Socket shield technique: Immediate implant placement and buccal tissue preservation

Situation

A 21-year-old male patient was referred to the clinic with fractured tooth #21. A radiographic view of the temporarily splinted crown with wire at another clinic (left) and clinical views after the wire was removed are shown above.

Pre-operative Observation

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The root was sectioned using a surgical bur.

An atraumatic removal of the lingual fragment was achieved.

A thin layer of the root aspect intact to the buccal plate of the bone was left.

Ф3.5 drilling on #21

The site was prepared to place an implant 3mm deeper than the future crown zenith.

Ф4.0*11mm IS ll active implant was immediately placed following root extraction (separation of the buccal plate).

40Ncm of primary stability was achieved.

Allogenic bone substitute material (RegenOss) applied to the defect.

Healing abutment in place

Facial view

Provisional restoration delivered right after the surgery

Occlusal view

Impression was made after 3 months of implant placement, and the final restoration of SCRP zirconia single crown was delivered 2 weeks after impression taking.

SCRP zirconia single crown delivered on #21

3 months follow-up

Postoperative periapical view: The volumetric stability of the labial bone is expected to be maintained due to the socket shield technique.

Facial view

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Conclusion

A 21-year-old male patient was referred to the clinic with fractured tooth 21. The root 21 was sectioned using a surgical bur and an atraumatic removal of the lingual fragment was achieved. As a result, a thin layer of the root aspect intact to the buccal plate of the bone was left. Ф4.0*11mm IS ll active implant was immediately placed following root 21 extraction (separation of the buccal plate).