A randomized clinical trial comparing 3D-printed resin and CAD/CAM-milled PMMA provisional restorations used for immediate loading of fully digitally guided immediate implants.

Sixty patients were randomly allocated to receive either a 3D-printed resin or a CAD/CAM-milled PMMA provisional crown used for immediate loading after fully digitally guided immediate implant placement in the maxillary esthetic zone. Clinical and peri-implant soft tissue outcomes will be evaluated.

Inclusion Criteria:

• 1. Patients presenting with non-restorable teeth in the maxillary esthetic zone indicated for extraction and immediate implant placement.

  2. Age ranging from 18 to 50 years. 3. Adequate interarch relationship and interocclusal space to accommodate the planned prosthetic restoration.

  4. Intact extraction socket walls with a jumping gap not exceeding 4 mm, as measured on preoperative CBCT images. The jumping gap will be defined as the horizontal distance between the implant surface and the inner aspect of the buccal socket wall and will be grafted in all cases.

  5. Good oral hygiene and periodontal health. 6. Willingness to attend all follow-up visits and comply with study requirements.

Exclusion Criteria:

• 1. Presence of acute infection, pathological lesions, or severe periodontal disease at the planned implant site.

  2. Smokers. 3. Alcohol or drug abuse. 4. Patients with systemic conditions contraindicating implant surgery (e.g., uncontrolled diabetes mellitus, bleeding disorders, immunosuppression, recent radiotherapy to the head and neck region).

  5. Pregnancy or lactation. 6. Patients with parafunctional habits such as bruxism or clenching. 7. Inability to maintain adequate oral hygiene or attend follow-up visits.