Modified socket shield therapy (SST) has been proposed to preserve the facial plate and peri implant tissues. Whether spontaneous healing after two stage modified SST provides outcomes comparable to grafted SST before delayed implant placement remains unclear.
There remains no consensus regarding management of the space adjacent to the retained shield-whether it should be filled with a biomaterial or left for spontaneous healing. Clinical observations suggest that healing may not always yield complete mineralized fill; instead, a soft tissue interface can develop along the internal aspect of the root fragment, potentially limiting bone formation within the defect. At present, it remains unclear whether placement of a bone substitute can reliably reduce or prevent this soft tissue ingrowth along the inner surface of the retained fragment, providing a rationale for controlled comparisons of grafted and nongrafted two stage SST protocols. Therefore, the present controlled clinical study was designed to compare SST with xenograft combined with MPM augmentation versus SST alone, followed by delayed implant placement after a 6 month healing period. The study evaluated soft tissue ingrowth as key healing outcomes, alongside histologic findings and implant related parameters, including implant stability, as well as the incidence and management of procedure related complications.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
24
No grafting material was placed, and the socket was closed with a figure-of-eight suture to stabilize the clot
The xenograft/MPM mixture was gently packed into the shield-associated space/socket without excessive compression, and the socket was sealed and stabilized using a figure-of-eight suture technique
Faculty of Dentistry - Mansoura University
Al Mansurah, Egypt
Soft tissue ingrowth dimension: depth
Soft tissue ingrowth dimensions; depth and width were measured using a calibrated periodontal probe with readings taken to the nearest millimeter and rounded up when the probe reading reached or exceeded the midpoint between millimeter markings. Depth (mm) was recorded from the most coronal aspect of the retained root fragment and measured apically until hard tissue was encountered.
Time frame: 6-month (at the time of implant placement)
Soft tissue ingrowth dimension: width
Width (mm) was measured in a buccopalatal direction from the central aspect of the socket shield to the point where hard tissue was reached, representing the maximum diameter of the soft tissue ingrowth.
Time frame: 6-month (at the time of implant placement)
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