Comparing conventional flap-less immediate implantation and socket-shield technique for esthetic and clinical outcomes: A randomized clinical study.

OBJECTIVE: The aim of this study was to assess the esthetic and clinical outcomes of immediate implantation using the conventional flap-less approach and the socket-shield technique (SST). METHODS: This study included 30 adult patients who underwent anterior teeth replacement and fulfilled the pre-defined criteria. Patients were randomly allocated to the SST (n = 15) and conventional flap-less (control, n = 15) groups. The esthetic outcomes were evaluated by assessing the degree of soft-tissue recession and the pink esthetic scores (PESs). Clinical parameters, including the modified plaque index, modified sulcus bleeding index (mSBI), probing depth (PD), and implant stability quotient (ISQ), were assessed. The buccal plate width (BPW) and height (BPH) were also measured. RESULTS: Implantation was clinically successful for all subjects in both groups. With a similar baseline, the SST group exhibited less reduction in the midfacial mucosal margins and the height of the mesial and distal papillae as well as higher BPW and BPH values compared with the control group (p < .001). The ISQ values were 76.01 +/- 1.31 for the SST group and 75.56 +/- 1.07 for the control group (p > .05), suggesting sufficient initial stability in both groups. At the 24-month follow-up, SST group patients had statistically significant lower values of PD, mSBI, and mPLI compared with the control group. There were no significant differences in the overall and individual PES values for both groups. CONCLUSION: SST may improve functional and esthetic outcomes by maintaining alveolar bone volume and peri-implant tissues. SST seems to be a promising treatment approach for implants in the esthetic zone.