Bone growth between socket shield and implant
As evidence in this field grows, with recently published articles in humans showing it is possible to get bone between shield and implant, but still some soft tissue invasion of the top third of the socket.
I would like to show some of my own experience.
Case A: Immediate implant placement with socket shield. At 3 months bone bridge all the way to the top of the crest. Zero probing, no soft tissue.
Case B: Delayed socket shield, extraction and allograft, implant placement at 3 months showing bone-like hard tissue to the top of the crest.
I have also added a related case on the right, old case where I had complete soft tissue invasion of the socket.
I have learnt a few lessons since then, nowadays my socket shield principles are:
- Open flap to improve visibility, ALWAYS.
- Reduce shield to bone level, beveling inwards.
- Thin socket shield.
- Place implant away from the shield.
- Not sure if bone graft makes a difference.
I always got soft tissue invasion if the shield became exposed. I work hard to avoid this now.
Thought on this? What's your own experience?