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Related Concept Videos

Fractures: Bone Repair01:27

Fractures: Bone Repair

Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...

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Use of Human Perivascular Stem Cells for Bone Regeneration
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Bone grafting in socket shield: necessary or optional for immediate implants?

Carlos Fernando Mourão1

  • 1Department of Basic and Clinical Translational Sciences, Tufts University School of Dental Medicine, Boston, MA, USA. carlos.mourao@tufts.edu.

Evidence-Based Dentistry
|April 18, 2025
PubMed
Summary

The non-grafted socket shield technique (SST) and guided bone regeneration (GBR) both effectively preserve bone during immediate implant placement. However, SST offers superior soft tissue and aesthetic outcomes for single-tooth replacements in the aesthetic zone.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Periodontology
  • Dental Implantology

Background:

  • Immediate dental implant placement in the maxillary aesthetic zone presents challenges for maintaining both hard and soft tissue contours.
  • The socket shield technique (SST) and guided bone regeneration (GBR) are surgical options to address these challenges.
  • Comparing the efficacy of SST versus GBR in preserving peri-implant tissues and achieving aesthetic results is crucial.

Purpose of the Study:

  • To compare the clinical, aesthetic, and radiographic outcomes of a non-grafted socket shield technique (SST) versus guided bone regeneration (GBR) for immediate dental implant placement.
  • To evaluate the effectiveness of both techniques in maintaining peri-implant health and bone stability over a 1-year period.
  • To determine if one technique offers superior soft tissue preservation and aesthetic enhancement.

Main Methods:

  • A randomized clinical trial involving 24 adult patients requiring immediate implant placement in the maxillary anterior region.
  • Participants were allocated to either the non-grafted SST group or the GBR group (12 patients each).
  • Clinical parameters (pocket depth, plaque/bleeding indices, keratinized mucosa width/thickness), radiographic bone levels, and aesthetic outcomes (Pink Aesthetic Score) were assessed at baseline and 1 year.

Main Results:

  • No significant differences were observed between SST and GBR in peri-implant health or bone stability at 1 year.
  • The SST group demonstrated significantly wider keratinized mucosa compared to the GBR group (P=0.013).
  • Aesthetic outcomes, measured by the Pink Aesthetic Score, were significantly higher in the SST group (P=0.004).

Conclusions:

  • Both SST and GBR are effective in maintaining hard tissue integrity following immediate implant placement in the aesthetic zone.
  • The non-grafted socket shield technique (SST) provides advantages in soft tissue preservation and aesthetic results.
  • SST represents a viable alternative to GBR for single-tooth replacements in the esthetic region, particularly when soft tissue quality is a priority.