Comparison Between Modified Periosteal Inhibition (MPI) and Flapless Immediate Implant Placement

Impact of Modified Periosteal Inhibition Technique on Alveolar Bone Stability in Immediate Implant Placement Procedures (Randomized Controlled Clinical Trial)

To clinically and radiographically assess the impact of the modified periosteal inhibition (MPI) technique, applied during immediate post-extraction implant placement, on alveolar bone dimensional changes, in comparison to the conventional flapless immediate implant approach.

To assess the impact of the modified periosteal inhibition (MPI) technique, applied during immediate post-extraction implant placement in comparison to the conventional flapless immediate implant approach on radiographically by assessing marginal bone level measurements and bucco-lingual alveolar width. Clinically, pain levels, wound healing index, primary, secondary implant stability measured by resonance frequency analysis (RFA), peri-implant probing depth, and pink esthetic score (PES) will be assessed.

Inclusion Criteria:

• Patient's age ranges between 20 and 50 years including both genders.
• General good health (American Society of Anesthesiologists I-II).
• Presence of one hopeless non-restorable tooth requiring extraction at the posterior region.
• Adequate amount of palatal bone and basal bone (≥ 3 mm) to engage the immediately placed implants.
• Adequate keratinized soft tissue.
• Thick gingival phenotype (˃ 1.5 mm).
• Thin buccal bone plate or presence of fenestration.
• Favorable pattern of occlusion.
• Patient who is able to understand and sign a written consent.

Exclusion Criteria:

• Pregnancy or lactating females.
• Untreated periodontitis.
• Acute dentoalveolar infection.
• Complete absence of buccal bone plate.
• Osteometabolic disease.
• Chemotherapy or radiation therapy history of the neck-head area within the past 12 months.
• Heavy smokers (>20 cigarettes/per day) according to WHO.