| PURPOSE:To evaluated the short-term clinical effect of socket-shield technique by comparing the thickness of labial bone mass and aesthetic restoration effects of patients undergoing socket-shield technique with routine immediate implant placement in the aesthetic area of maxillary anterior teeth.The differences between the two surgical methods were analyzed,and the clinical operation of the socket-shield technique were also discussed.METHODS:This study enrolled fifty-seven patients who underwent immediate implantation in the maxillary anterior teeth from September 2017 to January 2020 at the Affiliated Hospital of Qingdao University.The follow up time varies from 18-36 months.Among them,30 patients who received routine immediate implantation were divided into control group while 27 patients in experimental group who underwent immediate implantation with socket-shield technique.Cone-beam computed tomography was taken immediately after surgery,6 months after surgery,and 18 months after surgery,The thickness of labial bone plate at 0mm(I0),3mm(I3)and 6mm(I6)below the shoulder of the implant were measured,respectively,and the changes of labial bone thickness were calculated.Then analyze and compare the changes of labial bone thickness.The aesthetic effect of peri-implant soft tissue was evaluated according to Furhauser’s pink aesthetic score(PES)and Belser’s white aesthetic score(WES),and the implant success rate,modified gingival sulcus bleeding(MSBI)and clinical satisfaction were evaluated 18 months after operation.SPSS 25.0 software was used for statistical analysis,and the counting data was represented by (?) ±s.Shapiro-Wilk test was used for normality test.Two independent samples t-test is used to satisfy normality and homogeneity of variance,t’-test was used when normality was satisfied but variance was uneven,and non-parametric test of two independent samples was used when normality was not satisfied.There was significant difference(P < 0.05).RESULTS:At 6 and 18 months after operation,though the labial side bone thickness of implants decreased in both groups,the change of the bone thickness was less in experimental group compared with control group.The bone thickness changes at labial side were significantly different at I0 and I3(P < 0.05),no difference was found at I6(P > 0.05).At 18 months after surgery,the PES of experimental group was 12.15±1.29 while control group was11.53±1.17,and the WES was 9.22±0.64 in experimental group and 9.03±0.81 in control group,no statistical difference was found between groups(P > 0.05).The success rate in both groups was 100%.The MSBI of experimental group and control group was 0.70±0.47 and 0.83±0.46 respectively,with no statistical difference(P > 0.05).The scores of patient satisfaction in the two groups were 11.63±3.75 and 12.60±3.37,respectively,which were relatively high.CONCLUSION:1.Socket-shield technique could not completely avoid the absorption of soft and hard tissues on the labial side of implants,when it was applied in the aesthetic area of anterior teeth.However,compared with routine immediate implantation,the absorption process could be slowed down for a certain period of time,the contour of soft and hard tissues could be better maintained,and the rate of success was no significant difference.2.The socket-shield technique has more complex clinical operation and high technical sensitivity.It’s outstanding clinical effects can be obtained in a short period of time.However,long-term effects and feasibility still need to be verified by long-term follow-up studies with large samples.3.Technical points: preparing the root to the level of the bone surface,with a thickness of 1mm,leaving a space of about 1～2mm on the labial side of the implant and then filling the bone graft material into the defect sites. |
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