• Tianqi Guo, Ran Nie, Xirui Xin, Hanchi Wang, Manlin Qi, Kaixuan Yu, Yao Wang, Liuyi Du, and Yanmin Zhou.
• School and Hospital of Stomatology, Jilin University, Department of Dental Implantology, Jilin Provincial Key Laboratory of Tooth Development and Bone remodeling, Changchun, Jilin Province, China.
• Medicine (Baltimore). 2018 Dec 1; 97 (50): e13175.

RationaleIn this report, a combination of socket-shield technique (SST) and platelet-rich fibrin (PRF) technique was used for immediate implant placement on a fractured central incisor. During the follow-up visit, cone beam computed tomography (CBCT) and clinical observation were used to evaluate the preservation outcome of peri-implant bone and gingiva.Patient ConcernsThe patient was a 28-year-old healthy female patient who desired her fractured 21 to be replaced with an implant-supported single crown; the fractured 21 comprised a post-core crown with insufficient residual bone at the labial site.DiagnosisThe root of 21 exhibited a complex root fracture; the labial portion of the alveolar ridge was thin (<1 mm) and partial ankylosis of the residual root was observed.InterventionsModified SST was applied to the labial portion of the residual root. The implant was placed immediately at the lingual site of the retained socket-shield root fragment; PRF was the placed in the gap between the root fragment and the implant. Final prosthodontic treatment was performed at 24 weeks after implant placement.OutcomesClinical examination and CBCT scanning at various follow-up visits time showed that the periodontal tissue was well- preserved. At 6 months after surgery, the average horizontal and vertical peri-implant bone resorption was 0.4 mm; a follow-up visit at 18 months post-loading indicated that peri-implant tissue was well preserved by the shield-technique and no significant peri-implant tissue resorption was displayed.Lesson SubsectionsIn cases of anterior teeth with intact but insufficient residual alveolar ridge, the SST with PRF may be effective for preservation and maintenance of stable peri-implant tissue.

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