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Implant dentistry

Bone grafting in socket shield: necessary or optional for immediate implants?

Evidence-Based Dentistry volume 26, pages 78–79 (2025)Cite this article

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Abstract

A Commentary on

Gurbuz E, Ceylan E

Comparison of a non-grafted socket shield technique with guided bone regeneration in immediate implant placement: a randomized clinical trial. Int J Oral Maxillofac Surg 2025; 54: 356–364.

Design

This randomised clinical trial compared the outcomes of a non-grafted socket shield technique (SST) versus guided bone regeneration (GBR) in immediate dental implant placement within the maxillary aesthetic zone, evaluating clinical, aesthetic, and radiographic outcomes over a 1-year period.

Case selection

Participants were adults with a single unrestorable tooth in the maxillary anterior region requiring extraction and immediate implant placement. A total of 24 patients completed the study, with 12 allocated to each group (SST and GBR), following exclusions due to complications such as shield mobility or incomplete follow-up.

Data analysis

Clinical parameters (peri-implant pocket depth, plaque and bleeding indices, keratinized mucosa width, and mucosal thickness) and radiographic measures (horizontal and vertical bone levels) were assessed at baseline and 1-year post-procedure. Aesthetic outcomes were evaluated using the pink aesthetic score (PES). Statistical comparisons employed t tests and Mann–Whitney U-tests, with significance set at P < 0.05.

Results

At 1 year, no notable differences emerged between SST and GBR groups in terms of peri-implant health (pocket depth, plaque, bleeding) or bone stability (horizontal and vertical bone levels). However, the SST group exhibited significantly wider keratinized mucosa (P = 0.013) and superior aesthetic outcomes, with higher PES scores (P = 0.004), compared to the GBR group.

Conclusions

Both SST and GBR proved effective in maintaining hard tissue integrity during immediate implant placement in the aesthetic zone. The SST, however, offered advantages in soft tissue preservation and aesthetic enhancement, suggesting it as a viable alternative to GBR for single-tooth replacements in this region.

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References

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Authors and Affiliations

  1. Department of Basic and Clinical Translational Sciences, Tufts University School of Dental Medicine, Boston, MA, USA

    Carlos Fernando Mourão

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  1. Carlos Fernando Mourão
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Correspondence to Carlos Fernando Mourão.

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Mourão, C.F. Bone grafting in socket shield: necessary or optional for immediate implants?. Evid Based Dent 26, 78–79 (2025). https://doi.org/10.1038/s41432-025-01139-2

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