This study evaluated how maintaining a complete 360-degree socket-shield using the CastleWall Surgical Technique (CWST) affects the volumetric stability around immediate dental implants. In this retrospective study, 25 patients received a total of 31 immediate implants with the CWST. Pre-extraction and follow-up silicone impressions were digitized into STL files for volumetric analysis. The median follow-up duration was 14.2 ± 5.5 months. Measurements included tissue volume changes and gingival recession on both buccal and lingual sides, as well as alterations in papilla height from clinical photographs. Patients reported post-operative discomfort and overall satisfaction using a Visual Analogue Scale (VAS).
All implants healed successfully without complications. Average tissue reduction was 0.30 ± 0.32 mm buccally and 0.17 ± 0.27 mm lingually. Mid-buccal and mid-lingual gingival recession averaged 0.66 ± 0.64 mm and 0.87 ± 0.84 mm, while mesial and distal papillae showed 0.26 ± 0.55 mm and 0.29 ± 0.52 mm recession, respectively. Patients expressed high satisfaction, with a mean VAS score of 97.74 ± 5.60%, and reported minimal discomfort. The CWST appears to maintain excellent soft tissue volume and aesthetic outcomes with low post-operative pain. Preserving a full 360-degree socket-shield also provides greater surface area for implant stabilization, reducing the risk of shield displacement over time.
