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Modified Socket Shield Technique Using a Crest-Level C-Shaped Shield and Digital Workflow: A Step-by-Step Protocol

Gurgen Khachatrian, Joseph Kan, Ekaterina Zernitckaia

    The Journal of Oral Implantology
    |February 17, 2026
    PubMed
    Summary
    This summary is machine-generated.

    The modified Socket Shield Technique (M-SST) with a standardized shield and digital workflow effectively preserves bone and soft tissue for immediate implants. This approach shows excellent esthetic and functional outcomes in single-tooth replacements.

    Keywords:
    C-shaped shieldbuccal bone preservationdigital workflowesthetic implantologyimmediate implant placementsocket shield techniquesoft tissue stability

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    Area of Science:

    • Dental Implantology
    • Periodontology
    • Prosthodontics

    Background:

    • The Socket Shield Technique (SST) aims to preserve facial bone and soft tissue during immediate implant placement.
    • Clinical challenges include variations in shield morphology, thickness, and managing the implant-shield gap.
    • A standardized, digitally guided approach may improve SST outcomes.

    Purpose of the Study:

    • To present a step-by-step protocol for a modified Socket Shield Technique (M-SST).
    • To evaluate the esthetic and functional outcomes of M-SST using a fully guided digital workflow for single-tooth replacement in the esthetic zone.

    Main Methods:

    • A modified SST (M-SST) protocol was developed, featuring a standardized 1.0-1.5 mm C-shaped shield reduced to the bone crest.
    • A fully guided digital workflow was employed for atraumatic extraction and immediate implant placement.
    • Autologous bone grafting was selectively used for gaps exceeding 2 mm, followed by immediate provisionalization.

    Main Results:

    • Excellent soft tissue volume stability, intact papillae, and complete bone fill between the shield and implant were observed at 12 months.
    • No complications like shield exposure, displacement, or soft tissue recession occurred.
    • High esthetic outcomes were achieved with the final zirconia crown at 4 months postoperation.

    Conclusions:

    • The M-SST, with a standardized shield, crest-level termination, and digital guidance, provides favorable esthetic and functional results.
    • This protocol is a viable option for single-tooth rehabilitation in the esthetic zone, emphasizing soft tissue preservation.
    • Minimal intervention and immediate provisionalization contribute to successful outcomes.