Molar socket shield technique with immediate implant placement maintains stable tissue architecture at 5- to 7-year...

Immediate implant placement in fractured molar sites presents surgical challenges because of the complex root anatomy and the risk of buccal plate resorption. The molar socket shield technique with atraumatic tissue handling may help preserve the alveolar architecture and enhance peri-implant outcomes. However, the long-term success of this technique has not been well reported.

The purpose of this clinical series was to evaluate long-term success in terms of peri-implant tissue health after the molar socket shield technique and immediate implant placement.

Five patients (age range: 32-67 years) with fractured molars were treated between 2017 and 2020. The molar socket shield technique was performed on all patients with implants placed immediately with >35 Ncm primary stability. Custom healing abutments were fabricated chairside to establish a prosthetic seal and guide peri-implant soft tissue maturation. Screw- or cement-retained zirconia prostheses with Ti-base abutments were placed after 3 months of healing.

All 5 patients demonstrated uneventful healing with no postoperative complications, infection, or loss of implant stability. At a 5- to 7-year follow-up, favorable peri-implant tissue architecture was observed. Crestal bone loss between 0 and 1.5 mm was observed with no bleeding on probing. All implant-supported prostheses had good function and esthetics.

The molar socket shield technique with immediate implant placement and custom healing abutments represented a predictable protocol for managing fractured molars. This technique may preserve alveolar architecture and support peri-implant soft tissue stability, offering a straightforward alternative to more technique-sensitive conventional extraction with or without bone augmentation.