Two Stage Modified Socket Shield: Grafted vs Nongrafted (SST)

March 9, 2026 updated by: Mai Ahmed Haggag, Mansoura University

"Spontaneous Bone Healing in Two Stage Modified Socket Shield Therapy" Can It Be a Dependable Approach for Delayed Implant Placement? A Randomized Controlled Trial

Modified socket shield therapy (SST) has been proposed to preserve the facial plate and peri implant tissues. Whether spontaneous healing after two stage modified SST provides outcomes comparable to grafted SST before delayed implant placement remains unclear.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

There remains no consensus regarding management of the space adjacent to the retained shield-whether it should be filled with a biomaterial or left for spontaneous healing. Clinical observations suggest that healing may not always yield complete mineralized fill; instead, a soft tissue interface can develop along the internal aspect of the root fragment, potentially limiting bone formation within the defect. At present, it remains unclear whether placement of a bone substitute can reliably reduce or prevent this soft tissue ingrowth along the inner surface of the retained fragment, providing a rationale for controlled comparisons of grafted and nongrafted two stage SST protocols. Therefore, the present controlled clinical study was designed to compare SST with xenograft combined with MPM augmentation versus SST alone, followed by delayed implant placement after a 6 month healing period. The study evaluated soft tissue ingrowth as key healing outcomes, alongside histologic findings and implant related parameters, including implant stability, as well as the incidence and management of procedure related complications.

Study Type

Interventional

Enrollment (Actual)

24

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Egypt
      • Al Mansurah, Egypt
        • Faculty of Dentistry - Mansoura University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • ASA I (healthy)
  • With intact buccal periodontal tissues
  • No parafunctional habits
  • Good oral hygiene
  • Willingness to comply with the study protocol and follow up schedule

Exclusion Criteria:

  • Acute infection at the extraction site
  • Extensive buccal plate loss
  • Vertical root fracture on the buccal aspect
  • Fracture patterns extending below bone level
  • Internal or external resorption
  • Root caries compromising the shield
  • Excessive tooth mobility
  • Heavy smoking

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Control Group
Socket Shield Technique alone with spontaneous healing
Procedure: Socket Shield Technique
No grafting material was placed, and the socket was closed with a figure-of-eight suture to stabilize the clot
Procedure: Socket Shield Technique
The xenograft/MPM mixture was gently packed into the shield-associated space/socket without excessive compression, and the socket was sealed and stabilized using a figure-of-eight suture technique
Experimental: Test Group
Socket Shield Technique with MPM augmentation
Procedure: Socket Shield Technique
No grafting material was placed, and the socket was closed with a figure-of-eight suture to stabilize the clot
Procedure: Socket Shield Technique
The xenograft/MPM mixture was gently packed into the shield-associated space/socket without excessive compression, and the socket was sealed and stabilized using a figure-of-eight suture technique

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Soft tissue ingrowth dimension: depth
Time Frame: 6-month (at the time of implant placement)
Soft tissue ingrowth dimensions; depth and width were measured using a calibrated periodontal probe with readings taken to the nearest millimeter and rounded up when the probe reading reached or exceeded the midpoint between millimeter markings. Depth (mm) was recorded from the most coronal aspect of the retained root fragment and measured apically until hard tissue was encountered.
6-month (at the time of implant placement)
Soft tissue ingrowth dimension: width
Time Frame: 6-month (at the time of implant placement)
Width (mm) was measured in a buccopalatal direction from the central aspect of the socket shield to the point where hard tissue was reached, representing the maximum diameter of the soft tissue ingrowth.
6-month (at the time of implant placement)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Mansoura University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 1, 2025

Primary Completion (Actual)

December 31, 2025

Study Completion (Actual)

January 31, 2026

Study Registration Dates

First Submitted

February 28, 2026

First Submitted That Met QC Criteria

March 9, 2026

First Posted (Actual)

March 10, 2026

Study Record Updates

Last Update Posted (Actual)

March 10, 2026

Last Update Submitted That Met QC Criteria

March 9, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • R.26.02.109

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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