Comparison Between Xenograft and Extended PRF as Jumping Gap Grafting Material Versus Natural Healing of the Socket Without Any Material.

Clinical and Digital Evaluation of Different Jumping Gap Grafting Materials Versus No Grafting Material in Immediate Lower Molar Implant Placement

This study aims to clinically and digitally evaluate immediate implants placed in mandibular molar extraction sockets and compare the outcomes of xenograft, e-PRF, and no grafting material within the jumping gap.

Following atraumatic extraction and implant site preparation within the interradicular bone, the implant will be immediately inserted. A chairside customized healing abutment will then be fabricated to seal the extraction socket. According to group allocation, the jumping gap will be filled with xenograft, e-PRF, or left unfilled before placement of the customized healing abutment. Definitive prosthetic restoration will be delivered after three months of implant insertion.

1. Clinical Evaluation:

   Implant stability will be assessed at implant placement and at 3 and 6 months using resonance frequency analysis with the Osstell device, with implant stability quotient (ISQ) values recorded.

   Peri-implant soft-tissue health will be assessed using the modified sulcus bleeding index (mSBI) at 3 and 6 months intervals.

2. Digital Evaluation:

   Peri-implant soft-tissue dimensional changes will be assessed using intraoral optical scans obtained preoperatively and at 1, 3, and 6 months. The resulting STL files will be superimposed using a best-fit alignment algorithm to evaluate dimensional changes in the peri-implant soft tissues.

3. Radiographic Evaluation:

CBCT examinations will be obtained preoperatively, immediately after implant placement, and at 6 months. Three-dimensional superimposition of baseline and follow-up DICOM datasets will be used to evaluate hard-tissue dimensional changes.

Inclusion Criteria:

• Any partially dentate patients with non-restorable mandibular molar requiring dental extraction.
• Extraction sockets with intact bony walls and interradicular bone.
• Jumping gap more than 2mm.

Exclusion Criteria:

• Patients with any pathological lesion or aggressive periodontal disease at the planned surgical site impaired the immediate implant placement.
• Heavy smokers (≥ pack per day)
• Pregnancy.
• Patients with systemic diseases that absolutely contraindicate implant placement or para-functional habits (bruxism or clenching).
• Patients with poor oral hygiene or aggressive periodontal disease.