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Could the socket shield technique be better than conventional immediate implantation? A meta-analysis

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Abstract

Objectives

The purpose of this study was to evaluate whether the clinical outcome of socket shield technique (SST) is superior to that of conventional immediate implantation (CII).

Materials and method

Five electronic databases (PubMed, Cochrane, Web of Science, CNKI, and Google Scholar) were searched to identify randomized controlled trials up to June 31, 2021. Five evaluation indexes were extracted, namely, buccal bone resorption at the horizontal and vertical levels (BBH and BBV), the soft tissue recession assessed by pink evaluation scores (PES), patient satisfaction (PS), ISQ, and the success rate of implantation (SRI), to compare the superiority between SST and CII operations. All data analyses were performed using Review Manager (version 5.4).

Results

Ten studies were included in this review. The sample included 388 implants, with 194 in the SST group and 194 in the CII group. Compared with the CII group, the SST group had a lower BBH and BBV (standardized mean difference (SMD), − 1.77; 95% CI, − 2.26 to − 1.28; P < 0.00001 and SMD, − 1.85; 95% CI, − 2.16 to 1.54; P < 0.00001), higher PES improvement (SMD, 2.27; 95% CI, 1.59 to 2.95; P < 0.00001), higher rate of PS (OR, 3.12; 95% CI, 1.08 to 9.04; P = 0.04), and slightly higher ISQ (SMD, 0.71; 95% CI, 0.28 to 1.15; P = 0.001).

Conclusions

Compared with CII, SST could be a better option for esthetic area implantation, but evaluation of its long-term success is still needed.

Clinical relevance

By comparing and analyzing the operations of immediate implant in esthetic zone, we could choose SST to effectively alleviate the absorption of bone tissue and improve the contouring of soft tissue after anterior teeth extraction, so as to achieve a more stable and superior clinical outcomes of implant in esthetic zone.

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References

  1. Pihlstrom BL, Michalowicz BS, Johnson NW (2005) Periodontal diseases. Lancet (London, England) 366(9499):1809–1820. https://doi.org/10.1016/S0140-6736(05)67728-8

    Article  Google Scholar 

  2. Jenny G, Jauernik J, Bierbaum S, Bigler M, Grätz KW, Rücker M, Stadlinger B (2016) A systematic review and meta-analysis on the influence of biological implant surface coatings on periimplant bone formation. J Biomed Mater Res, Part A 104(11):2898–2910. https://doi.org/10.1002/jbm.a.35805

    Article  Google Scholar 

  3. Jung RE, Zembic A, Pjetursson BE, Zwahlen M, Thoma DS (2012) Systematic review of the survival rate and the incidence of biological, technical, and aesthetic complications of single crowns on implants reported in longitudinal studies with a mean follow-up of 5 years. Clin Oral Implant Res 23(Suppl 6):2–21. https://doi.org/10.1111/j.1600-0501.2012.02547.x

    Article  Google Scholar 

  4. Shemtov-Yona K, Rittel D (2015) An overview of the mechanical integrity of dental implants. Biomed Res Int 2015:547384. https://doi.org/10.1155/2015/547384

    Article  PubMed  PubMed Central  Google Scholar 

  5. Adell R, Lekholm U, Rockler B, Brånemark PI (1981) A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg 10(6):387–416. https://doi.org/10.1016/s0300-9785(81)80077-4

    Article  PubMed  Google Scholar 

  6. Gotfredsen K, Walls AW (2007) What dentition assures oral function? Clin Oral Implant Res 18(Suppl 3):34–45. https://doi.org/10.1111/j.1600-0501.2007.01436.x

    Article  Google Scholar 

  7. Esposito M, Grusovin MG, Polyzos IP, Felice P, Worthington HV (2010) Timing of implant placement after tooth extraction: immediate, immediate-delayed or delayed implants? A Cochrane systematic review. Eur J Oral Implantol 3(3):189–205

    PubMed  Google Scholar 

  8. Seyssens L, De Lat L, Cosyn J (2021) Immediate implant placement with or without connective tissue graft: a systematic review and meta-analysis. J Clin Periodontol 48(2):284–301. https://doi.org/10.1111/jcpe.13397

    Article  PubMed  Google Scholar 

  9. Avila-Ortiz G, Elangovan S, Kramer KW, Blanchette D, Dawson DV (2014) Effect of alveolar ridge preservation after tooth extraction: a systematic review and meta-analysis. J Dent Res 93(10):950–958. https://doi.org/10.1177/0022034514541127

    Article  PubMed  PubMed Central  Google Scholar 

  10. Pietrokovski J, Massler M (1967) Alveolar ridge resorption following tooth extraction. J Prosthet Dent 17(1):21–27. https://doi.org/10.1016/0022-3913(67)90046-7

    Article  PubMed  Google Scholar 

  11. Araújo MG, Lindhe J (2005) Dimensional ridge alterations following tooth extraction. An experimental study in the dog. J Clin Periodontol 32(2):212–218. https://doi.org/10.1111/j.1600-051X.2005.00642.x

    Article  PubMed  Google Scholar 

  12. Kotsakis G, Chrepa V, Marcou N, Prasad H, Hinrichs J (2014) Flapless alveolar ridge preservation utilizing the “socket-plug” technique: clinical technique and review of the literature. J Oral Implantol 40(6):690–698. https://doi.org/10.1563/AAID-JOI-D-12-00028

    Article  PubMed  Google Scholar 

  13. Casey DM, Lauciello FR (1980) A review of the submerged-root concept. J Prosthet Dent 43(2):128–132. https://doi.org/10.1016/0022-3913(80)90174-2

    Article  PubMed  Google Scholar 

  14. Gharpure AS, Bhatavadekar NB (2017) Current evidence on the socket-shield technique: a systematic review. J Oral Implantol 43(5):395–403. https://doi.org/10.1563/aaid-joi-D-17-00118

    Article  PubMed  Google Scholar 

  15. Bäumer D, Zuhr O, Rebele S, Schneider D, Schupbach P, Hürzeler M (2015) The socket-shield technique: first histological, clinical, and volumetrical observations after separation of the buccal tooth segment – a pilot study. Clin Implant Dent Relat Res 17(1):71–82. https://doi.org/10.1111/cid.12076

    Article  PubMed  Google Scholar 

  16. Abadzhiev M, Nenkov P, Velcheva P (2014) Conventional immediate implant placement and immediate placement with socket-shield technique – which is better. International Journal Clinical Medicine Research 1:176–180

    Google Scholar 

  17. Saeidi Pour R, Zuhr O, Hürzeler M, Prandtner O, Rafael CF, Edelhoff D, Liebermann A (2017) Clinical benefits of the immediate implant socket shield technique. J Esthet Restor Dent 29(2):93–101. https://doi.org/10.1111/jerd.12291

    Article  PubMed  Google Scholar 

  18. Siormpas KD, Mitsias ME, Kontsiotou-Siormpa E, Garber D, Kotsakis GA (2014) Immediate implant placement in the esthetic zone utilizing the “root-membrane” technique: clinical results up to 5 years postloading. Int J oral Maxillofacial Implants 29(6):1397–1405. https://doi.org/10.11607/jomi.3707

    Article  Google Scholar 

  19. Bäumer D, Zuhr O, Rebele S, Hürzeler M (2017) Socket shield technique for immediate implant placement - clinical, radiographic and volumetric data after 5 years. Clin Oral Implant Res 28(11):1450–1458. https://doi.org/10.1111/clr.13012

    Article  Google Scholar 

  20. Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA, Cochrane Bias Methods Group, & Cochrane Statistical Methods Group (2011) The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ (Clinical research ed) 343:d5928. https://doi.org/10.1136/bmj.d5928

    Article  Google Scholar 

  21. Fürhauser R, Florescu D, Benesch T, Haas R, Mailath G, Watzek G (2005) Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score. Clin Oral Implant Res 16(6):639–644. https://doi.org/10.1111/j.1600-0501.2005.01193.x

    Article  Google Scholar 

  22. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6(7):e1000097. https://doi.org/10.1371/journal.pmed.1000097

    Article  PubMed  PubMed Central  Google Scholar 

  23. Abd-Elrahman A, Shaheen M, Askar N, Atef M (2020) Socket shield technique vs conventional immediate implant placement with immediate temporization Randomized clinical trial. Clin Implant Dentistry Related Res 22(5):602–611. https://doi.org/10.1111/cid.12938

    Article  Google Scholar 

  24. Bramanti E, Norcia A, Cicciù M, Matacena G, Cervino G, Troiano G, Zhurakivska K, Laino L (2018) Postextraction dental implant in the aesthetic zone, socket shield technique versus conventional protocol. J Craniofac Surg 29(4):1037–1041. https://doi.org/10.1097/SCS.0000000000004419

    Article  PubMed  Google Scholar 

  25. Yunbin Li (2021) Comparison of modified shield tecnique and traditional immediate implant in the treatment of patients with single dental implant in maxillary esthetic area. Medical Journal of Chinese people’s health 33(08):134–136. https://doi.org/10.3969/j.issn.1672-0369.2021.08.054

    Article  Google Scholar 

  26. Atef M, El Barbary A, Dahrous M, Zahran AF (2021) Comparison of the soft and hard peri-implant tissue dimensional changes around single immediate implants in the esthetic zone with socket shield technique versus using xenograft: a randomized controlled clinical trial. Clin Implant Dent Relat Res 23(3):456–465. https://doi.org/10.1111/cid.13008

    Article  PubMed  Google Scholar 

  27. Sun C, Zhao J, Liu Z, Tan L, Huang Y, Zhao L, Tao H (2020) Comparing conventional flap-less immediate implantation and socket-shield technique for esthetic and clinical outcomes: a randomized clinical study. Clin Oral Implant Res 31(2):181–191. https://doi.org/10.1111/clr.13554

    Article  Google Scholar 

  28. Fattouh H (2018) Socket-shield technique versus guided bone regeneration technique for ridge preservation with immediate implant placement in the esthetic zone. Egypt Dent J 64(3):2047–2055. https://doi.org/10.21608/edj.2018.76748

    Article  Google Scholar 

  29. Tiwari S, Bedi RS, Wadhwani P, Aurora JK, Chauhan H (2020) Comparison of immediate implant placement following extraction with and without socket-shield technique in esthetic region. Journal of maxillofacial and oral surgery 19(4):552–560. https://doi.org/10.1007/s12663-019-01272-3

    Article  PubMed  Google Scholar 

  30. BinLihua ZS, Junhua Z et al (2020) Short-term effect comparison of a modified socket shield technique and conventional flapless immediate implant and immediate restoration in maxillary aesthetic area. Zhongguo Zuzhi Gongcheng Yanjiu 24(34):5514–5519. https://doi.org/10.3969/j.issn.2095-4344.2344

    Article  Google Scholar 

  31. Hana SA, Omar OA (2020) Socket shield technique for dental implants in the esthetic zone, clinical and radiographical evaluation. J University of Duhok 23(1):69–80. https://doi.org/10.26682/sjuod.2020.23.1.8

    Article  Google Scholar 

  32. Barakat D, Hassan R, Eldibany R (2017) Evaluation of the socket shield technique for immediate implantation. Alex Dent J 42(2):155–161. https://doi.org/10.21608/adjalexu.2017.57919

    Article  Google Scholar 

  33. Hürzeler MB, Zuhr O, Schupbach P, Rebele SF, Emmanouilidis N, Fickl S (2010) The socket-shield technique: a proof-of-principle report. J Clin Periodontol 37(9):855–862. https://doi.org/10.1111/j.1600-051X.2010.01595.x

    Article  PubMed  Google Scholar 

  34. Schwimer, C., Pette, G. A., Gluckman, H., Salama, M., & Du Toit, J. (2018). Human histologic evidence of new bone formation and osseointegration between root dentin (unplanned socket-shield) and dental implant: case report. The International journal of oral & maxillofacial implants, 33(1), e19–e23.https://doi.org/10.11607/jomi. 6215

  35. Buser D, Warrer K, Karring T (1990) Formation of a periodontal ligament around titanium implants. J Periodontol 61(9):597–601. https://doi.org/10.1902/jop.1990.61.9.597

    Article  PubMed  Google Scholar 

  36. Degidi M, Daprile G, Piattelli A (2010) Determination of primary stability: a comparison of the surgeon’s perception and objective measurements. Int J Oral Maxillofac Implants 25(3):558–561

    PubMed  Google Scholar 

  37. Mourya A, Mishra SK, Gaddale R, Chowdhary R (2019) Socket-shield technique for implant placement to stabilize the facial gingival and osseous architecture: a systematic review. J Investig Clin Dent 10(4):e12449. https://doi.org/10.1111/jicd.12449

    Article  PubMed  Google Scholar 

  38. Kumar PR, Kher U (2018) Shield the socket: procedure, case report and classification. Journal of Indian Society of Periodontology 22(3):266–272. https://doi.org/10.4103/jisp.jisp_78_18

    Article  PubMed  PubMed Central  Google Scholar 

  39. Esteve-Pardo G, Esteve-Colomina L (2018) Clinical application of the socket-shield concept in multiple anterior teeth. Case reports in dentistry 2018:9014372. https://doi.org/10.1155/2018/9014372

    Article  PubMed  PubMed Central  Google Scholar 

  40. Schwimer CW, Gluckman H, Salama M, Nagy K, Du Toit J (2019) The socket-shield technique at molar sites: a proof-of-principle technique report. J Prosthet Dent 121(2):229–233. https://doi.org/10.1016/j.prosdent.2018.05.006

    Article  PubMed  Google Scholar 

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Funding

This work was supported by research grants from the National Nature Science Foundation of China (81671006, 30901680) and CAMS Innovation Fund for Medical Sciences (2019-I2M-5–038).

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Authors and Affiliations

  1. Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, 100081, China

    Aobo Zhang, Xiaoxiao Liu, XinJia Cai & Tiejun Li

  2. Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, 100081, China

    Aobo Zhang, Xiaoxiao Liu, XinJia Cai & Lisha Sun

  3. School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271016, Shandong, China

    Yuping Liu

  4. Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, 100081, China

    Lisha Sun

  5. National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China

    Lisha Sun

  6. No.22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, People’s Republic of China

    Lisha Sun & Tiejun Li

Authors
  1. Aobo Zhang
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  2. Yuping Liu
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Correspondence to Lisha Sun or Tiejun Li.

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Aobo Zhang and Yuping Liu contributed equally to this work

Appendices

Appendix

Search Strategies.

PubMed (MEDLINE):

(((((Socket Shield Technique[Title/Abstract]) OR (Socket Shield Techniques[Title/Abstract])) OR (Technique, Socket Shield[Title/Abstract])) OR (Socket-Shield Technique[Title/Abstract])) OR (Socket-Shield Techniques[Title/Abstract])) OR (Technique, Socket-Shield[Title/Abstract]).

Result: 67 studies.

WEB OF SCIENCE:

Socket Shield Technique (Topic) or Socket Shield Techniques (Topic) or Technique, Socket Shield (Topic) or Socket-Shield Technique (Topic) or Socket-Shield Techniques (Topic) or Technique, Socket-Shield (Topic) and Clinical Trial (Document Types).

Result: 119 studies.

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Zhang, A., Liu, Y., Liu, X. et al. Could the socket shield technique be better than conventional immediate implantation? A meta-analysis. Clin Oral Invest 26, 1173–1182 (2022). https://doi.org/10.1007/s00784-021-04266-z

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  • DOI: https://doi.org/10.1007/s00784-021-04266-z

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