Tooth loss is accompanied by bone loss in all dimensions, so preservation of the bone is mandatory for placement of dental implant, as bone quantity and quality are predictive factors in achieving proper primary stability. Low level bio stimulation has stimulatory effect on bone cells so it can be used in immediate implants to increase bone formation around the implant.

the Aim of this study is to evaluate the effect of low-level diode laser Biostimulation on immediate implants in maxillary premolars.

20 patients with unrestorable maxillary premolars were included in the study treated with immediate implants. Patients were divided into two groups (n=10). Group 1 Received immediate implant with low level diode laser application (study), and group 2 received immediate implant without laser application (control). Preoperative clinical and radiographic evaluation, immediate post operative and after 4 months radiographic evaluation to assess stability and bone density around the implant.

Inclusion Criteria:

1. Patients with unrestorable maxillary premolars with sufficient bone quantity to receive the dental implant.
2. Age ranging from 25-45.
3. Patients with no local or systemic pathology that can interfere with normal wound healing.
4. Non- smokers.
5. Patients that are properly motivated to complete follow up visits.
6. Patients with adequate oral hygiene or willing to improve their oral hygiene to ensure uncompromised wound healing.

Exclusion Criteria:

1. Patients with uncontrolled medical condition that can affect surgical outcome or bone and wound healing. (ex: diabetes mellitus)
2. Patients with periapical pathology that may contraindicate immediate implant placement.
3. History of receiving irradiation in head and neck region

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

to any one who required them after deidentification

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 Furthermore, outcome assessor was blinded from the group enrollment