Open flap strategies in socket-shield therapy

The socket-shield technique shows promising results in the esthetic zone. It is a technically challenging procedure but is effective in maintaining the buccal plate after tooth extraction and avoiding tissue collapse. Therefore, it could be considered a valid option in the immediate implant scenario. A careful shield preparation and handling are paramount for the success of the treatment and to minimize complications. Raising a flap can improve visibility and simplify the procedure. This article reports on a case in which a small crestal approach is used to visualize the root and the buccal plate, combined with a buccal semilunar flap, to gain access to the apical area. This surgical management is especially indicated when long roots are involved, in order to determine the correct axis for cutting and sectioning the root and to remove the apex if conventional drills are not long enough. Possible esthetic complications of raising a flap are also discussed.