Socket shield technique: Stress distribution analysis

To analyze through finite element analysis the stress distribution in peri-implant bone tissues, implants, and prosthetic components induced by the socket shield (SS) technique in comparison to other techniques used to treat tooth loss.

A three-dimensional model of a superior central incisor crown supported by implant was modeled and three different placement conditions were simulated: SS - 2.0-mm-thick root dentin fragment positioned between the alveolar buccal wall and implant; heterologous bone graft (HBG) - bovine bone graft positioned the alveolar buccal wall and implant; and control (C) - implant fully placed in bone tissue of a healed alveolus. The model was restricted at the lateral surfaces of the bone tissue and the following loads were simulated: Both oblique (45°) loads of 100 N on the lingual surface of the crown (maximal habitual intercuspation) and 25.5 N on the incisal edge of the crown (tooth contact during mandibular protrusion) were simultaneously applied. Tensile stress, shear stress, compression, and displacement were analyzed in the cortical bone, trabecular bone, dentin root fragment, and bone graft; while equivalent von Mises stresses were quantified in the implant and prosthetic components.

Stress values of SS and HBG in the bone tissues were higher than C, while slight differences within models were observed for dentin root fragment, bone graft, implant, and prosthetic components.

The SS technique presented the highest stress concentration in the peri-implant tissues.