Effectiveness of Socket Shield Technique Compared to Conventional Immediate Implant Placement for Clinical, Radiological, and Esthetic Rehabilitation: A Systematic Review

Introduction: Immediate implant placement is often indicated when extraction is due to trauma, endodontic lesions, root fractures, root resorption, root perforations, or unfavorable crown-to-root ratios with intact alveolar bone walls. The socket shield technique (SST) has been proposed to minimize post-extraction tissue loss and optimize esthetic outcomes.

Methods: This systematic review followed the PRISMA 2020 guidelines and was registered in PROSPERO (CRD42024497579). Electronic searches were conducted in PubMed (including MEDLINE), Cochrane, and Google Scholar from January 2014 to May 2024, supplemented by manual searches. Studies involving adult patients receiving immediate implant placement using SST were compared with conventional immediate implant placement. Primary outcomes included marginal bone loss, buccal bone width change, and radiographic bone thickness. Secondary outcomes included pink esthetic score (PES), implant stability quotient (ISQ), implant failure rate, and complications.

Results: Seven randomized controlled or prospective clinical studies met the inclusion criteria. Across studies, SST consistently demonstrated reduced marginal bone loss and buccal bone resorption, with better PES values compared to the conventional technique. ISQ values improved in both groups, with a slightly greater increase in SST cases. Implant survival rates were high for both approaches, but SST was associated with improved soft tissue stability and patient satisfaction.

Conclusion: Within the limitations of the available evidence, SST appears to preserve peri-implant hard and soft tissues more effectively than conventional immediate implant placement, particularly in the esthetic zone. While survival rates are similar, SST may offer superior esthetic outcomes and reduced labial bone loss. Further long-term, high-quality studies are needed to confirm these findings.