الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 159 |  |  |
| | | from | 159 | | |
Abstract
The objective of this research was to assess the precision of the guided Socket Shield Technique (SST) preparation ”along the entire length of the root” and to evaluate the duration of the procedure and the stability of the implant in SST.
This was a randomized controlled clinical trial involving two groups (control group and study group) with 1:1 allocation ratio. In which the study group had twelve Maxillary anterior teeth that were extracted followed by immediate implant placement using the guided socket shield technique. While the control group had twelve Maxillary anterior teeth that were extracted followed by immediate implant placement using the conventional socket shield technique.
To correctly prepare the residual root and place the implant, two distinct guidance templates were constructed. An impression and a preoperative CBCT and intraoral scan of the whole dentition were obtained and superimposed.
In the study group, the first surgical guide that was designed to prepare the retained root was placed and the preparation procedure was executed using a highspeed air-driven dental handpiece under profuse saline irrigation, the labial root fragment was detached from the rest of the retained root using an Extra-long-shank carbide bur (Bone cutter H162SXL.314.014; Komet Dental) in gentle mesio-distal in a sweeping like motion from the margin of the gingiva to the apex of the root following the slot of the surgical guide, with the aim of separating the labial segment from the palatal segment without violating the integrity of the labial portion.
The periodontal ligaments were then severed by inserting a fine periotome between the palatal root part that will be extracted and the palatal alveolar plate. The divided palatal tooth remnant was then cautiously removed without disrupting the labial shard. Tungsten carbide round bur (bur 197; Mani) was used to refine the remaining tooth shard to 1.0 mm above the alveolar bone level. Following cautious pruning in a mesio-distal and apical-coronal directions with a long-shanked round diamond bur that sculpted the internal surface of the shield contour to be concave, the coronal section of the labial section was approximately at the crest level. The second surgical template was then used to drill the osteotomy for the implant, drilling the socket was done with the manufacturer’s recommended drills (Guided surgical kit, B and B, Italy). In order to gain stability, drilling of 3 to 5 mm apical to the socket was done. After that, the implant was inserted (V-line,Vitronex implant system, Italy) and customized healing abutment was placed.
In the control group: utilizing a high-speed handpiece while being profusely irrigated. Using the same bur, the palatal segment were aimed to be separated from the rest of the root without violating the integrity of the labial part by gently utilizing a sweep like motion mesiodistally from the margin of the gingiva to the root apical area (conventional SST).
The palatal fragment was then removed and preparing the shield was executed as previously explained in the study group.
To compare the guided SST and the traditional free-hand SST, the length of the procedure for both groups was measured from the beginning of shield preparation until the implant insertion.
Early follow-up (1-2 weeks) to assess pain, edema and infection. Postoperative pain was assessed on daily basis for one week through a 10-point Visual Analogue Scale (VAS).