Socket Shield Technique and Guided Bone Regeneration
Condition: Immediate Implant Placement
Study type: Interventional

Summary: 
      Among the individuals who applied to the Department of Periodontology, Faculty of Dentistry,
      Health Sciences University between 2019 and 2021, patients with an unrestorable tooth in the
      maxillary esthetic region and required implant placement were included in this randomized
      clinical trial. Before implant surgery, patients were randomized into socket shield technique
      and guided bone regeneration groups. While the buccal gap was untreated in the socket shield
      group, a xenograft, and membrane were applied in the regeneration group. Peri-implant pocket
      depth, modified plaque index, modified bleeding index, keratinized mucosa width, and mucosal
      thickness were recorded at the permanent restoration and the postoperative first year.
      Horizontal bone level and vertical bone level were assessed with cone beam computed
      tomography images taken before the surgery and one year after prosthesis insertion. The pink
      esthetic score was evaluated with intraoral photographs taken before the surgical procedure
      and first-year follow-up.
    

Detailed description: 
      This study aimed to compare the non-grafted socket shield technique with simultaneously
      guided bone regeneration in immediate implant placement in terms of clinical, esthetic, and
      radiographic parameters. Within the scope, immediate implant placement was applied to
      randomized groups (socket shield technique and guided bone regeneration). Immediate implant
      placement was performed following shield preparation in the shield group, and guided bone
      regeneration was applied in the regeneration group. A temporary non-functional immediate
      prosthesis was inserted at the same visit. After four months, permanent restorations were
      applied. Clinical, radiographic, and esthetic parameters were compared between two groups at
      baseline and first-year follow-up.
    

Intervention name(s): Socket shield technique; Guided bone regeneration
Intervention type(s): Procedure; Procedure
Intervention description(s): For the patients in the shield group, shields were prepared with the Root Membrane Kit. After the palatal part was removed, the buccal fragment was prepared at the crest level, and an internal bevel chamfer was formed on the fragment. Implants were placed 3-4 mm apical to the gingival margin of the adjacent teeth. Healing caps were placed, and the periphery of the caps was covered with an absorbable gelatin sponge.; For the patients in the regeneration group, teeth were extracted atraumatically, implants were placed 3-4 mm to the gingival margin, and the space between the implant and buccal bone was filled with anorganic bovine bone graft at the time of implant placement. The graft particles were covered by a pericardium membrane. The membrane was fixed to the bone with titanium pins.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: bone regeneration; dental implant; esthetics; grafts; socket shield technique