# Tissue Preservation Using Socket-Shield Technique in Lower Molar Site: A Proof of Principle Report

## TL;DR

This case report shows that a technique called socket-shield can preserve bone and soft tissue after molar extraction, potentially preventing ridge collapse.

## Contribution

The study presents the first proof-of-principle case applying the socket-shield technique in a lower molar site.

## Key findings

- Minimal horizontal bone loss (~0.2 mm at 4 months and ~0.1 mm additional loss by 12 months) was observed.
- The implant achieved osseointegration with high primary and secondary stability.
- Soft tissue profile remained stable over 12 months.

## Abstract

Background/Objectives: The socket-shield technique (SST) was developed to preserve the facial/buccal portion of a tooth root to prevent post-extraction ridge resorption. It has gained attention for use in anterior implant sites, but its application in posterior sites remains unexplored. The aim of this case report was to report a proof-of-principle case using SST in a lower molar site and evaluate its effectiveness in preserving tissues. Methods: A 34-year-old non-smoking patient with a non-restorable mandibular first molar (tooth #36) underwent immediate implant placement with the SST. The tooth’s crown was removed, and the buccal segments of the roots were retained as “shields” while the implant was placed in the center of the socket. Preoperative and postoperative cone-beam CT (CBCT) scans and clinical exams were used to assess outcomes up to 12 months. Results: The SST procedure was completed uneventfully. CBCT after 4 months and 12 months showed minimal horizontal bone loss: ~0.2 mm at 4 months; ~0.1 mm additional loss by 12 months. The peri-implant soft tissue profile remained stable, and the implant achieved osseointegration with high primary and secondary stability. Conclusions: In this clinical case, the socket-shield technique effectively preserved alveolar bone and soft tissue contours in a molar extraction site, avoiding the ridge collapse often seen post-extraction. This suggests SST may be a viable tissue preservation approach in posterior sites; however, long-term follow-up and further studies are needed to confirm sustained outcomes and validate the technique’s predictability.