Socket Shield Technique for Immediate and Delayed Implant Placement: A 6-Year Clinical Tria

NCT07171866 | Completed

• 1 other identifier: R.25.09.21
• Study Type: interventional
• Target: 25
• Locations: 1 country
• Sites: 1

Brief Summary

This study investigates the long-term performance of the Socket Shield Technique (SST) for preserving the bone and soft tissue around dental implants when used with two different timing protocols: immediate versus delayed implant placement. SST is a surgical technique where a thin portion of the tooth root (the buccal shield) is intentionally retained to support the facial bone and gum tissues after tooth extraction. While SST is known to enhance esthetics and preserve bone in the short term, little evidence exists on its long-term effectiveness in different clinical scenarios. This randomized clinical trial enrolled patients who needed single-tooth implants in the esthetic zone. Participants were randomly assigned to one of two groups: Immediate SST group: the implant was placed at the same time the socket shield was prepared. Delayed SST group: implant placement was performed six months after socket shield preparation. Over a 6-year follow-up period, both groups were evaluated for: Changes in ridge width and bone height using CBCT imaging. Esthetic outcomes using the Pink Esthetic Score (PES). Patient satisfaction through a structured questionnaire. The goal is to determine whether SST offers reliable long-term outcomes in either immediate or delayed implant placement scenarios, supporting its broader clinical use.

Conditions

Alveolar Ridge Preservation; Implant Dentistry

Keywords

Socket Shield Technique; Immediate Implant Placement; Delayed Implant Placement; CBCT; Ridge Width Change; Pink Esthetic Score; Alveolar Ridge Preservation; Long-term Implant Outcomes

Outcome Measures

Primary Outcomes (1)

• Horizontal Ridge Width Change at 1, 2, 4, and 6 mm Apical to the Implant Platform

  Ridge width was measured at 1 mm, 2 mm, 4 mm, and 6 mm apical to the implant platform using standardized CBCT scans. Superimposed scans were aligned using the Fusion module of OnDemand3D™ software. Changes in horizontal ridge width were calculated by subtracting baseline values from those at 1 year and 6 years to assess dimensional stability over time. Unit of Measure: → Millimeters (mm) Safety Issue: → No

  Immediately after implant placement (baseline), 1 year, and 6 years post-placement

Secondary Outcomes (4)

• Buccal and Palatal Bone Height Change

  Immediately after implant placement (baseline), 1 year, and 6 years post-placement

• Implant Stability Quotient (ISQ)

  Immediately after implant placement, loading time and 1-year post-placement

• Pink Esthetic Score (PES)

  At implant loading, 1 year, and 6 years post-placement

• Patient Satisfaction (VAS Score)

  At implant loading, 1 year, and 6 years post-placement

Study Arms (2)

Immediate Implant Placement with SST

ACTIVE COMPARATOR

Participants received the SST with immediate implant placement performed at the time of extraction.

Procedure: Immediate Implant Placement with SST

Delayed Implant Placement with SST

ACTIVE COMPARATOR

Participants received the SST with delayed implant placement, performed 6 months after extraction and shield preparation.

Procedure: Delayed Implant Placement with SST

Interventions

Immediate Implant Placement with SST PROCEDURE

Participants underwent extraction and socket shield preparation, followed by immediate implant placement in the esthetic maxillary zone. The implant was inserted at the same surgical session using a flapless or minimally invasive approach. CBCT was used to guide planning and assess ridge dimensions. Healing and follow-up assessments were conducted at 1 year and 6 years post-placement.

Immediate Implant Placement with SST

Delayed Implant Placement with SST PROCEDURE

Participants underwent extraction and socket shield preparation. Implant placement was delayed for 6 months to allow soft and hard tissue healing. The implant was placed after verifying shield stability and ridge preservation via CBCT. Follow-up assessments were conducted at 1 year and 6 years post-placement.

Delayed Implant Placement with SST

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients requiring single-tooth replacement in the anterior maxilla (esthetic zone)
• Age between 18-65 years
• Good systemic health
• Demonstrated good oral hygiene
• Presence of an intact buccal plate
• Class I or II sagittal root position
• Sufficient apical bone volume and quality for implant placement
• Willingness and ability to comply with study protocol and follow-up schedule
• Signed informed consent

You may not qualify if:

• Presence of acute infection at the extraction site (e.g., abscess)
• Vertical root fracture or advanced periodontitis with buccal plate loss
• Uncontrolled systemic disease (e.g., diabetes, osteoporosis)
• Parafunctional habits (e.g., bruxism, clenching)

Sponsors & Collaborators

• Soaad Tolba Mohammed Tolba Badawi: lead

Study Sites (1)

Faculty of Dentistry, Mansoura University

Al Mansurah, Dakahlia Governorate, 35511, Egypt

Location

Study Officials

• Soaad Tolba Badawy, Lecturer, Oral Surgery, MU

  Faculty of dentistry, Mansoura university

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: The radiographic outcomes assessor was blinded to group allocation. No other masking was implemented due to the surgical nature of the intervention.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Lecturer of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University

Model Details: Participants were randomized into two parallel groups: one receiving immediate implant placement and the other delayed placement following the SST. Each group followed the assigned intervention protocol throughout the study.

Study Record Dates

• First Submitted: September 6, 2025
• First Posted: September 15, 2025
• Study Start: February 1, 2019
• Primary Completion: July 1, 2025
• Study Completion: July 1, 2025
• Last Updated: September 17, 2025

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)