Extraction Socket Healing undergoes a remodeling process that leads to vertical and horizontal tissue loss. Ridge volume alteration embeds a huge challenge on restoratively oriented three-dimensional placement of dental Implants. Socket shield technique demonstrated a histologic and clinical evidence on preventing soft and hard tissue alteration following tooth extraction. This case report describes an immediate implant placement with modification on socket-shied technique, where a buccal and palatal tooth fragments where prepared on buccal and palatal roots respectively of a failing upper first premolar, with two divergent roots. 3D deviation analysis of alveolar bone showed minimal loss of volume (-0.052mm, Avg+/-: 0.128/-0.232, SD 0.48), as well as, 3D deviation analysis of the ridge showed minimal loss of volume (-0.122mm, Avg+/-: 0.029/-0.202, SD 0.263). This Double Socket-shield procedure showed to be a feasible treatment option for maximum tissue preservation at immediate implant replacement of multi-rooted teeth.

socket-shield, multi-rooted teeth, ridge preservation, volumetric measurement, immediate implant placement, tooth retention