Clinical and Radiographic Assessment of the Socket Shield Technique Accompanied by Sticky Bone Around the Immediate Implant

Biological mechanisms involved in the healing of the periodontal tissues after tooth extraction can cause the loss of the periodontal ligament and its vascular support. The physiological process can lead to esthetic problems that are difficult to resolve by methods of restoration that are able to preserve the emergence profile, especially in the anterior region . Therefore, preserving and maintaining the bone anatomy and soft tissue architecture in the anterior region is essential for maintaining esthetics restorations .

Teeth extractions basis volumetric changes characterized by alveolar bone resorption, specifically the buccal plate of bone, with a consequential associated soft tissue retraction . Several studies proved that buccal dimension of the alveolar ridge undergoes horizontal bone resorption of about 56% and a resorption of the palatal /lingual bone of 30% through the interval four-month prior extraction of the tooth. Correspondingly . detected overall horizontal dimension resorption of the alveolar ridge subsequent the extraction, and the buccal wall reduction of the alveolar ridge is more obvious than lingual wall .

Immediate placement of implant does not totally overcome the resorption of the alveolar bone and recession of the soft tissue in esthetic region following teeth extractions. Loss of alveolar bone prior extraction consider as irreversible process concerning both vertical and horizontal resorption. Moreover, the alveolar bone resorption is more distinct on the buccal wall than on the lingual wall of the extraction socket.

The ridge dimension is reduced when implants are placed immediately without subsequent directed bone regeneration treatments. When compared to spontaneous healing, it appears to be ineffective at around half of the initial bone width in horizontal dimension . By using a grafting substance and combining instantaneous implant insertion with a guided bone-regeneration process, less horizontal bone resorption can be expected .

Several augmentation techniques are used in the surgical field to create sufficient bone volume. Grafting techniques for particulate bone augmentation include autograft, allograft, xenograft, and alloplast. Autograft is the gold standard in bone augmentation, but it has drawbacks such as second surgical-site morbidity and insufficient bone volume. Secondary infections are a disadvantage of allografts and xenografts Since 2010, a novel method of producing growth factor-enriched bone graft matrix (also known as sticky bone) with autologous fibrin glue has been demonstrated. Sticky bone stabilizes the bone graft in the defect, accelerating tissue healing and minimizing bone loss during the healing period. It is moldable and adaptable to a variety of bony defects, preventing micro and macro movement of the grafted bone. As a result, the volume of the augmentation is maintained during the healing process, and the need of titanium mesh and bone block is reduced .