Investigate New Surgical Techniques to Improve Esthetics and Patient Satisfaction at Implant Sites

2019-09-27 06:30:35 | BioPortfolio


Many techniques have been proposed to prevent or rather minimize the labial bone resorption following extraction including guided bone regeneration techniques that has been attempted for many years now to preserve the alveolar ridge dimensions .

Immediate implant placement, flapless implant placement, palataly positioned implants and even platform switching.

However none of these methods were able to completely preserve the coronal part of the facial bone wall, and since the main reason of bone loss following extraction is the loss of the periodontal ligament, it seemed logical that root retention may affect the resorption process,The reason the root retention technique works in its different applications is due to the maintenance of the periodontal attachment including cementum, periodontal ligaments and bundle bone, this principle was used by Hurzeler in 2010 in a technique called socket shied technique.


- The selected patients will be informed of the nature of the research work and informed consent will be obtained then randomized in equal proportions between control group conventional immediate implant placement with immediate temporization and study group socket shield technique with immediate temporization.

- Patients of both groups will be subjected to CBCT (diagnostic for upper arch).

- Intra operative procedures (for both groups) followed by CBCT will be taken for every patient

- Infiltration local anesthesia will be given to the patient (Articaine 4% 1:100 000 epinephrine)

- Scrubbing and draping of the patient will be carried out in a standard fashion for intra oral procedures.

- In the study group: along surgical fissure bur will be used for hemisectioning.

- The palatal portion will be carefully separated and extracted by a periotome and forceps.

- The osteomy site will be inspected and cleaned from any granulation tissue and the implant will be placed palatal to the tooth fragment.

- The jump gap was grafted with a xenogeneic bone particulate (De-proteinized bovine bone mineral Small granules (0.25-1 mm), the implant gained primary stability from bone apical and palatal sufficient to immediately restore with provisional restoration.

- In the control group: the root was hemisected using a fissure bur in a mesio-distal direction, and a traumatic removal of the palatal fragment of the root was achieved (no pressure was applied on it), then the buccal fragment was reduced using surgical bur leaving a thin layer of the root aspect intact to the buccal plate of the bone.

- The implant is placed in the socket in a way leaving space away from the remaining buccal plate without grafting this jumping gap

- The provisional restorations were relieved of occlusal contacts in centric occlusion and excursive movements. These restorations remained in situ for at least 6 to 12 weeks prior to any modifications or commencement of definitive restorative therapy

- A soft diet was recommended for the duration of the implant-healing phase. The patient was advised against functioning or activities to the implant site.

Study Design


Fractured Tooth


socket shield technique with xenophobic graft particulate and without the use of graft


Not yet recruiting


Cairo University

Results (where available)

View Results


Published on BioPortfolio: 2019-09-27T06:30:35-0400

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Medical and Biotech [MESH] Definitions

A condition sometimes occurring after tooth extraction, particularly after traumatic extraction, resulting in a dry appearance of the exposed bone in the socket, due to disintegration or loss of the blood clot. It is basically a focal osteomyelitis without suppuration and is accompanied by severe pain (alveolalgia) and foul odor. (Dorland, 28th ed)

The immune responses of a host to a graft. A specific response is GRAFT REJECTION.

An immunological attack mounted by a graft against the host because of tissue incompatibility when immunologically competent cells are transplanted to an immunologically incompetent host; the resulting clinical picture is that of GRAFT VS HOST DISEASE.

The survival of a graft in a host, the factors responsible for the survival and the changes occurring within the graft during growth in the host.

The induction of prolonged survival and growth of allografts of either tumors or normal tissues which would ordinarily be rejected. It may be induced passively by introducing graft-specific antibodies from previously immunized donors, which bind to the graft's surface antigens, masking them from recognition by T-cells; or actively by prior immunization of the recipient with graft antigens which evoke specific antibodies and form antigen-antibody complexes which bind to the antigen receptor sites of the T-cells and block their cytotoxic activity.

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