The Socket Shield Technique using Bone Trephine: A Case Report

Abstract

Background: To avoid tissue alterations of the ridge after tooth extraction the socket shield technique was first introduced in 2010 by Hurzeler. It was suggested that instead of extracting the whole tooth, the buccal aspect of the root could be left intact to preserve the buccal plate of bone and prevent post extraction resorption, at the same time an immediate implant is placed; this would lead to an optimal stable esthetic result after the final delivery of the restoration. To extract the tooth while keeping the buccal aspect intact, a fissure bur is used to cut the tooth mesiodistaly then the lingual aspect of the tooth is extracted leaving a socket where the implant is to be placed. Materials and Methods: In this case report a bone trephine was used to take out the remaining root on tooth number 24 leaving an organized rounded section of the palatal/lingual extraction site with a semi lunar internal shape of the buccal aspect of the root that will receive an implant. Results after the implant prosthesis was delivered an unchanged emergence profile was noted. The pre operative cone beam computer tomography (CBCT) showed that there were no signs of infection and that the buccal plate was intact. The post-operative CBCT showed the same unchanged findings. Conclusion: Socket shield represents a promising technique to preserve the buccal plate of bone allowing for immediate implant placement. This helps in achieving an ultimate aesthetic outcome that may imitate the natural emergence profile of the neighboring dentition. In this case report we demonstrate that preparing the shield with a trephine may be of a great advantage.