Immediate implant placement in the esthetic zone is often associated with buccal bone deficiency, which may compromise esthetic outcomes and long-term implant stability. Autogenous bone graft harvested from the maxillary tuberosity provides corticocancellous bone with favorable biological properties and may help reconstruct the buccal bone plate during immediate implant placement.

This prospective case series aims to evaluate the clinical and esthetic outcomes of immediate implant placement combined with autogenous maxillary tuberosity graft in the esthetic zone. The primary outcomes include buccal bone thickness measured on cone-beam computed tomography (CBCT), facial soft tissue thickness measured clinically, and the pink esthetic score (PES) after implant restoration.

Immediate implant placement has become a widely accepted treatment modality in the esthetic zone. However, the presence of buccal bone defects following tooth extraction may negatively affect peri-implant tissue stability and esthetic outcomes. Autogenous bone graft harvested from the maxillary tuberosity has been proposed as a reliable grafting material due to its corticocancellous structure and high osteogenic potential.

This prospective interventional case series aims to evaluate the effectiveness of autogenous maxillary tuberosity graft used in conjunction with immediate implant placement in the esthetic zone. Patients requiring extraction and implant placement in the maxillary esthetic region will be treated with immediate implant placement and augmentation using a two-layer autogenous graft harvested from the maxillary tuberosity, consisting of cortical bone and connective tissue.

Clinical and radiographic outcomes will be assessed during follow-up. Buccal bone thickness will be evaluated using cone-beam computed tomography (CBCT). Facial soft tissue thickness will be measured clinically. Esthetic outcomes will be assessed using the pink esthetic score (PES) following definitive prosthetic restoration.

The results of this study are expected to provide clinical evidence regarding the effectiveness of maxillary tuberosity autogenous grafts for improving peri-implant tissue stability and esthetic outcomes in immediate implant placement.

Inclusion Criteria:

• Adults aged 18 years or older
• Patients requiring single implant placement in the maxillary esthetic zone
• Indication for immediate implant placement following tooth extraction
• Presence of a buccal bone defect requiring augmentation with an autogenous maxillary tuberosity bone graft
• Adequate oral hygiene and ability to maintain postoperative care
• Willingness to participate in the study and provide informed consent

Exclusion Criteria:

• Uncontrolled sHistory of radiotherapy in the head and neck region ystemic diseases
• History of radiotherapy in the head and neck region
• Active periodontal disease or untreated oral infection
• Heavy smoking (more than 10 cigarettes per day)
• Pregnancy or lactation
• Severe parafunctional habits
• Insufficient bone volume preventing implant placement with the planned protocol
• Patients unable to attend follow-up visits