International Journal of Chemical and Biochemical Sciences (ISSN 2226-9614)[/vc_column_text][/vc_column][/vc_row]
VOLUME 28(22) (2025)
Biological and Tissue-Preservation Mechanisms of the Socket Shield Technique and Subepithelial Connective Tissue Grafting in Immediate Implant Placement: A Mini-Review
Osama Ahmed El Naggar1, Mohamed Wagdy Bissar2, Mahetab M. Abdalwahab3
1Master candidate at the Department of Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Dentistry, Ain shams University, Cairo, Egypt
2Associate Professor of Oral Medicine, Periodontology, and Oral Diagnosis, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
3Associate Professor of Oral Medicine, Periodontology, and Oral Diagnosis Faculty of Dentistry, Ain Shams University, Cairo, Egypt
Abstract
Restoration of esthetics in the anterior maxilla following tooth extraction and immediate implant placement remains biologically challenging due to the inevitable remodeling of hard and soft tissues. These dimensional changes are largely governed by biological and biochemical processes initiated after extraction, particularly the loss of the periodontal ligament (PDL), which serves as a critical source of vascular supply, cellular signaling, and metabolic support to the labial bundle bone. Disruption of this vascularized interface accelerates bone resorption and compromises peri-implant tissue stability. This mini-review highlights the biological rationale and tissue-preservation mechanisms of two complementary techniques: the Socket Shield Technique (SST) and the Subepithelial Connective Tissue Graft (SCTG). SST, as a partial extraction therapy, preserves the buccal root fragment and maintains the PDL–bundle bone complex, thereby sustaining local blood supply, cellular viability, and bone metabolism at the implant site. This biological preservation limits facial bone resorption and supports structural stability. In contrast, SCTG functions as a soft tissue augmentation strategy that enhances mucosal thickness and tissue quality. Increasing peri-implant mucosal thickness beyond 2 mm has been associated with improved vascularization, reduced inflammatory response, and decreased marginal bone loss. The grafted connective tissue contributes to a more resilient biological seal, promoting long-term tissue homeostasis around implants. The combined application of SST and SCTG addresses both hard and soft tissue remodeling at a biological level, offering a predictable approach for maintaining peri-implant tissue architecture and optimizing long-term esthetic and functional outcomes in immediate implant therapy.
Keywords: Socket Shield Technique, Partial Extraction Therapy, Subepithelial Connective Tissue Graft, Immediate Implant Placement, Alveolar Bone Resorption, Esthetic Zone.
Full length article *Corresponding Author, e-mail: osaamaa.eg@gmail.com, Doi # https://doi.org/10.62877/5-IJCBS-25-28-22-5,
Submitted: 03-12-2025; Accepted: 30-12-2025; Published: 31-12-2025