Thesis (Ph.D.) - Cairo University - Faculty of Oral and Dental Medicine - Department of Periodontology

Aim: Evaluate the effect of immediate implant and socket preservation on bone volume with and without releasing flap. Research question: Does an immediate implant placement with xenogenic graft whether using flap or flapless will provide more alveolar bone preservation than delayed implant after socket preservation with xenogenic graft whether using flap or flapless in the upper esthetic region? Methodology: Thirty-two patients indicated for immediate implants or socket preservation were randomly allocated into 4 equal groups. Intervention group 1 (immediate implant placement with a xenogenic bone graft using the flapless technique) Intervention group 2 (immediate implant placement with the xenogenic bone graft after releasing flap) Intervention group 3 (alveolar socket preservation with a xenogenic bone graft using a flapless technique with delayed implant placement after 3 months) and control group alveolar socket preservation with xenogenic bone graft after releasing flap with delayed implant placement after 3 months). Bone volume was evaluated at baseline and after 6 months of implant placement using superimposition of CBCT, Implant stability was measured using periotest after abutment placement, Facial gingival level was assessed at baseline and after crown cementation Results: All implants were clinically successful. The results of the present study showed that socket preservation using xenograft yielded significantly less bone volume loss either with a flap or flapless tooth extraction than immediate implant placement with xenogenic bone graft either with a flap or flapless where the percentage of bone volume loss was 6.7% in flapless socket preservation with the delayed implant and 6.1% in socket preservation with flap and delayed implant and 11.2% in the immediate implant with flap and 10.7% in the flapless immediate implant. However, there is no significant difference between all groups in both Facial gingival level and Implant stability

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