Dual zone, Socket Shield or Buccal Contour Grafting?
It's just amazing to see 3 lectures from 3 top teams showing 3 ways to deal with the single implant in the esthetic area.
I think anyone doing an immediate/delayed implant in the esthetic area would be pretty much looking at one of these techniques. We can discuss connective tissue grafting in addition as well of course.
I regularly use these 3 techniques, I think they all have their indication. Not 1 size fits all. This would be my insight:
- Dual Zone grafting: The very first procedure I used for immediate implants. In my hands the simplest one, works beautifully used in the right case. Doesn't work that well in thin biotypes or prominent roots with high potential of buccal plate resorption. Custom healing cap or provisional crown is paramount.
- Socket shield: Definitively here to stay. Not always possible unfortunately ( periodontal/ apical disease, buccal plate loss). Nothing comparable to this technique from a cosmetic point of view.
- Buccal Contour Grafting: The most technically challenging and time consuming in my hands. By far the worst from a patient's morbidity aspect. Still, necessary in many cases, but not all biotypes respond in the same way. In order to obtain the results (bone graft), I many times have to give up some cosmetic points ( papilla, scarring, mucogingival line asymmetry, gingival color).
Would love to hear from others.