Digital surgical guide-assisted immediate implant placement combined with the socket-shield technique in the anterior esthetic zone: a case report

doi:10.12337/zgkqzzxzz.2025.12.014

Abstract

Abstract: This article reports a case of immediate implant placement in the esthetic zone of the anterior maxilla using a digital surgical guide combined with the socket-shield technique. The anterior esthetic region demands high precision in implant positioning, as minor deviations may lead to esthetic complications. The digital guide enables prosthetically driven implant placement through precise control of the insertion position. Meanwhile, to address the collapse of the buccal bundle bone following tooth extraction, the socket-shield technique preserves the facial root fragment to maintain the blood supply to the periodontal ligament-bundle bone complex, thereby maximizing the preservation of the alveolar bone contour and gingival esthetics.

Key words: Digital surgical guide, Socket-shield technique, Immediate implant placement

Liu Mengqi, Xiao Weiwei, Bu Xiaoling, Gong Lingling, Feng Bo. Digital surgical guide-assisted immediate implant placement combined with the socket-shield technique in the anterior esthetic zone: a case report[J]. Chinese Journal of Oral Implantology, 2025, 30(6): 599-603.

References

[1] Buser D, Martin W, Belser UC.Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations[J]. Int J Oral Maxillofac Implants, 2004, 19(Suppl):43-61.
[2] Lou FZ, Zhang MR, Rao PC, et al.[Precise investigation of digital guide plates applied to implant surgery of anterior teeth] [J]. Hua Xi Kou Qiang Yi Xue Za Zhi, 2020,38(2):170-176. DOI: 10.7518/hxkq.2020.02.011.
[3] Huynh-Ba G, Pjetursson BE, Sanz M, et al.Analysis of the socket bone wall dimensions in the upper maxilla in relation to immediate implant placement[J]. Clin Oral Implants Res, 2010,21(1):37-42. DOI: 10.1111/j.1600-0501.2009.01870.x.
[4] Calvo-Guirado JL, Troiano M, López-López PJ, et al.Different configuration of socket-shield technique in peri-implant bone preservation: an experimental study in dog mandible[J]. Ann Anat, 2016,208:109-115. DOI: 10.1016/j.aanat.2016.06.008.
[5] Araújo MG, Lindhe J.Dimensional ridge alterations following tooth extraction. An experimental study in the dog[J]. J Clin Periodontol, 2005,32(2):212-218. DOI: 10.1111/j.1600-051X.2005.00642.x.
[6] Botticelli D, Berglundh T, Lindhe J.Hard-tissue alterations following immediate implant placement in extraction sites[J]. J Clin Periodontol, 2004,31(10):820-828. DOI: 10.1111/j.1600-051X.2004.00565.x.
[7] Hürzeler MB, Zuhr O, Schupbach P, et al.The socket-shield technique: a proof-of-principle report[J]. J Clin Periodontol, 2010,37(9):855-862. DOI: 10.1111/j.1600-051X.2010.01595.x.
[8] Majid OW.For immediate implant placement, socket shield technique may significantly reduce marginal bone loss as compared to conventional protocol[J]. J Evid Based Dent Pract, 2023,23(4):101923. DOI: 10.1016/j.jebdp.2023.101923.
[9] Li X, Liu N, Li X, et al.Comparing bone alteration and esthetic recovery between the socket-shield technique and the conventional immediate implant technique: a retrospective study[J]. Int J Oral Maxillofac Implants, 2024,39(2):254-262. DOI: 10.11607/jomi.10833.
[10] 温小娜, 马索男, 刘燕. 上颌前牙区行根盾技术即刻种植和常规不翻瓣即刻种植的临床效果观察[J].临床口腔医学杂志,2025,41(8):480-483,491. DOI: 10.3969/j.issn.1003-1634.2025.08.008.
Wen XN, Ma SN, Liu Y.Clinical effects of immediate implantation under socket-shield technique and non-flap in maxillary anterior tooth area[J].J Clin Stomatol, 2025,41(8):480-483,491. DOI: 10.3969/j.issn.1003-1634.2025.08.008.
[11] 朱蒙飞, 刘鑫, 唐旭炎. 根盾技术和不翻瓣即刻种植在不同牙龈生物型的种植美学比较[J].口腔医学,2023,43(4):327-333. DOI: 10.13591/j.cnki.kqyx.2023. 04.008.
Zhu MF, Liu X, Tang XY.Comparison of the esthetics in different gingival biotypes between the socket-shield technique and the flap-less immediate implant[J].Stomatology,2023,43(4):327-333. DOI: 10.13591/j.cnki.kqyx.2023.04.008.
[12] Cherel F, Etienne D.Papilla preservation between two implants: a modified socket-shield technique to maintain the scalloped anatomy? A case report[J]. Quintessence Int, 2014,45(1):23-30. DOI: 10.3290/j.qi.a30765.
[13] 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.
[14] Staehler P, Abraha SM, Bastos J, et al.The socket-shield technique: a step-by-step protocol after 12 years of experience[J]. Int J Esthet Dent, 2020,15(3):288-305.
[15] Mitsias ME, Siormpas KD, Kontsiotou-Siormpa E, et al.A step-by-step description of PDL-mediated ridge preservation for immediate implant rehabilitation in the esthetic region[J]. Int J Periodontics Restorative Dent, 2015,35(6):835-841. DOI: 10.11607/prd.2148.
[16] 尹曦, 郭琳, 陈亮. 改良盾构术与传统即刻种植术的临床效果对比研究[J].临床口腔医学杂志,2024,40(12):745-748.DOI: 10.3969/j.issn.1003-1634.2024.12.010.
Yin X,Guo L,Chen L.Comparison of clinical effects of a modified socket-shield technique and the conventional immediate implant placement[J].J Clin Stomatol,2024,40(12):745-748.DOI: 10.3969/j.issn.1003-1634.2024.12.010.
[17] Chen Y, Sun C, Li H.Effects of flapless and flapped implantations on soft tissue: a systematic review and Meta-analysis[J]. Hua Xi Kou Qiang Yi Xue Za Zhi, 2024,42(3):382-393. DOI: 10.7518/hxkq.2024.2023341.
[18] Wang Z, Liu J, Wang X, et al.Effect of CAD/CAM guide plate combined with socket-shield technique in immediate implantation of anterior teeth aesthetic area and its influence on aesthetics[J]. Front Surg, 2021,8:833288. DOI: 10.3389/fsurg.2021.833288.
[19] Feng Y, Su Z, Mo A, et al.Comparison of the accuracy of immediate implant placement using static and dynamic computer-assisted implant system in the esthetic zone of the maxilla: a prospective study[J]. Int J Implant Dent, 2022,8(1):65. DOI: 10.1186/s40729-022-00464-w.
[20] 史俊宇, 赖漪娆, 王蓓. CAD/CAM全程手术导板结合改良根盾技术在前牙区即刻种植中的应用[J].口腔材料器械杂志, 2021,30(1):55-60.DOI: 10.11752/j.kqcl.2021.01.00.
Shi JY,Lai YR,Wang B.Application of the fully-guided implant surgical template with CAD/CAM technology and modified socket-shield technique for immediate implant placement of anterior teeth[J].Chin J Dental Mater Devices,2021,30(1):55-60.DOI: 10.11752/j.kqcl.2021.01.00.
[21] He P, Duan S, Li L, et al.A socket-shield technique: preparation of the shield under oral microscopy[J]. J Prosthet Dent, 2025,134(1):28-32. DOI: 10.1016/j.prosdent.2025.03.011.
[22] Song Z, Li Z, Li X, et al.Design and application of modified CAD/CAM socket-shield preparation template in immediate implantation in the esthetic area[J]. J Esthet Restor Dent, 2023,35(8):1186-1193. DOI: 10.1111/jerd.13077.