This randomized clinical trial aims to evaluate labial bone plate changes following immediate implant placement in Type II extraction sockets using two different xenograft materials and de-epithelialized free gingival graft in the esthetic zone . Patients requiring extraction and immediate implant placement will be randomly allocated into two groups according to the xenograft material used for defect grafting. Clinical and radiographic outcomes will be assessed to determine dimensional bone changes and implant success

Immediate implant placement in the esthetic zone has become a predictable treatment modality aiming to reduce treatment time while preserving alveolar bone and soft tissue architecture. However, dimensional alterations of the labial bone plate remain a clinical concern, particularly in Type II extraction sockets.

The present randomized controlled clinical trial will compare the effect of two different xenograft materials and de-epithelialized free gingival graft used for defect grafting during immediate implant placement. Eligible patients indicated for tooth extraction and immediate implant placement will be randomly assigned into two parallel groups based on the grafting material used.

Clinical evaluation and standardized radiographic assessment using CBCT will be performed to measure labial plate thickness changes, peri-implant bone stability, and implant success outcomes over a defined follow-up period. The findings of this study aim to provide clinical evidence regarding the most effective xenograft material for preserving peri-implant hard tissue contours in the esthetic zone

Inclusion Criteria:

• Patients with one or more non-restorable teeth or remaining roots without signs of acute infection in the maxillary anterior region.
• Type II extraction sockets.
• Sufficient bone (>3 mm) apically and palatally to allow for proper implant positioning with sufficient primary stability (≥ 30 N cm).
• Good compliance.

Exclusion Criteria:

• Teeth with current acute periapical infection.
• Medically compromised patients.
• Heavy smokers (smoking of more than 10 cigarettes per day ).
• Alcohol or drug abuse.
• Patients undergoing chemotherapy and radiotherapy.
• Poor oral hygiene.
• Vulnerable groups (pregnant females and decision- impaired individual).

This study is a randomized clinical trial designed to evaluate labial bone plate preservation following immediate implant placement in Type II extraction sockets using two different xenograft materials in the esthetic zone. Eligible participants will be randomly assigned to one of two parallel groups based on the xenograft material used for gap grafting. Clinical and radiographic assessments will be conducted to monitor dimensional changes of the labial bone plate, peri-implant tissue health, and implant success over a six-month follow-up period. All procedures will be performed under standard clinical protocols at the Faculty of Dentistry, Alexandria University