Peri-implant Tissue Changes Around Maxillary Anterior Immediate Tooth Replacement With and Without Socket- Shield: 1-Year Randomized Controlled Clinical Trial

Purpose: To evaluate implant success rates and facial mucosal profile changes in maxillary single immediate implant placement and provisionalization with the socket-shield (IIPP+SS) technique and without the socket-shield (IIPP-SS) technique. Materials and Methods: A total of 30 dental implants in 25 patients were assigned to either the IIPP-SS group (15 implants) or the IIPP+SS (15 implants) group. Clinical and radiographic outcomes were collected preoperatively (T0) as well as at 2-week (T1), 6-month (T6), and 12-month (T12) postoperative follow-ups. The implant success rate, marginal bone level changes, facial mucosal level changes, and papilla level changes were evaluated at different time points. Facial mucosal profile changes were assessed individually for hard and soft tissue zones and as a whole using volumetric analysis. Results: Two implants were excluded (one patient dropped out and one implant failed) from the data analysis in this study, resulting in an overall implant success rate of 96.6% (28/29) after 1 year. Fewer facial mucosal profile changes were noted in the IIPP+SS group than in the IIPP-SS group; however, the difference was only marginally statistically significant (P = .06).  No statistically significant difference was found in the facial mucosal level changes (P = .18) and papilla level changes (P = .67 for the mesial papilla level, P = .41 for the distal papilla level) between the IIPP-SS and IIPP+SS groups. Conclusions: Within the limitations of this 1-year randomized controlled clinical trial, the IIPP+SS group appeared to maintain the implant facial mucosal profile slightly better than IIPP alone. Both treatment modalities provide clinically satisfactory outcomes biologically, functionally, and esthetically.