Long-Term Stability of Alveolar Bone Dimensions Using the Socket Shield Technique: A Retrospective Cone Beam Computed...

Area of Science:

• Dental Implantology
• Periodontology
• Oral and Maxillofacial Surgery

Background:

• Alveolar bone resorption, particularly of the buccal plate after tooth extraction, can negatively impact ridge dimensions, aesthetics, and implant stability.
• The socket shield technique (SST) is designed to preserve buccal bone by retaining a portion of the buccal root fragment, thereby maintaining the periodontal ligament (PDL) and associated bone.

Purpose of the Study:

• To assess the long-term (3-year) dimensional stability of the alveolar ridge after immediate implant placement using the socket shield technique (SST).
• To specifically evaluate horizontal changes in buccal and palatal bone dimensions.

Main Methods:

• A retrospective study involving 20 patients who received single-tooth implants in the esthetic zone between 2019 and 2021.
• Implants were placed using the SST with a "Preserving Nature" protocol, retaining a ~1mm buccal root fragment, followed by immediate provisionalization.
• Cone-beam computed tomography (CBCT) scans at baseline and 3 years were analyzed using standardized superimposition to measure bone dimensional changes.

Main Results:

• No horizontal buccal bone loss was observed in any patient over the 3-year period.
• Minimal horizontal palatal bone loss occurred in 15% of cases; vertical palatal bone height remained stable.
• Overall mean dimensional changes in the alveolar ridge were not statistically significant (p=0.109).

Conclusions:

• The socket shield technique (SST) demonstrates excellent preservation of alveolar bone dimensions, particularly the buccal plate, over a 3-year follow-up.
• SST offers predictable advantages for dental implant procedures in the esthetic zone.
• While the study has limitations (retrospective design, small sample size), the standardized protocol and CBCT analysis suggest reproducibility, with further RCTs recommended.