Supracrestal Socket Shield Technique in Anterior Maxilla. A Case Report.

April 11, 2026 updated by: International Dental Contiuing Education

Post-extraction labio-palatal ridge collapse is a significant challenge in restorative and implant dentistry particularly in anterior maxilla. Following tooth extraction, marked dimensional alveolar ridge changes occur. The buccal plate of bone in the anterior zone is primarily composed of bundle bone, a tooth dependent structure that derives its blood supply from the periodontal ligament (PDL). The PDL loss after tooth extraction results in rapid resorption of the bundle bone, leading to horizontal and vertical ridge reduction (Araújo and Lindhe, 2005, Schropp et al., 2003). Studies have shown that 50% of ridge width reduction occurs within 12 months, with two thirds of this reduction occurring within the first 3 months (Schropp et al., 2003). Moreover, the labial plate thickness in the anterior maxilla is frequently thinner than 1 mm in the majority of cases (Huynh-Ba et al., 2010). The high incidence of mid-facial recession and soft tissue volume loss is attributed to those biological events.

Although IIP has become increasingly popular due to its short treatment time, it doesn't prevent physiological remodeling associated with bundle bone resorption (Araújo and Lindhe, 2005). Consequently, soft tissue collapse and midfacial recession remain common complications, especially in thin periodontal phenotypes (Chappuis et al., 2013, Cosyn et al., 2012). In order to overcome the inevitable consequences of tooth extraction, a variety of ridge preservation techniques were proposed in the literature including; flapless implant placement, bone grafting, soft tissue augmentation procedures, immediate provisionalization, a more palatal orientation of the implant in the socket and the socket shield technique.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

The Supracrestal Socket Shield Technique is a modification of the original Socket Shield Technique used in implant dentistry to preserve buccal bone and gingival architecture after tooth extraction, especially in the esthetic zone (anterior maxilla). The key difference is that a small portion of the buccal root fragment is intentionally left slightly above the crestal bone level (supracrestal) to better support the soft tissue contour.

Study Type

Interventional

Enrollment (Estimated)

5

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 Contact

Study Locations

  • Egypt
    • Cairo Governorate
      • Cairo, Cairo Governorate, Egypt
        • International Dental Continuing Education
        • Contact:

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

Yes

Description

Inclusion Criteria:

  • Patients who have a single bounded non-restorable maxillary anterior tooth with opposing natural dentition with no periapical pathosis.
  • Adults above the age of 21.
  • Good oral hygiene.
  • Patient accepts to provide informed consent.
  • Thin intact labial plate of bone (1 mm or less), assessed by CBCT.
  • Intact gingival tissue with at least 2 mm keratinized tissue.
  • Teeth with intact labial root surfaces.
  • Minimum of 3-4 mm of apical bone for primary stability

Exclusion Criteria: • Smokers.

  • Pregnant and lactating females.
  • Medically compromised patients.
  • Patients with untreated active periodontal diseases.
  • Patients with active infection related to the implant site

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: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Supracrestal socket shield

Supracrestal Socket Shield Technique (SSST)

1. Concept and Biological Principle The technique is based on partial extraction therapy.

Normally, after extraction:

The periodontal ligament (PDL) is lost The bundle bone of the buccal plate resorbs This leads to buccal bone collapse and gingival recession

In SSST:

The buccal root fragment is preserved The PDL and vascular supply remain intact The bundle bone does not resorb This maintains ridge contour and papilla stability

The supracrestal extension (≈0.5-1 mm above bone crest) helps:

Maintain soft tissue support Improve emergence profile Reduce mid-facial recession
Procedure: Supracrestal SST

Supracrestal Socket Shield Technique (SSST)

1. Concept and Biological Principle The technique is based on partial extraction therapy.

Normally, after extraction:

The periodontal ligament (PDL) is lost The bundle bone of the buccal plate resorbs This leads to buccal bone collapse and gingival recession

In SSST:

The buccal root fragment is preserved The PDL and vascular supply remain intact The bundle bone does not resorb This maintains ridge contour and papilla stability

The supracrestal extension (≈0.5-1 mm above bone crest) helps:

Maintain soft tissue support Improve emergence profile Reduce mid-facial recession

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Midfacial margin changes
Time Frame: 6 months
In each patient, the AOI will be kept constants for all pairwise comparisons. The volumetric analysis software will calculate the midfacial margin changes (mm)
6 months

Collaborators and Investigators

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

Sponsor

International Dental Contiuing Education

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 (Estimated)

April 1, 2026

Primary Completion (Estimated)

October 1, 2026

Study Completion (Estimated)

November 1, 2026

Study Registration Dates

First Submitted

March 11, 2026

First Submitted That Met QC Criteria

March 11, 2026

First Posted (Actual)

March 16, 2026

Study Record Updates

Last Update Posted (Actual)

April 15, 2026

Last Update Submitted That Met QC Criteria

April 11, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • IDCE-111032026

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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