the SST. PES had a better outcome in the SST group, with an average of 12.08±1.18 versus 10.77±0.74. BBPR had more favorable results in implants placed with the SST (0.32±0.10 mm) than in implants placed with the standard technique (1.05±0.18 mm). CONCLUSIONS The SST could be considered beneficial for preserving the buccal bone plate. However, since only 7 of the included studies were long-term randomized controlled trials comparing the SST with the standard implant placement technique, the conclusions drawn from this systematic review should be interpreted with caution. TRIAL REGISTRATION PROSPERO Identifier: CRD42020180637.
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Affiliation(s)
- Stefano Oliva
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Coppito, Italy
| | - Mario Capogreco
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Coppito, Italy
| | - Giovanna Murmura
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
| | - Ettore Lupi
- Maxillo-Facial Surgery Unit, Department of Life, Health and Environmental Sciences, University of L’Aquila, Coppito, Italy
| | - Di Carlo Mariachiara
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Coppito, Italy
| | - Maurizio D’Amario
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Coppito, Italy
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Santhanakrishnan M, Subramanian V, Ramesh N, Kamaleeshwari R. Radiographic and Esthetic Evaluation Following Immediate Implant Placement with or without Socket Shield and Delayed Implant Placement Following Socket Preservation in the Maxillary Esthetic Region - A Randomized Controlled Clinical Trial. Clin Cosmet Investig Dent 2021; 13:479-494. [PMID: 34824552 PMCID: PMC8610775 DOI: 10.2147/ccide.s332687] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 11/04/2021] [Indexed: 12/25/2022] Open
Abstract
Objective The purpose of this study was assessment of the changes in soft and hard tissues in the esthetic zone of maxilla following immediate implant placement (IIP) with and without the socket shield technique (SST) and placement of implants 4 months following socket preservation (DIP) in terms of alterations in crestal bone thickness (CBT) and soft tissue changes evaluated by means of pink esthetic scores (PES) following placement of implants in the esthetic zone of maxilla. Materials and Methods In the maxillary esthetic region, 75 dental implants were placed totally, with 25 implants each in the SST, IIP, and DIP groups. All participants were subjected to undergo CBCT for assessing the variations in thickness of crestal aspect of facial/buccal/labial alveolar bone (CBT). PES and PROMS (patient-related outcome measures) were assessed using VAS for pain threshold and esthetic satisfaction following implant placement and after 6th post-operative month. Results The mean reduction in CBT showed a statistically significant difference between and within the groups, in comparison to IIP and DIP groups, which demonstrated an average reduction in CBT 0.4 ± 0.1 and 0.2 ± 0.1 at 6 months following implant placement, respectively. The SST group showed a significantly lesser reduction in CBT of 0.05 ± 0.02. However, the mean difference in PES within and among the groups showed no significant difference statistically at P < 0.05. On comparison of individual scores of PES between the groups, the results showed significant difference statistically at P < 0.001. Conclusion The SST group demonstrated minimal reduction in CBT and a superior PES at the end of 6 months compared with the IIP and DIP groups.
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Affiliation(s)
- Muthukumar Santhanakrishnan
- Faculty of Dental Sciences, Department of Periodontology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Vedavalli Subramanian
- Department of Periodontology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Nithyakalyani Ramesh
- Department of Periodontology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - R Kamaleeshwari
- Department of Periodontology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
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Zhang A, Liu Y, Liu X, Cai X, Sun L, Li T. Could the socket shield technique be better than conventional immediate implantation? A meta-analysis. Clin Oral Investig 2021; 26:1173-1182. [PMID: 34783912 DOI: 10.1007/s00784-021-04266-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/07/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate whether the clinical outcome of socket shield technique (SST) is superior to that of conventional immediate implantation (CII). MATERIALS AND METHOD Five electronic databases (PubMed, Cochrane, Web of Science, CNKI, and Google Scholar) were searched to identify randomized controlled trials up to June 31, 2021. Five evaluation indexes were extracted, namely, buccal bone resorption at the horizontal and vertical levels (BBH and BBV), the soft tissue recession assessed by pink evaluation scores (PES), patient satisfaction (PS), ISQ, and the success rate of implantation (SRI), to compare the superiority between SST and CII operations. All data analyses were performed using Review Manager (version 5.4). RESULTS Ten studies were included in this review. The sample included 388 implants, with 194 in the SST group and 194 in the CII group. Compared with the CII group, the SST group had a lower BBH and BBV (standardized mean difference (SMD), - 1.77; 95% CI, - 2.26 to - 1.28; P < 0.00001 and SMD, - 1.85; 95% CI, - 2.16 to 1.54; P < 0.00001), higher PES improvement (SMD, 2.27; 95% CI, 1.59 to 2.95; P < 0.00001), higher rate of PS (OR, 3.12; 95% CI, 1.08 to 9.04; P = 0.04), and slightly higher ISQ (SMD, 0.71; 95% CI, 0.28 to 1.15; P = 0.001). CONCLUSIONS Compared with CII, SST could be a better option for esthetic area implantation, but evaluation of its long-term success is still needed. CLINICAL RELEVANCE By comparing and analyzing the operations of immediate implant in esthetic zone, we could choose SST to effectively alleviate the absorption of bone tissue and improve the contouring of soft tissue after anterior teeth extraction, so as to achieve a more stable and superior clinical outcomes of implant in esthetic zone.
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Affiliation(s)
- Aobo Zhang
- Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, 100081, China.,Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, 100081, China
| | - Yuping Liu
- School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271016, Shandong, China
| | - Xiaoxiao Liu
- Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, 100081, China.,Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, 100081, China
| | - XinJia Cai
- Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, 100081, China.,Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, 100081, China
| | - Lisha Sun
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, 100081, China. .,Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, 100081, China. .,National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China. .,, No.22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, People's Republic of China.
| | - Tiejun Li
- Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, 100081, China. .,, No.22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, People's Republic of China.
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15
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De Angelis N, Signore A, Alsayed A, Hai Hock W, Solimei L, Barberis F, Amaroli A. Immediate Implants in the Aesthetic Zone: Is Socket Shield Technique a Predictable Treatment Option? A Narrative Review. J Clin Med 2021; 10:4963. [PMID: 34768483 PMCID: PMC8584280 DOI: 10.3390/jcm10214963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/20/2021] [Accepted: 10/25/2021] [Indexed: 02/07/2023] Open
Abstract
(1) Background. Dental implant placement in the anterior region requires extreme precision due to relatively high aesthetic demand. This narrative review aimed to analyse some of the available clinical studies of the socket-shield technique and determine its viability for dental implant survival/success and complication rates. (2) Methods. An electronic search for publications was performed using the Cochrane, PubMed-MEDLINE, Web of Science, and Google Scholar databases. All electronic searches included human clinical and animal studies and were performed by three independent examiners. (3) Results. A total of 1383 records were identified with the initial search strategies, but only 25 full texts + five abstracts clinical studies were kept after the recruitment criteria screening. The technical details, advantages, and limitations of the techniques were illustrated. (4) Conclusion. Within the limitations of the present review, it would be merely justified that immediate dental implant placement in conjunction with the socket-shield technique can be a promising strategy for dental implant therapy.
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Affiliation(s)
- Nicola De Angelis
- Department of Surgical and Diagnostic Sciences, University of Genoa, 16132 Genoa, Italy; (A.S.); (A.A.); (W.H.H.); (L.S.)
- Department of Dentistry, University Tunku Abdul Raman (UTAR), Sungai Buloh 47000, Malaysia
| | - Antonio Signore
- Department of Surgical and Diagnostic Sciences, University of Genoa, 16132 Genoa, Italy; (A.S.); (A.A.); (W.H.H.); (L.S.)
- Therapeutic Dentistry Department, Faculty of Dentistry, First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Arwa Alsayed
- Department of Surgical and Diagnostic Sciences, University of Genoa, 16132 Genoa, Italy; (A.S.); (A.A.); (W.H.H.); (L.S.)
| | - Wong Hai Hock
- Department of Surgical and Diagnostic Sciences, University of Genoa, 16132 Genoa, Italy; (A.S.); (A.A.); (W.H.H.); (L.S.)
| | - Luca Solimei
- Department of Surgical and Diagnostic Sciences, University of Genoa, 16132 Genoa, Italy; (A.S.); (A.A.); (W.H.H.); (L.S.)
| | - Fabrizio Barberis
- Department of Civil, Chemical and Environmental Engineering, University of Genoa, 16100 Genoa, Italy;
| | - Andrea Amaroli
- Department of Surgical and Diagnostic Sciences, University of Genoa, 16132 Genoa, Italy; (A.S.); (A.A.); (W.H.H.); (L.S.)
- Department of Orthopedic Dentistry, Faculty of Dentistry, First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
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16
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Lin X, Gao Y, Ding X, Zheng X. Socket shield technique: A systemic review and meta-analysis. J Prosthodont Res 2021; 66:226-235. [PMID: 34526435 DOI: 10.2186/jpr.jpr_d_20_00262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE The aim of the present study was to evaluate the clinical feasibility of the socket shield technique (SST). STUDY SELECTION An electronic search of the PubMed, Cochrane Central Register of Controlled Trials, and Wiley Online Library databases, and a manual reference search for articles published up to September 2020 was conducted. Meta-analysis was performed to estimate marginal bone loss (MBL), changes in buccal bone width (cBBW), pink esthetic score (PES), implant stability quotient (ISQ), implant failure rate, and complication rate between SST and conventional immediate implant placement (IIP). All pooled analyses were based on random effects models. RESULTS Sixteen relevant studies were ultimately selected by two independent reviewers: four randomized clinical trials (RCTs), four case-control studies, and eight retrospective studies. Meta-analysis revealed a trend toward lower MBL and cBBW and higher PES in the SST group. ISQ, implant failure rate, and complication rate were similar between the groups. CONCLUSIONS The included studies provided evidence that SST may be a feasible treatment option. However, this technique should not be used as a routine clinical protocol due to the lack of evidence-based consensus guidelines, large-scale RCTs, and long-term follow-up data. Therefore, there is an urgent need for well-conducted RCTs in this field.
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Affiliation(s)
- Xi Lin
- Affiliated Implantology center, Stomatological Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Yan Gao
- Affiliated Implantology center, Stomatological Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Xianglong Ding
- Affiliated Implantology center, Stomatological Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Xianghuai Zheng
- Affiliated Implantology center, Stomatological Hospital, Southern Medical University, Guangzhou, People's Republic of China
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17
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Atieh MA, Shah M, Abdulkareem M, AlQahtani HA, Alsabeeha NHM. The socket shield technique for immediate implant placement: A systematic review and meta-analysis. J ESTHET RESTOR DENT 2021; 33:1186-1200. [PMID: 34380176 DOI: 10.1111/jerd.12812] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/19/2021] [Accepted: 08/02/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Immediate implant placement with socket shield technique (SST) may maintain the buccal bone plate and soft tissue levels, however, the potential clinical benefits of SST lack strong scientific evidence. The aim of this systematic review and meta-analysis was to evaluate the effects of SST on dimensional changes of hard tissues, esthetic outcomes, implant stability, complication, and implant failure rates. METHODS Electronic databases were searched to identify randomized controlled trials (RCTs) that compared immediate implant placement with and without SST. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool. Data were analyzed using a statistical software program. RESULTS A total of 982 studies were identified, of which, seven RCTs with 206 immediately placed dental implants in 191 participants were included. Overall meta-analysis showed significant differences in the changes in buccal bone plate width (mean difference (MD) -0.22; 95% confidence interval (CI) -0.30 to -0.15; p < 0.0001) and height (MD -0.52; 95% CI -0.85 to -0.18; p = 0.002) in favor of SST. The use of SST was also associated with significantly less changes in peri-implant marginal bone levels and better pink esthetic score than immediately placing implants without SST. The differences in implant stability, complication and implant failure rates were not statistically significant between immediate implant placement with or without SST. CONCLUSIONS The short-term complication and implant failure rates following immediate implant placement with or without SST were comparable. The SST has short-term positive effects on the changes in width and height of buccal bone plate, peri-implant marginal bone levels and esthetic outcomes. Further evidence from long-term RCTs are still required to substantiate the current findings. CLINICAL SIGNIFICANCE SST can reduce changes in buccal plate width and height and improve the soft tissue profile following immediate implant placement in esthetic zone.
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Affiliation(s)
- Momen A Atieh
- Chair and Associate Professor of Periodontology, Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai, United Arab Emirates.,Honorary Associate Professor, Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Maanas Shah
- Department of Periodontology, Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai, United Arab Emirates
| | - Mohammed Abdulkareem
- Dental Intern, Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai, United Arab Emirates
| | - Haif A AlQahtani
- Dental Intern, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Nabeel H M Alsabeeha
- Consultant Prosthodontist, Department of Prosthodontics, Ras Al-Khaimah Dental Center, Ministry of Health and Prevention, United Arab Emirates
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18
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Sáez-Alcaide LM, González Fernández-Tresguerres F, Cortés-Bretón Brinkmann J, Segura-Mori L, Iglesias-Velázquez O, Pérez-González F, López-Pintor RM, Torres García-Denche J. Socket shield technique: A systematic review of human studies. Ann Anat 2021; 238:151779. [PMID: 34087383 DOI: 10.1016/j.aanat.2021.151779] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 05/13/2021] [Accepted: 05/17/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND PURPOSE Alveolar bone resorption after dental extraction frequently leads to situations in which long-term function and esthetic success of rehabilitations with dental implants is a challenge. Socket shield has been described as an alternative technique to maintain the alveolar ridge when placing immediate implants. The aim of this review is to evaluate the medium- and long-term clinical outcomes of the socket shield technique in human studies. MATERIAL AND METHODS This review was conducted according to PRISMA guidelines. An electronic search was conducted in four databases: (1) The National Library of Medicine (MEDLINE/PubMed) via Ovid; (2) Web of Science (WOS); (3) SCOPUS; and (4) Cochrane Central Register of Controlled Trials (CENTRAL). The Cochrane Collaboration tool, the Newcastle-Ottawa Quality Assessment Scale and The Joanna Briggs Institute Critical Appraisal tool were used to assess the quality of evidence in the studies reviewed. RESULTS Six articles were included in this review. The studies analysed showed lower rates of horizontal and vertical alveolar bone resorption, better maintenance of the buccal plate, less marginal bone loss and better esthetic results than simple placement of immediate implants. However, a lack of homogeneity was found in evaluation methods of the different outcomes, surgical procedures and prosthetic management. CONCLUSIONS Based on the results of this review, it is possible to suggest that socket shield technique could be a good alternative in terms of alveolar bone maintenance, marginal bone stability and aesthetic outcomes in immediate implant treatment. However, it is not possible to recommend this technique as an alternative treatment with the same long-terms predictability as conventional immediate implants.
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Affiliation(s)
- Luis Miguel Sáez-Alcaide
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Spain.
| | | | | | - Luis Segura-Mori
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, Spain
| | - Oscar Iglesias-Velázquez
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Spain
| | - Fabián Pérez-González
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Spain
| | - Rosa María López-Pintor
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Spain
| | - Jesús Torres García-Denche
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Spain
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Atef M, El Barbary A, Dahrous MSED, Zahran AF. 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. Clin Implant Dent Relat Res 2021; 23:456-465. [PMID: 34028974 DOI: 10.1111/cid.13008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/22/2021] [Accepted: 04/26/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Compare the dimensional changes of the peri-implant soft and hard tissues clinically and radiographically around single immediate implants in the esthetic zone with socket shield technique versus filling the buccal gap with xenograft. MATERIALS AND METHODS Forty-two patients with a single non-restorable tooth in the esthetic zone replaced with an immediate implant were randomly assigned either to the socket shield technique (test) or to grafting the buccal gap with xenograft (control). The vertical and horizontal buccal bone resorption were measured 6-months following implant placement. The esthetic outcomes were evaluated by assessing the Pink Esthetic Score (PES) and the amount of midfacial mucosal alteration, in addition to patient satisfaction assessment through a Visual Analogue Scale (VAS) based questionnaire 1-year following implant restoration. RESULTS The present study showed that the socket shield group yielded significantly less vertical and horizontal buccal bone resorption of 0.35 (±0.62) mm and 0.29 (±0.34) mm compared to 1.71 (±1.02) mm and 1.45 (±0.72) mm in the xenograft group respectively. Also, there was a significantly greater midfacial mucosal recession in the xenograft group of 0.466 (±0.58) mm compared to midfacial mucosal coronal migration of 0.45 (±0.75) mm in the socket shield group. However, there was no statistically significant difference regarding the total PES and patient satisfaction in both treatment groups. CONCLUSION The socket shield technique can preserve hard and soft peri-implant tissues following immediate implant placement. (ClinicalTrials.gov Identifier: NCT03684356).
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Affiliation(s)
- Mohamed Atef
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Ahmed El Barbary
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Mona Salah El-D Dahrous
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Amr Fouad Zahran
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
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20
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The Use of Autogenous Teeth for Alveolar Ridge Preservation: A Literature Review. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11041853] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Alveolar ridge resorption is a natural consequence of teeth extraction, with unpleasant aesthetic and functional consequences that might compromise a future oral rehabilitation. To minimize the biological consequences of alveolar ridge resorption, several surgical procedures have been designed, the so-called alveolar ridge preservation (ARP) techniques. One important characteristic is the concomitant use of biomaterial in ARP. In the past decade, autogenous teeth as a bone graft material in post-extraction sockets have been proposed with very interesting outcomes, yet with different protocols of preparation. Here we summarize the available evidence on autogenous teeth as a biomaterial in ARP, its different protocols and future directions.
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21
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Blaschke C, Schwass DR. The socket-shield technique: a critical literature review. Int J Implant Dent 2020; 6:52. [PMID: 32893327 PMCID: PMC7475165 DOI: 10.1186/s40729-020-00246-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 07/29/2020] [Indexed: 12/11/2022] Open
Abstract
Introduction Dental implants have become a standard treatment in the replacement of missing teeth. After tooth extraction and implant placement, resorption of buccal bundle bone can pose a significant complication with often very negative cosmetic impacts. Studies have shown that if the dental root remains in the alveolar process, bundle bone resorption is very minimal. However, to date, the deliberate retention of roots to preserve bone has not been routinely used in dental implantology. Material and methods This study aims to collect and evaluate the present knowledge with regard to the socket-shield technique as described by Hurzeler et al. (J Clin Periodontol 37(9):855-62, 2010). A PubMed database search (www.ncbi.nlm.nih.gov/pubmed) was conducted to identify relevant publication. Results The initial database search returned 229 results. After screening the abstracts, 13 articles were downloaded and further scrutinised. Twelve studies were found to meet the inclusion and exclusion criteria. Conclusion Whilst the socket-shield technique potentially offers promising outcomes, reducing the need for invasive bone grafts around implants in the aesthetic zone, clinical data to support this is very limited. The limited data available is compromised by a lack of well-designed prospective randomised controlled studies. The existing case reports are of very limited scientific value. Retrospective studies exist in limited numbers but are of inconsistent design. At this stage, it is unclear whether the socket-shield technique will provide a stable long-time outcome.
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Affiliation(s)
- Christian Blaschke
- Department of Oral Diagnostic and Surgical Sciences, Faculty of Dentistry, University of Otago, 310 Great King Street, Dunedin, New Zealand.
| | - Donald R Schwass
- Faculty of Dentistry, University of Otago, 310 Great King Street, Dunedin, New Zealand
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Faggion CM. The (in)adequacy of translational research in dentistry. Eur J Oral Sci 2020; 128:103-109. [PMID: 32153065 DOI: 10.1111/eos.12684] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2020] [Indexed: 12/17/2022]
Abstract
Translational research, as the name suggests, "translates" research findings into clinical practice to improve the health of human beings. The translational process builds on information from experiments conducted at a basic level (i.e., in vitro and/or animal studies) and progresses over experimental human studies for efficacy, efficiency, and safety to implementation. Therefore, all steps in the process should be based on studies conducted with the highest methodological quality possible in order to provide accurate and useful information. Furthermore, the systematic dissemination of new procedures/techniques should be done only when they have been proven to be effective and safe. This focus article describes examples of new techniques/procedures in dentistry that have not resulted from an adequate translational research process since the initial evidence was published. These procedures are generally characterised by lack of good evidence, particularly on their potential harms, and lack of adequate chronological order, regarding the translational research process (i.e., human research being conducted before animal research). Even so, they seem to be widely disseminated, and their promotion involves a wide range of sources, including social media. Some guidance is proposed to improve the quality of the translational research process in dentistry, as well as the level of awareness of all parties involved with the use of this research: clinicians, researchers, and patients. By improving the translational research process, optimization of the application and use of these resources, with less risk to the patients, is expected.
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Affiliation(s)
- Clovis Mariano Faggion
- Department of Periodontology and Operative Dentistry, Faculty of Dentistry, University Hospital Münster, Münster, Germany
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