Tooth extraction is critical for dental treatment complications followed by immediate implant placement to restore the extracted tooth . The use of devices or instruments such as piezotome and periotome as aids in atraumatic surgical proceduresو conserving both bone and soft tissue, allowing extraction without unnecessary socket expansion. Immediate implant placement into fresh extraction sockets offers some esthetic and functional advantages.

the Aim of this study is to compare and evaluate the effectiveness of the piezotome and periotome as aids for atraumatic extraction in immediate implant placement in maxillary anterior teeth.

30 patients with non-restorable maxillary anterior teeth will be included. Teeth will be extracted using an atraumatic tooth extraction using piezotome and periotome as aids in atraumatic surgical procedures. After that an immediate implant will be placed into the fresh extraction socket . patients will be recalled for follow-up 3months after implant placement to evaluate pain by VAS and evaluate bone healing using CBCT.

Inclusion Criteria:

1. Patients of both gender with a non-restorable maxillary anterior tooth in the aesthetic zone indicated for extraction and subsequent immediate implant placement. Including those with:

   1. Severely carious tooth that it cannot be restored.
   2. Pulpal necrosis or irreversible pulpitis that is not amenable to endodontics.
   3. Periodontally involved Tooth with grade 2 mobility or above.
   4. Tooth with root caries that can't be restored.

2. Patients with extraction socket Type I, according to Elian's classification

Exclusion Criteria:

1. Patients with extraction socket Type II or III, with defect in the buccal plate
2. Patients with deciduous teeth.
3. Heavy smokers.
4. Medically compromised patients with conditions that would impede implant osteointegration and healing.

all data will be de-identified to protect the participant data. patients signed an informed consent for the use of their medical records and data for study

Sequentially numbered, opaque, sealed envelopes (SNOSE) allocation concealment method will be utilized. Each participant included in the study will be given a serial number that will be used in the allocation. These numbers will be written in identical sheets of paper with the group to which each participant is allocated and placed inside opaque envelopes carrying the respective names of participants. A trial independent personnel will be assigned the role of keeping the envelopes and unfolding them only at the time of the operation, so that the participant is allocated to a group which is concealed from the operator