Hard Tissue Augmentation With or Without Connective Tissue Graft in Immediate Esthetic Implants

Effectiveness of Hard Tissue Augmentation With or Without Connective Tissue Graft Following Immediate Dental Implants in the Esthetic Zone: A Randomized Controlled Study

This randomized controlled study is aimed to evaluate the esthetic, clinical, and radiographic outcomes following the placement of immediate single-tooth implant with hard and soft tissue augmentation.

Subjects will randomly assigned to one of two groups:

• Group A (control group) receiving an immediate single-tooth implant in the esthetic zone with bone augmentation only.
• Group B (study group) receiving an immediate single-tooth implant in the esthetic zone with bone augmentation and connective tissue graft (CTG).

The main questions it aims to answer is:

Is there is a significant difference in the esthetic outcome between bone augmentation alone and bone augmentation combined with connective tissue graft after immediate dental implant in the esthetic zone?

Inclusion Criteria:

• Patients with a non-restorable tooth or a remaining root without signs of acute infection in the maxillary esthetic zone.
• The failing tooth is an incisor, canine or first bicuspid in the maxilla bounded by natural sound teeth.
• Sufficient bone (>4 mm) apically and palatally to allow for proper implant positioning with sufficient primary stability (≥35 N cm).
• Sufficient mesial-distal and interocclusal space for placement of the implant and definitive restoration.

Exclusion Criteria:

• Patients with systemic conditions affecting bone healing (e.g., uncontrolled diabetes).
• Teeth with current acute periapical infection.
• Dehiscence of the labial (facial) bone plate after extraction.
• Signs of uncontrolled periodontal disease.
• Heavy smokers and vulnerable groups (pregnant females and decision-impaired individuals).
• History of head and neck radiation therapy.