Removal of Socket Shield

There is no obvious black triangle between the implants at #8-11 (Fig.1 post infiltration).  Following papilla (Fig.2 *) sparing incision and elevation of the buccal flap, the fenetration of the buccal plate around the socket shield (Fig.3 S) is found at #11; there is a distal defect with granulation tissue (*).  After shield and granulation tissue removal, the coronal implant is found exposed (Fig.4 until osteotomy).  The relatively flat surface of IBS implant is apparently less likely to develop periimplantitis.  With periosteal relief and placement of sticky bone (Fig.7 *), PRF and 6-month membrane, the wound is closed with 4-0 PTFE suture (Fig.5).  Failure of socket shield is related to retention of the apex (Fig.6 <).  Probe before extraction and remove apex and gutta percha.

Return to Upper Canine Immediate Implant, Trajectory II Shield
Xin Wei, DDS, PhD, MS 1st edition 12/16/2019, last revision 12/17/2019