The socket-shield technique: a step-by-step protocol after 12 years of experience.

The socket-shield technique, first published in 2010, has gained worldwide scientific and clinical acceptance. To address possible complications with this innovative approach in esthetic implant dentistry, we provide a comprehensive step-by-step protocol incorporating what we have learnt in the past decade. After initial decoronation of the tooth, the implant bed is prepared through the root of the tooth to be extracted. Following extraction of the palatal root fragments, the shield is prepared according to either a mechanical or biologic 'locking' principle. The mechanical 'locking' comprises a direct contact between the implant and the shield, whereas the biologic approach facilitates ankylosis of the shield, preventing its coronal displacement. The coronal part of the shield is brought into a concave shape, ending up 0.5 mm coronal to the buccal bone. The implant is consequently inserted, and an individualized healing cap fabricated. When performed according to the underlying biologic and mechanical principles, the socket-shield technique can provide highly esthetic and predictable outcomes.

Complication Management of a Socket Shield Case After 6 Years of Function.

Maintaining soft and hard tissues around dental implants after tooth extraction is one of the major challenges in implant dentistry. After tooth extraction, the subsequent loss of bone and soft tissue is inevitable due to the partial resorption of the buccal bone plate. The recently described socket shield technique addresses the problem by maintaining the buccal piece of the tooth in the extraction socket in order to preserve the buccal bone. As with every new technique, specific complications, like infection of the buccal piece of the tooth, can occur. Herein, the authors present a clinical case that developed a complication with the socket shield technique and the consequential surgical management.