Improved volume and contour stability with thin socket-shield preparation in immediate implant placement and provisionalization in the esthetic zone

Tooth replacement with a dental implant in the esthetic zone is a challenging treatment modality for the clinician. Each step of the treatment from tooth extraction to the definitive restoration should be performed meticulously to achieve a good esthetic outcome. Negative effects of the extraction can be minimized by various treatment protocols. Recent developments involving partial root retention (socket-shield technique) offer enhanced buccal tissue contour in these cases. This clinical report presents a slight modification to the socket-shield technique by preparing a thin shield and performing immediate implant placement. The gap between the shield and the implant was filled with a bone graft, and a screw-retained provisional restoration supported the natural emergence profile. Through the 6-month healing period, and after 1 year of function, the natural appearance of the buccal contour was maintained. Cone beam computed tomography (CBCT) and volumetric analysis confirmed the presence of the buccal bone plate and volume stability. This case report demonstrates that improved buccal contour stability and a high esthetic outcome can be achieved with thin socket-shield preparation.