Standardization of vertical root resection during socket shield technique in immediate implant placement

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Objectives. The aim of the present study was to standardize an accurate and significant technique of root separation during socket shield technique. Patients and methods. Two phases of the study were conducted. In vitro study was performed on 20 extracted single-rooted anterior teeth. The second phase was clinical application of the new technique on 10 patients seeking to restore their badly decayed anterior teeth in the esthetic area with immediate implant placement utilizing the socket shield technique. Decoronation was done. The root canal was mechanically enlarged by means of manual assorted files. Canals were further enlarged with Gates Glidden drills. Peeso Reamer drills were used till the root was entirely separated into two parts (buccal & palatal). The palatal root was cautiously removed when the labial and palatal root halves were sufficiently separated. In case the root to be removed was endodontically treated, Gutta-percha was mechanically removed using Gates Glidden, & Gutta-percha solvent to remove the coronal and apical parts. Outcomes. Using manual endodontic K-files, Gates Glidden burs, and Peeso Reamer’s drills in separating the single-rooted teeth into two halves is a reproducible, and reliable procedure during socket shield technique. Conclusions. This technique prevents possible complications of root sectioning during socket shield technique with immediate implant placement. It preserves surrounding soft tissue structures, and labial shield during shield preparations, maintains the integrity of the labial plate of bone during extraction. Additionally, it offers total root apex removal by entirely separating the palatal portion from the labial shield.

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