Understanding the Socket Shield Technique
What is the Socket Shield Technique?
The Socket Shield Technique (SST) is a cutting-edge surgical approach that preserves the buccal portion of a tooth root during implant placement. This technique minimizes post-extraction bone resorption and maintains the natural contour of both the bone and soft tissue, ensuring optimal aesthetic and functional outcomes.
Originally developed to overcome aesthetic challenges in the anterior maxilla, SST has proven especially effective for immediate implant placement in high-aesthetic-demand cases. By preserving the buccal bone and soft tissue architecture, it provides long-term stability and enhances implant success rates.
What Are the Steps Involved in the Socket Shield Technique?
(A) The tooth is sectioned horizontally, leaving the root intact within the alveolus. (B) A vertical mesiodistal cut is made, and the palatal half of the root is carefully removed. (C) The buccal portion of the root is thinned and shaped into a stable shield .(D) A chamfer bevel is created at the coronal edge for optimal soft tissue adaptation. (E) The implant is placed behind the buccal shield, ensuring bone preservation. (F) A temporary restoration is attached to guide tissue healing and provide immediate aesthetics.
When Is It Indicated?
The Socket Shield Technique is ideal for cases where:
Buccal bone integrity is intact and crucial for aesthetics.
Immediate implant placement is planned to prevent ridge collapse.
The patient demands excellent aesthetics, particularly in the anterior maxillary region.
The retained tooth structure is free of infection and offers sufficient mechanical stability.
Case Summary 🔎
Patient Information
Age/Gender: 21-year-old male.
Reason for Referral: Fractured tooth #21.
Previous Treatment: Temporarily splinted crown with a wire performed at another clinic.
Results
The root of tooth #21 was sectioned using a surgical bur, and the lingual fragment was removed atraumatically.
A thin layer of the root was preserved to maintain the stability of the buccal plate.
Following the extraction, a ∅4.0×11mm IS-II Active implant was immediately placed, ensuring stable outcomes without compromising the buccal plate integrity.
Before & After
Case Presentation
1️⃣ Pre-Op
fig 1. A periapical radiographic view showing the temporarily splinted crown with a wire placed at a previous clinic.
fig 2-3. Clinical photographs taken after the wire was removed.
2️⃣ Surgery
[Root Sectioning and Atraumatic Extraction]
fig 1. The root was sectioned using a surgical bur.
fig 2-4. An atraumatic removal of the lingual fragment was achieved.
[Implant Site Preparation]
fig 1. A thin layer of the root aspect intact to the buccal plate of the bone was left.
fig 2-3. ∅3.5 drilling on #21.
fig 4. The site was prepared to place an implant 3mm deeper than the future crown zenith.
[Implant Placement and Bone Augmentation]
fig 1. A ∅4.0×11mm IS-II Active implant was immediately placed following root extraction, preserving the buccal plate.
fig 2. An initial primary stability of 40 N/cm was achieved during implant placement.
fig 3. An allogenic bone graft material (RegenOss) was applied to the defect site to promote bone regeneration.
fig 4. A healing abutment was placed to support soft tissue healing around the implant.
3️⃣ Post-Op
Provisional restoration delivered right after the surgery.
4️⃣Final Restoration
fig 1. 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.
fig 2. SCRP zirconia single crown delivered on #21.
5️⃣ Follow-Up
At the 3-month follow-up, the volumetric stability of the labial bone was confirmed, attributed to the socket shield technique.
