Tissue Changes After Immediate Tooth Replacement With and Without Socket-Shield: 1-Year Prospective Study

this study evaluates implant success rates and facial mucosal profile changes in maxillary single immediate implant placement and provisionalization with socket-shield (IIPP+SS) and without socket-shield (IIPP-SS) technique.

thirty dental implants in 25 patients were assigned to either the IIPP-SS group (15 implants) or the IIPP+SS (15 implants) group. Clinical and radiographic outcomes were collected at pre-surgery (T0), 2- week (T1), 6-month (T6), and 12-month (T12) post-surgical follow-ups. The implant success rate, marginal bone level changes, facial mucosal level changes, and papilla level changes were evaluated at different time points. Facial mucosal profile changes were assessed individually for hard and soft tissue zones and as a whole using volumetric analysis.

two implants were excluded (1 patient dropped out and 1 implant failed) from the data analysis in this study, resulting in an overall implant success rate of 96.6% (28/29) after 1 year. Less facial mucosal profile changes were noted in the IIPP+SS group than in the IIPP-SS group, although the difference was only marginally statistically significant (p= 0.06). No statistically significant difference was found in the facial mucosal level changes (p=0.18) and papilla level changes (p = 0.67 for mesial papilla level and p = 0.41 for distal papilla level) changes between the IIPP-SS and IIPP+SS groups.

Within the limitations of this 1-year prospective study, IIPP+SS appears to maintain only the implant facial mucosal profile slightly better than IIPP alone. Both treatment modalities provide clinically satisfactory outcomes biologically, functionally, and esthetically.