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Clin Implant Dent Relat Res. 2018 Apr;20(2):122-129. doi: 10.1111/cid.12554. Epub 2017 Nov 26.

A retrospective evaluation of 128 socket-shield cases in the esthetic zone and posterior sites: Partial extraction therapy with up to 4 years follow-up.

Author information

The Implant and Aesthetic Academy, Cape Town, South Africa.
Medical College of Georgia, University of Pennsylvania, Philadelphia, Augusta, Georgia.
Department of Periodontics and Oral Medicine, School of Dentistry, Faculty of Health Sciences, University of Pretoria, South Africa.



Tooth loss results in an inevitable alveolar ridge reduction. This has established a cautionary approach to extract, wait, augment, and insert the implant, in lieu of immediate placement. However, saving the tooth or part of it whenever possible is more conservative and supports the vital periodontal tissue buccofacial to an implant. The purpose of this cases series was to report on implant survival using this technique in a large cohort of patients at mid-term follow-up.


A private practice patient database was searched for all patients having received socket-shield treatment in conjunction with immediate implant placement. Of the results returned, 128 met the inclusion criteria of ≥12 months from date of restoration, or failing prior to definitive restoration. These patients were recalled for evaluation of the restored implants up to 4 years post-treatment.


Seventy immediate implants with socket-shields were placed in female patients and 58 in males, age range 24-71 (mean 39 years). The distribution of sites treated were: maxillary incisors (64%), premolars (22%), canines (14%); maxilla (89.9%), mandible (10.1%). 123/128 implants osseointegrated and survived 1-4 years following restoration (survival rate 96.1%). A combined complication rate of 25/128 implants occurred (19.5%). Five implants failed to osseointegrate and were removed. The remaining 20 complications were all managed or observed without management, with implants surviving at mid-term follow-up.


Notwithstanding technique sensitivity and the need for randomized control studies, this case series demonstrates that the socket-shield performs competitively when compared to implant survival rates in both conventional immediate and delayed implant placement.


dental implant; implant dentistry; partial extraction therapy; socket-shield technique

[Indexed for MEDLINE]

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