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

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.