Aesthetic outcomes and clinical analysis of the socket-shield technique in immediate implant restoration of a single maxillary anterior tooth

doi:10.12337/zgkqzzxzz.2025.10.005

Abstract

Abstract: Objective This study aims to investigate the clinical efficacy of the socket-shield technique in immediate implant restoration of a single maxillary anterior tooth in a retrospective study. Methods A total of 86 patients who underwent immediate implant restoration of a single maxillary anterior tooth at our hospital from April 2021 to March 2022 were selected and divided into two groups according to different implant surgical techniques, with 43 patients in each group. The socket-shield technique group (experimental group) received immediate implant placement combined with the root membrane technique, while the conventional implant group (control group) underwent minimally invasive tooth extraction followed by immediate implant placement.Implant survival rate, complication rate, and patient satisfaction were compared between the two groups. Additionally, probing depth (PD), pink esthetic score (PES), white esthetic score (WES), and modified bleeding index (mBI) were assessed pre- and postoperatively between the two groups. Results The implant retention rate was 95.35% in the socket-shield technique group and 88.37% in the conventional implant group, with no statistically significant difference between the two groups (P=0.237). Patient satisfaction in terms of soft tissue color, overall esthetics, chewing comfort, and total score was significantly higher in the experimental group (P<0.001), with scores of (8.72±0.90), (9.13±0.54), (8.45±0.67), and (25.36±1.42), respectively, compared with (7.36±1.45), (8.22±1.30), (7.01±1.63), and (22.59±1.74) in the control group. Preoperatively, there were no significant differences in PES, mBI, and PD between the two groups (P>0.05).Postoperatively, PES and WES were significantly higher in the experimental group [(8.68±0.89) and (9.01±0.33)] than in the control group [(7.25±1.41) and (8.30±0.76)] (P < 0.001). The socket-shield technique group also exhibited significantly lower mBI and PD values [(0.27±0.08) and (2.35±0.68) mm] than the control group [(1.39±0.36) and (3.27±0.91) mm] (P < 0.001). Additionally, the complication rate in the socket-shield technique group was 9.30%, which was not significantly different from that in the conventional implant group (13.95%; P=0.501). Conclusion Both treatment modalities demonstrated high Implant retention rates and safety profiles. However, the socket-shield technique exhibited superior esthetic outcomes and higher patient satisfaction in the immediate implant restoration of a single maxillary anterior tooth, making it worthy of broader clinical application and promotion.

Key words: Immediate implant, Socket-shield technique, Maxillary anterior tooth, Flapless immediate implant

Zhang Jiayuan, Liu Hui, Huang Shishi, Chen Ying, Chen Qingsheng. Aesthetic outcomes and clinical analysis of the socket-shield technique in immediate implant restoration of a single maxillary anterior tooth[J]. Chinese Journal of Oral Implantology, 2025, 30(5): 456-463.

References

[1] 刘国春, 杨露, 郭航. 上颌前牙单牙即刻种植修复与延期修复的临床疗效分析[J].中国美容医学,2022,31(4):121-124.DOI:10.15909/j.cnki.cn61-1347/r.004996.
Liu GC, Yang L, Guo H.Clinical effect analysis of immediate implant restoration and delayed restoration of maxillary anterior single tooth[J].Chin J Aesthetic Med,2022,31(4):121-124. DOI:10.15909/j.cnki.cn61-1347/r.004996.
[2] 秦蓉, 员东星, 刘晶, 等. 根盾技术在上颌单前牙即刻种植修复中应用的美学效果[J].海军医学杂志, 2021,42(1):112-114. DOI: 10.3969/j.issn. 1009-0754.2021.01.033.
Qin R, Yuan DX, Liu J, et al.Aesthetic effect of the socket-shield technique in immediate implant restoration of a single maxillary anterior tooth[J]. Naval Med J, 2021, 42(1):112-114.DOI: 10.3969/j.issn.1009-0754.2021.01.033.
[3] 李诗琪, 苏镇亚, 莫安春. 翻瓣GBR在薄骨壁表型上颌单颗前牙即刻种植即刻修复中的临床效果[J].口腔疾病防治,2022,30(8):556-563. DOI: 10.12016/j.issn. 2096-1456.2022.08.004.
Li SQ, Su ZY, Mo AC .Clinical outcomes of immediate implantation and provisionalization combined with guided bone regeneration for a single anterior maxillary tooth with a thin facial bone phenotype[J].J Prev Treat Stomatol Dis,2022,30(8):556-563. DOI: 10.12016/j.issn.2096-1456.2022.08.004.
[4] Meijer H, Slagter KW, Vissink A, et al.Buccal bone thickness at dental implants in the maxillary anterior region with large bony defects at time of immediate implant placement: a 1-year cohort study[J]. Clin Implant Dent Relat Res, 2019,21(1):73-79. DOI: 10.1111/cid.12701.
[5] 张璐, 冯艳芬, 张瑞平, 等. 即刻种植修复与延期种植修复对上颌单前牙患者牙周组织健康、美学效果以及炎症因子的影响[J].现代生物医学进展,2021,21(11): 2061-2064.DOI: 10.13241/j.cnki.pmb.2021.11.013.
Zhang L, Feng YF, Zhang RP, et al.The effect of immediate implant and delayed implant restoration on periodontal tissue health,aesthetic effect and inflammatory factors in patients with maxillary single anterior teeth[J].Pro Mod Biomed,2021,21(11): 2061-2064.DOI: 10.13241/j.cnki.pmb.2021.11.013.
[6] 孙绍山, 阴旭斌, 王昊. 上颌单前牙不同种植修复时机对种植后修复效果的影响研究[J].中国美容医学,2021,30(7):143-145. DOI:10.15909/j.cnki.cn61-1347/r.0004537.
Sun SS, Yin XB, Wang H .Influence of single maxillary anterior implant restoration at different time on the prosthetic effect[J].Chin J Aesthetic Med,2021,30(7):143-145. DOI:10.15909/j.cnki.cn61-1347/r.0004537.
[7] 满毅, 于海洋, 王佐林, 等. 种植修复临床评价标准[J].华西口腔医学杂志,2019,37(1):1-6. DOI: 10.7518/hxkq. 2019.01.001.
Man Y, Yu HY,Wang ZL, et al.Criteria for success in dental implants[J].West Chin J Stomatol,2019,37(1):1-6. DOI: 10.7518/hxkq.2019.01.001.
[8] 中华口腔医学会.中华口腔医学会团体标准-牙周基本检查评估规范[M].北京:人民卫生出版社, 2023.
Chinese Stomatological Association.Group standard of the Chinese stomatological association-standard of periodontal examination and evaluation[M].Beijing: People's Medical Publishing House, 2023.
[9] Fürhauser R, Florescu D, Benesch T, et al.Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score[J]. Clin Oral Implants Res, 2005,16(6):639-644. DOI: 10.1111/j.1600-0501.2005.01193.x.
[10] 魏冬豪, 赵一姣, 邸萍, 等. 上颌中切牙即刻种植即刻修复后唇侧软组织形态三维变化的定量分析[J].中华口腔医学杂志,2019,54(1):3-9.DOI: 10.3760/cma.j.issn. 1002-0098.2019.01.002.
Wei DH,Zhao YJ, Di P,et al.Quantitative three-dimensional methodology based on intraoral scan to assess the soft tissue contour alterations following single immediate implant and immediate provisionalization in maxillary[J].Chin J Stomatol,2019,54(1):3-9.DOI: 10.3760/cma.j.issn.1002-0098.2019.01.002.
[11] Belser UC, Grütter L, Vailati F, et al.Outcome evaluation of early placed maxillary anterior single-tooth implants using objective esthetic criteria: a cross-sectional, retrospective study in 45 patients with a 2- to 4-year follow-up using pink and white esthetic scores[J]. J Periodontol, 2009,80(1):140-151. DOI: 10.1902/jop.2009.080435.
[12] 范孟钊, 国正则, 侯新华, 等. 即刻种植美学修复治疗对前牙外伤患者临床效果及整体美观度的影响[J].中国美容医学,2021,30(2):119-122. DOI:10.15909/j.cnki.cn61-1347/r.004303.
Fan MZ, Guo ZZ, Hou XH, et al.The effect of immediate implant aesthetic restoration treatment on the clinical effect and overall aesthetics of patients with anterior tooth trauma[J].Chin J Aesthetic Med,2021,30(2):119-122. DOI:10.15909/j.cnki.cn61-1347/r.004303.
[13] 桂芳, 刘桂红, 马赫, 等. 即刻种植的牙槽骨吸收程度的CBCT观察及种植体稳定性分析[J].影像科学与光化学,2022,40(2):362-366. DOI: 10.7517/issn.1674-0475. 210910.
Gui F,Liu GH, Ma H, et al.CBCT observation of alveolar bone resorption and stability analysis of immediate implant[J].Imag Sci Photoche Mistry,2022,40(2):362-366. DOI: 10.7517/issn.1674-0475.210910.
[14] 王红, 张亚军, 薛陆峰, 等. Ⅲ类和Ⅳ类骨质前牙单牙缺失患者即刻种植的修复效果及对美学指数的影响[J].中国美容医学,2022,31(8):138-141. DOI:10.15909/j.cnki.cn61-1347/r.005213.
Wang H,Zhang YJ, Xue LF, et al.The effect of immediate implant restoration and its influence on aesthetic index in patients with single tooth loss of anterior bones of class Ⅲ and Ⅳ[J].Chin J Aesthetic Med,2022,31(8):138-141. DOI:10.15909/j.cnki.cn61-1347/r.005213.
[15] Ihde S, Ihde A, Sipic O.Patient acceptance and outcomes of treatments with Corticobasal^® implants. A prospective cohort study[J]. Natl J Maxillofac Surg, 2025,16(1):7-13. DOI: 10.4103/njms.njms_31_24.
[16] 柯敏, 施优灵. 美学区单牙即刻种植即刻修复的牙龈美学分析[J].湖北医药学院学报,2022,41(2):149-152,158. DOI: 10.13819/j.issn.2096-708X.2022.02.008.
Ke M,Shi YL.The gingival aesthetic analysis of immediate implant restoration of single tooth in esthetic zone[J].J Hubei Univ Med,2022,41(2):149-152,158. DOI: 10.13819/j.issn.2096-708X.2022.02.008.
[17] 王文丽, 张子晗, 李友瑞. 口腔种植修复应用的根盾技术[J].中国组织工程研究,2022,26(27):4406-4410.
Wang WL,Zhang ZH, Li YR .Application of the socket-shield technique in the implant restoration[J].Chin J Tissue Eng Res,2022,26(27):4406-4410.
[18] 闫圣杰,周聪,刘金,等.上颌前牙区应用根盾技术即刻种植的临床效果观察[J].华西口腔医学杂志, 2019, 37(6):615-620.DOI:10.7518/hxkq.2019.06.008.
Yan SJ,Zhou C,Liu J, et al.Clinical evaluation of the socket-shield technique for immediate implantation in the maxillary anterior region[J].West China J Stomatol, 2019, 37(6):615-620.DOI:10.7518/hxkq.2019.06.008.
[19] 周笑天, 王海丞, 黄洁, 等. 盾构技术对种植修复后牙槽骨吸收和牙龈退缩的影响[J].口腔颌面外科杂志, 2021,31(4):201-206.DOI: 10.3969/j.issn.1005-4979. 2021.04.01.
Zhou XT, Wang HC, Huang J, et al.Influence of socket-shield technique on the alveolar bone resorption and gingival recession after implant loading[J].J Oral Maxillofac Surg,2021,31(4):201-206.DOI: 10.3969/j.issn.1005-4979. 2021.04.01.
[20] Markus G, Thomas A, Patrick S.Ridge preservation with modified“socket-shield” technique: a methodological case series[J]. Dentistry Journal, 2014,2(1):11-21.DOI:10.3390/dj2010011.
[21] Troiano M, Benincasa M, Snchez P, at al. Bundle bone preservation with root-t-belt: case study[J]. Annals of Oral & Maxillofacial Surgery, 2014,2(1):7.
[22] Tan Z, Kang J, Liu W,et al.The effect of the heights and thicknesses of the remaining root segments on buccal bone resorption in the socket‐shield technique: an experimental study in dogs[J].Clin Implant Dent Relat Res, 2018.20(3):352-359.DOI:10.1111/cid.12588.
[23] Mourya A, Mishra SK, Gaddale R,et al.Socket-shield technique for implant placement to stabilize the facial gingival and osseous architecture: a systematic review[J].Journal of Investigative and Clinical Dentistry, 2019, 10(4):e12449.DOI:10.1111/jicd.12449.
[24] 刘森庆, 杨华旋, 杜瑞钿, 等. 上颌单颗前牙不翻瓣即刻种植修复的临床效果观察[J].北京口腔医学, 2021, 29(1):32-36.
Liu SQ, Yang HX, Du RD, et al.Clinical evaluation of the outcomes of flapless single-tooth immediate implant placement and provisionalization in the anterior maxillary region[J].Beijing J Stomatol,2021,29(1):32-36.
[25] Liu R, Yang Z, Tan J, et al.Immediate implant placement for a single anterior maxillary tooth with a facial bone wall defect: a prospective clinical study with a one-year follow-up period[J]. Clin Implant Dent Relat Res, 2019,21(6):1164-1174. DOI: 10.1111/cid.12854.
[26] 赵丽娜,刘鑫,唐旭炎.上颌前牙单牙即刻种植术后即刻修复和延期修复的临床效果比较[J].口腔医学, 2019,39(9):799-804.DOI:10.13591/jcnki.kqyx.2019.09.007.
Zhao LN,Liu X,Tang XY.Comparison of the clinical effects of single implant crowns in the anterior of maxilla following immediate implant placement with immediate prosthesis or delayed prosthesis[J].Stomatology,2019,39(9):799-804.DOI:10.13591/jcnki.kqyx.2019.09.007.