To evaluate immediate implant placement feasibility and esthetic outcomes in severely damaged sockets that received simultaneously bone reconstruction (cortical bone shield) and implant placement versus intact sockets that needed no reconstruction and had immediate implant placement.

The present clinical trial aims at demonstrating facial bone regeneration on sites that presented large buccal bone dehiscences & vertical bone loss and evaluate the feasibility of performing simultaneous bone augmentation and implant placement, comparing the outcomes with sites that had intact sockets that did not require reconstruction. A secondary objective was to evaluate pink esthetics and marginal bone levels at final follow-up.

Inclusion Criteria:

• individuals 20 Years and older
• Patients requiring single implants to replace missing teeth to restore masticatory function and esthetics.
• ASA1 or ASA2 (American Society of Anesthesiologists)
• Healthy individuals with good oral hygiene and motivation
• No systemic uncontrolled diseases
• Not taking drugs known to modify bone metabolism

Exclusion Criteria:

• Individuals with untreated & generalized severe periodontitis
• Smokers (>5 cigarettes/day)
• Poor oral hygiene
• Diabetes (HbA1C >6.5% as cutoff value)
• Uncontrolled cardiovascular disease
• Poor overall health (ASA IV)