Assessment of effectiveness of socket shielding in the placement of immediate implants in anterior aesthetic region

Aims and objectives: The aim of the study is to provide an alternative treatment modality in immediate implant placement in the anterior aesthetic region by assessing the effectiveness of socket shielding technique for immediate implant placement with respect to specific clinical and radiographic parameters.

The main objectives of study will be:

1. Reducing need of bone graft there by reducing the cost of treatment
2. Reducing the post operative complications of grafting
3. Making a convenient and easy surgical technique thereby reducing operating time
4. Promoting faster osseointegration of implants
5. Providing a minimally invasive procedure benefitting the general population
6. Providing more aesthetic value to the therapy

Materials and methods:

Type Of Study : prospective study

Site of study : Sree Balaji Dental College and Hospital

Samplesize : 10

Sampling method: Purposive sampling

Study Design : clinical study

Funding : self

Expenditure : 90000

INITIALLY THE STUDY WILL BE PERFOMED BY SKILLED PROFESSIONAL AND THE INVESTIGATOR WILL BE PERFORMING UNDER GUIDANCE AFTER PROPER OBSERVATION OF INITIAL CASES

Inclusion criteria:

Cases requiring extraction of teeth in the anterior region of maxilla and mandible

Patients above 18 years of age

Exclusion criteria:

Anterior teeth requiring extraction with periapical pathology.

Completely edentulous patients.

Immunocompromised patients.

Patients with other systemic conditions contraindicated for surgery.

Procedure:

1. Patient consent both written and informed will be obtained

2. Pre-operative assessment and examination

2a. History of the patient: The pre-operative data will be collected and recorded including name, age, gender, occupation, address, onset and aetiology of the fracture

2b. Clinical examination

Extraoral examination

Inspection: To record swelling, or sinus discharge in the teeth to be extracted.

Intraoral examination

Inspection: To find out mobility, presence of any cystic lesion or sinus tract opening

Palpation: To detect areas of tenderness and alteration of bony contour, each tooth was examined for mobility and fracture.

2c. Radiographic examination:

Standard orthopantomograms (OPG) and intraoral periapaical radiographs (IOPA)  will be performed for all the cases.

3. Operative Procedure

Patient will be prepared under sterile aseptic protocol

Preparation of surgical site will be done with 5% betadiene solution

Local anaesthesia (lignocaine) with adrenaline (1:80000) will be administered in buccal and palatal aspects as infiltration anaesthesia

Vertical release incision will be placed

Full thickness mucoperiosteal flap will be raised

Tooth will be sectioned using periotome and palatal fragment will be removed leaving behind the intact buccal fragment

Pulp tissue if present will be extripated

Initial pilot drill will be placed followed by sequential drilling

Implant will be placed in the socket and cover screw placement to be done

Check Xray will be taken for analysing the position of implant

Closure of socket will be done using simple interrupted or mattress suture