Five-Year Outcomes of Immediate Implant Placement in a Focal Cemento-Osseous Dysplasia Site: A Contralateral Comparison With the Socket Shield Technique

This report presents an intra-patient comparison of 2 immediate implant strategies in the anterior maxilla, including placement in a site affected by focal cemento-osseous dysplasia (FoCOD). A 40-year-old female presented with residual roots of teeth #11 and #21, with CBCT revealing a small, mature FoCOD lesion at #11. After conservative curettage, an immediate implant was placed at #11, while the socket shield technique (SST) was applied at the contralateral site (#21). Both implants achieved primary stability and were immediately provisionalized. Five-year clinical and radiographic evaluations demonstrated stable osseointegration, preserved soft-tissue architecture, and consistent Pink Esthetic Scores. CBCT analysis indicated that the SST site showed less labial ridge remodeling compared with the FoCOD site. This case supports the feasibility of immediate implantation in well-selected mature FoCOD lesions and highlights the long-term ridge-preservation advantages of the SST within the same patient.