Socket Shield Technique to Improve the Outcomes of Immediate Implant: A Systematic Review and Meta-Analysis

Prosthesis

article

Antonio Scarano¹  Mariastella Di Carmine¹  Faez Saleh Al-Hamed²  Ahmad G. A. Khater³  Sergio Alexandre Gehrke⁴  Sergio Rexhep Tari¹  Lucia Leo¹  Francesco Inchingolo⁶  Felice Lorusso¹ 

[1] Department of Innovative Technologies in Medicine and Dentistry, University of Chieti–Pescara;College of Dental Medicine, QU Health, Qatar University;Health Affairs Directorate, Egyptian Ministry of Health and Population;Department of Research;Department of Biotechnology, Universidad Católica de Murcia;Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”

关键词: dental implant;    esthetic zone;    evidence-based dentistry;    immediate implant placement;    immediate loading;    partial extraction;    socket shield;    systematic review;   

DOI  :  10.3390/prosthesis5020035

学科分类：自然科学（综合）

来源: mdpi

【 摘 要 】

Background: The socket shield technique (SST) could address the challenges in immediate implant placement by minimizing post-extraction bone resorption while maintaining soft tissue levels. This study aimed to summarize the available evidence and systematically assess the effectiveness of SST immediate implant placement regarding all outcomes (bone loss, esthetics, implant stability, probing depth, complications, and survival rate). Methods: We searched seven electronic databases through April 2023 to identify randomized clinical trials that assessed the effect of immediate implant placed with SST (test group) versus other implant placement protocols without SST. The risk of bias was assessed using Cochrane’s randomized trial quality assessment Tool (RoB 2.0). Random-effects meta-analysis was conducted, with mean difference and 95% confidence intervals (MD, 95% CI) as effect estimates. We used the GRADE approach to assess the certainty of evidence. Results: Twelve RCTs, involving 414 immediate implants, placed in 398 patients, were included. Meta-analyses revealed that the immediate implants placed with SST had a statistically significant decrease in horizontal (MD = −0.28, 95% CI [−0.37, −0.19], p < 0.0001), vertical (MD = −0.85, 95% CI [−1.12, −0.58], p < 0.0001), and crestal (MD = −0.35, 95% CI [−0.56, −0.13], p = 0.002) bone loss, as well as probing depth (MD = −0.64, 95% CI [−0.99, −0.29], p = 0.0003). Additionally, SST had a significant increase in implant stability (MD = 3.46, 95 % CI [1.22, 5.69], p = 0.002) and pink esthetic score (MD = 1.60, 95% CI [0.90, 2.30], p < 0.0001). Only two studies reported shield exposure incidences in the SST group; however, all studies revealed no implant failure and a 100% survival rate. The evidence certainty was assessed as very low. Conclusions: Based on limited evidence, SST was more effective in minimizing bone resorption and improving implant stability and esthetic outcomes than conventional immediate implant placement. Still, SST could not be recommended as a routine clinical protocol due to the lack of a standardized surgical approach; thus, further high-quality RCTs are required to support this conclusion.

【 授权许可】

CC BY