Dimensional Changes of Alveolar Ridge After Tooth Extraction Using the Socket Shield Technique Without Immediate Implant Placement: A Randomized Controlled Study

PURPOSE: To compare radiographic dimensional changes in postextraction sites treated with spontaneous healing versus the modified socket shield technique (mSST) without immediate placement using CBCT scans. MATERIALS AND METHODS: This randomized clinical study included 80 patients with a single maxillary anterior tooth that was not restorable. Patients were divided into two equal groups: (1) the test group, which used the mSST, and (2) the control group, which used the atraumatic extraction technique with spontaneous healing. CBCT scans were performed at baseline (before or immediately after extraction) and 6 months postsurgery. Measurements included alveolar ridge width at 1-mm, 3-mm, and 5-mm levels and buccal and palatal bone plate heights. Following this, implants were placed, and their primary stability was assessed. The main intervention was the use of the mSST compared to the atraumatic tooth extraction technique. The primary outcome was the change in buccal bone plate height over a 6-month follow-up period. In addition, covariates included patient age and sex. Paired t tests and independent t tests were used to evaluate intra- and intergroup differences, respectively. Statistical significance was set at P < .05. RESULTS: In the test group, a significant reduction in palatal wall height was observed (P < .001), while no significant changes were noted in other parameters (P ≥ .05). In the control group, significant decreases were observed in buccal and palatal plate heights as well as ridge width (P < .05). When comparing the groups, the test group demonstrated significantly less buccal wall height and ridge width resorption than the control group (P < .05). However, no significant difference was observed in palatal plate height resorption between the two groups (P = .507). The test group exhibited significantly higher primary stability rates compared to the control group (P = .001). CONCLUSIONS: The mSST with delayed implant placement demonstrated superior maintenance of buccal bone plate height and ridge width, along with significantly greater primary implant stability, compared to spontaneously healed sockets. This approach is beneficial for maintaining ridge integrity when immediate implant placement is not planned.