Clinical, radiographic, and esthetic outcomes of the socket shield technique versus conventional postextraction implant placement: A systematic review.
STATEMENT OF PROBLEM The socket shield technique (SST) has been proposed to preserve the buccal bone plate and peri-implant soft tissues during immediate implant placement, potentially improving esthetic outcomes. While its biological rationale has been well supported, comparative evidence with conventional protocols remains heterogeneous. PURPOSE The purpose of this systematic review was to compare the clinical and radiographic outcomes of SST and conventional immediate implant placement (CIP) by assessing implant survival, marginal bone loss (MBL), buccal bone thickness, pink esthetic score (PES), soft tissue changes, and complications. MATERIAL AND METHODS A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines across 6 electronic databases up to July 2025. Comparative clinical studies with a minimum follow-up of 3 months evaluating SST versus CIP were included. RESULTS Eleven studies involving 423 implants were included. Implant survival rates exceeded 95% in both groups. SST showed significantly less buccal and crestal bone loss and consistently higher PES scores across short- and long-term follow-up. The technique improved peri-implant soft tissue contours and reduced midfacial recession. SST-related complications, such as mobility or exposure, were infrequent and mostly linked to surgical error or poor patient selection. CONCLUSIONS SST offers better outcomes than CIP without compromising implant survival. However, it is technique-sensitive and demands careful execution. Digital workflows and guided shield preparation may enhance predictability, but further high-quality, long-term studies are needed to support clinical standardization.