This randomized controlled clinical trial aims to evaluate the effect of recombinant human Bone Morphogenetic Protein-2 (rhBMP-2) on the stability and marginal bone level of dental implants following immediate placement.

patients requiring extraction of unrestorable tooth in upper incisors or premolar region will be randomly assigned into two groups: the experimental group will receive immediate implant placement with rhBMP-2 application, while the control group will receive immediate implant placement without rhBMP-2.

each group includes 16 immediate implants. Implant stability will be assessed using resonance frequency analysis (RFA) at baseline, and 16 weeks after implant placement. Marginal bone level changes will be evaluated radiographically using cone beam computed tomography (CBCT).

The study aims to determine whether the use of rhBMP-2 enhances osseointegration and reduces marginal bone loss compared with conventional immediate implant placement.

Inclusion Criteria:

• Healthy patients ≥18 years of either sex
• Having a single or multiple unrestorable maxillary anterior and premolar teeth indicated for extraction
• Jumping gap ≥2 mm
• Apical bone ≥3 mm from the vertical structure beyond the apex
• Willing to comply with the study and provide informed consent
• Good oral hygiene

Exclusion Criteria:

• Active infection or inflammation in implant area
• Uncontrolled diabetes or coagulation disorders
• Immunocompromised patients
• Patients treated with bisphosphonate drugs
• Psychiatric problems
• Pregnant women
• Medical conditions affecting bone healing
• Clinical evidence of parafunctional habits
• Heavy smokers (≥20 cigarettes/day)

Individual participant data (IPD) will not be shared because this is an academic clinical study with a limited number of participants, and data will be used only for internal analysis within the University of Baghdad.