engleski

Immediate implanto- prosthetic rehabilitation after socket shield technique of implant placement 6 years follow up - a clinical study

Background : Socket shield technique was introduced by Hurzeler and associates in year 2010., which is used at immediate implantation in order to preserve buccal wall bone. During tooth extraction, buccal root with periodontal ligament should be left in alveola and implant is inserted little bit towards palatal wall bone, in direct contact with buccal part of the root. As written above preservation of buccal bone and soft tissues has a huge influence on esthetic outcome of implant prosthetic work. Aim/Hypothesis : The aim of this clinical study was to investigate clinical success of the socket shield technique and to evaluate its outcome 6 years after surgical and prosthetic rehabilitation. Materials and Methods : This clinical study constituted of 30 patients with strong indication for tooth extraction in the frontal part of the maxilla. Patients were divided due to their clinical indications: Postendodontic horizontal tooth fracture where the fracture line is prosper enough to preserve buccal tooth root and immediate implant placement ; Postendodontic submarginal fracture when patient rejects orthodontic tooth extrusion ; Crown fracture of vital tooth beyond the marginal bone surface. In each group consisted of 10 patients. Partial resection of palatal root was performed in each patient with a view to preserve buccal root as well as buccal bone wall. Before implant was inserted a buccal root was smeared with Emdogain gel. Immediate crowns were made. After 4 months a permanent implant- prosthetic substitute was made, while x- ray analysis was made after 6 months, 4 years and after 6 years and esthetic (PES) evaluation has been made on clinical photo. Results : Patients did not have any kind of complications after surgery. Immediate crowns were replaced with permanent tooth crowns after 4 months. Soft tissue contours were preserved in all cases, also buccal bone wall was preserved after 6 months and after 4 and 6 years. In a period of following 6 years there were one biological complication regarding peri- implantitis after 5 years and that implant was lost. There were mechanical complications with 4 patients regarding screw loosening. All mechanical complications occured after 1 year in function and were resolved in one visit. The mean PES of evaluations after 6 years in function were 12.23 (±3.7 SD) regarding 12.78 after 6 months post implant and crown placement. Conclusions and Clinical Implications : With buccal bone wall preservation as well as a preservation of gingival tissue using technique of immediate implant placement, very good esthetic results were achieved. By deciding which patients are candidates for this surgery indications and guidelines written above need to be followed.

socket shield ; PES ; Emdogain ; immediate implant placement

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