Compared to conventional immediate implant placement, the socket shield technique appears to show greater effectiveness in reducing bone resorption and improving implant stability and esthetic outcomes.

The objective of a systematic review and meta-analysis was to evaluate the efficacy of immediate implant placement with a socket shield technique in terms of outcomes, including survival rate, complications, probing depth, implant stability, esthetics, and bone loss.

A comprehensive search of 7 electronic databases was conducted for the identification of randomized clinical trials (RCTs) examining the impact of immediate implant placement with socket shield technique (test group) compared to other implant placement protocols without socket shield technique.

The risk of bias was evaluated using Cochrane's randomized trial quality assessment Tool (RoB 2.0), and a random-effects meta-analysis was performed. Certainty of the evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.

A total of 12 RCTs, involving 414 immediate implants placed in 398 subjects, were included. Meta-analyses indicated that immediate implants placed with socket shield technique demonstrated a statistically significant reduction in probing depth (mean difference [MD] = -0.64), as well as crestal (MD = -0.35), vertical (MD = -0.85), and horizontal (MD = -0.28) bone loss.

Furthermore, the socket shield technique showed a remarkable improvement in the pink esthetic score (MD = 1.60) and implant stability (MD = 3.46). Only 2 studies reported shield exposure incidences in the socket shield technique group, while all studies reported no implant failures and a 100% survival rate. The certainty of the evidence was found to be very low.

The use of immediate implants with socket shield technique proved superior to the conventional method (with or without grafting) in various aspects. These include reducing horizontal, vertical, and crestal bone loss, enhancing esthetic results, improving implant stability, and decreasing probing depth. These benefits were observed across different time intervals, spanning from three months to three years. Notably, complications were minimal, and the implants had a survival rate of 100%.