Socket Shield Technique Implant Placement, Socket Shield Technique, Dental Implant, Bone Grafting, Delayed Implant
Conditions
Keywords
Modified socket shield, Delayed implant placement, Xenograft, Mineralized plasmatic matrix, Histomorphometry, Implant stability, Socket shield technique
Brief summary
Modified socket shield therapy (SST) has been proposed to preserve the facial plate and peri implant tissues. Whether spontaneous healing after two stage modified SST provides outcomes comparable to grafted SST before delayed implant placement remains unclear.
Detailed description
There remains no consensus regarding management of the space adjacent to the retained shield-whether it should be filled with a biomaterial or left for spontaneous healing. Clinical observations suggest that healing may not always yield complete mineralized fill; instead, a soft tissue interface can develop along the internal aspect of the root fragment, potentially limiting bone formation within the defect. At present, it remains unclear whether placement of a bone substitute can reliably reduce or prevent this soft tissue ingrowth along the inner surface of the retained fragment, providing a rationale for controlled comparisons of grafted and nongrafted two stage SST protocols. Therefore, the present controlled clinical study was designed to compare SST with xenograft combined with MPM augmentation versus SST alone, followed by delayed implant placement after a 6 month healing period. The study evaluated soft tissue ingrowth as key healing outcomes, alongside histologic findings and implant related parameters, including implant stability, as well as the incidence and management of procedure related complications.
Interventions
PROCEDURESocket Shield Technique
No grafting material was placed, and the socket was closed with a figure-of-eight suture to stabilize the clot
Sponsors
Mansoura University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Masking description
Statistician
Eligibility
Sex/Gender
ALL
Age
18 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* ASA I (healthy) * With intact buccal periodontal tissues * No parafunctional habits * Good oral hygiene * Willingness to comply with the study protocol and follow up schedule
Exclusion criteria
* Acute infection at the extraction site * Extensive buccal plate loss * Vertical root fracture on the buccal aspect * Fracture patterns extending below bone level * Internal or external resorption * Root caries compromising the shield * Excessive tooth mobility * Heavy smoking
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Soft tissue ingrowth dimension: depth | 6-month (at the time of implant placement) | Soft tissue ingrowth dimensions; depth and width were measured using a calibrated periodontal probe with readings taken to the nearest millimeter and rounded up when the probe reading reached or exceeded the midpoint between millimeter markings. Depth (mm) was recorded from the most coronal aspect of the retained root fragment and measured apically until hard tissue was encountered. |
| Soft tissue ingrowth dimension: width | 6-month (at the time of implant placement) | Width (mm) was measured in a buccopalatal direction from the central aspect of the socket shield to the point where hard tissue was reached, representing the maximum diameter of the soft tissue ingrowth. |
Countries
Egypt
Outcome results
None listed