Dimensional Changes in Periodontium with Immediate Replacement of Tooth by Socket Shield Technique: Two-year Follow-up

Extraction socket healing and osseous remodeling take 120 to 180 days. Healing results in 50% reduction in the buccolingual bone in 12 months. Buccal bone loss of the extraction socket exceeds more than two-thirds with reduction in apicocoronal height by approximately 0.8 mm within 3 months of healing. Bundle bone is the portion of alveolar bone where fibers from the periodontal ligament (PDL) insert. A clinical technique was developed to preserve the bundle bone and the surrounding PDL through retention of buccal tooth root portion. This clinical case describes about immediate tooth replacement with an implant by preserving the buccal root in the anterior maxillary region with a 2-year follow-up. The hard tissue comparative correlation preand postoperative was measured using multislice computed tomography scanner (MSCT) and soft tissue by pink esthetic score (PES). The result after 2 years of evaluation was promising with negligible changes in hard and soft tissues. The study predicts encouraging results for immediate replacement of hopeless tooth in anterior maxilla without the use of augmentation materials. The surgeon should be experienced as the skills require expertise and knowledge.