Clinical efficacy of the socket shield technique used in the aesthetic zone: A systematic review and meta-analysis

To systematically review and analyse the efficacy of the socket shield technique in conjunction with immediate implant placement in the aesthetic zone in randomised controlled trials.

The PubMed, Web of Science, Embase and Cochrane databases were searched from 1 January 2010 to 31 December 2020. All randomised controlled trials reporting on immediate implantation with the socket shield technique in the aesthetic zone, with at least 15 patients and a 6-month follow-up, were included and analysed. A meta-analysis was then performed using both fixed and random effects models to evaluate the differences in buccal plate height, buccal plate width and pink aesthetic score between immediate implant placement with the socket shield technique and the conventional immediate implant placement technique.

Four randomised controlled trials were included and underwent quantitative analysis in the present systematic review and meta-analysis. When compared with the conventional immediate implantation group, the buccal plate height and buccal plate width for the socket shield technique group were statistically significant, with an overall increase of 0.57 mm (95% confidence interval -0.73 to -0.40) and 0.21 mm (95% confidence interval -0.26 to -0.16), respectively, at 6 months. Moreover, the pink aesthetic score for the socket shield technique group improved significantly by 1.59 points (95% confidence interval 0.05 to 3.15) at 6 months, and also demonstrated a statistically significant increase of 1.39 points (95% confidence interval 0.32 to 2.46) compared to the control group at the medium-term follow-up (12 to 36 months).

The present findings suggest that the socket shield technique has the potential to maintain buccal tissue contours and peri-implant tissue stability, improving functional and aesthetic outcomes in the aesthetic zone compared with the conventional immediate implant placement technique.