Design and application of modified CAD/CAM socket-shield preparation template in immediate implantation in the esthetic area.

OBJECTIVE: Designed and applicated a modified customized CAD-CAM socket-shield preparation guide template in immediate implant and followed up for 3 years. CLINICAL CONSIDERATIONS: Socket-shield technique could improve the esthetic effect of immediate implant restorations by preserving the labial fascicular bone-periodontal complex at the implant site. While the socket-shield technique is highly technique-sensitive. A modified customized CAD/CAM guided template was designed and fabricated by 3D printing. The movement of the carbide bur during preparing the socket-shield was limited by the socket-shield preparation template. In this case report, the socket-shield preparation template was used for preparing the socket-shield in the tooth root with irregular morphology and the case was followed up for 3 years. CONCLUSIONS: The modified CAD/CAM socket-shield preparation template effectively improved the accuracy and efficiency of preparing the socket-shield by limiting the movement of the high-speed carbide bur in both in both lip-to-palatal and crown-to-root orientation. The socket-shield with accurate morphology could effectively maintain the gingival marginal level and contour. CLINICAL SIGNIFICANCE: The modified CAD/CAM socket-shield preparation template with the depth-locking ring effectively reduced the technique sensitivity and time consumption of the socket-shield technique, especially for tooth roots with irregular morphology.