Pink esthetic and radiological scores around immediate implants placed in the esthetic zone – Socket-Shield Technique versus Immediate Conventional Technique: A Pilot Study

OBJECTIVE: It is irrefutable that the extraction of teeth inextricably results in definitive changes in the surrounding hard and soft tissues. Recently, Socket-Shield Technique (SST) has been used to keep the buccal two-third of the root intact in the socket. This buccal shield further preserves the periodontium-bundle bone complex and hence preserves the buccal hard and soft tissue. The purpose of the study was to do a statistical comparative analysis of two different types of flapless and graftless techniques using the esthetic (Pink Esthetic Index) and radiological parameters. MATERIALS AND METHODS: A total of thirty nonrestorable tooth/root stumps (vital or nonvital) were selected and randomly allocated to two different groups: control group with immediate conventional implant placement (without SST) (Group C, n = 15) and test group with immediate implant placement using SST (Group S, n = 15). All of the sites received immediate chairside temporaries. All implants were restored either with screw- or cement-retained prostheses 4 months postoperative. Each control and test group was analyzed at two different durations: 15 days after placement of provisional and 15 days after placement of definitive prosthesis. Five parameters of Pink Esthetic Score (PES) were used for esthetic analysis, and digital periapical radiographs were used for radiographic analysis. RESULTS: Within the time frame of the study (15 days postplacement of definitive prosthesis), a statistically significant difference (p < 0.05) was observed between PES of the two techniques. Test group S (mean = 9.07) showed better scores than control group C (mean = 6.87). It was observed that buccal bone was maintained in all the cases of test group S while there was loss of buccal bone in almost all the cases of control group C. CONCLUSION: Within the limitations of this short-term pilot study, better soft-tissue parameters were observed with SST as compared to a conventional graftless technique whenever a restoration on immediate implant placement is considered.