Introduction
angulation, bone loss, tooth
COMPLICATIONS, BONE LOSS
One of the main goals that modern dentistry strives to achieve is the successful and predictable restoration of missing teeth. Many materials and treatment modalities have been introduced for tooth replacement in the esthetic zone. The introduction of dental implants has brought this goal closer, leading to a revolutionary era for successful treatment [Immediate implant placement following tooth extraction has shown comparable survival rates to implants placed in healed alveolar ridges [Different techniques have been used for grafting the jumping gap such as Autograft based, Allograft-based bone which could be used alone or in combination with other materials for example: freeze-dried bone, Xenograft such as bovine bone, and Ceramic-based bone graft substitutes that include calcium phosphate, calcium sulfate, and bio-glass used alone or in combination [Bovine bone substitutes counteract many of the dimensional changes that occur in the post-extraction sockets. Bovine bone grafts act as an ideal barrier material, which in turn preserves the ridge width and volume and supports the soft tissue, preventing it from collapsing [The bone formation around an implant is an important factor for a better esthetic outcome; on the contrary, any bone loss means the loss of soft tissue, which in turn affects the ideal implant aesthetic result [With the advancement of computer-aided design and computer-aided manufacturing (CAD-CAM) technology, there are different approaches for implant prosthetics’ digital workflow [The CAD-CAM guided templates have many applications in dentistry such as implant placement and endodontic access preparations, the guided implant osteotomy presents an accurate protocol for implant placement in the preplanned position with less surgical time and few post-surgical complications. The digitally designed surgical guides transfer the virtually planned implant angulation, width and length through the use of 3D printed transparent template [Many debates with different opinions have existed regarding grafting or leaving the buccal jumping gap empty. Therefore, the primary purpose of this in vivo study was to evaluate the pink esthetic score in the maxillary esthetic zone after computer-guided immediate implant installation and fully digital immediate temporalization with and without grafting the jumping gap with a mixture of 1:1 autogenous and xenograft particulates.