Background
peri-implant, infection, tooth
INFECTION, CLOT, ALVEOLAR BONE LOSS, SECONDARY
The indications for dental implant treatment options have greatly expanded in recent years due to development in biomaterials and clinical procedures [Original protocol (gold standard) recommended a 6- to 12-month waiting time before implant placement in cases where a tooth had to be extracted and replaced. New methods that involve implant placement during tooth extraction have been developed. This protocol is called immediate implant placement [Immediate implant placement has an overall survival rate of 98.5%, while delayed implant placement has a survival rate of 98.9% [In contrast, immediate implant placement has some disadvantages including, lack of control of the final implant position, difficulty of achieving primary stability, incomplete soft tissue closure over the extraction socket, inability to inspect all aspects of the extraction site for infection and difficulty in preparing the osteotomy due to bur movement (chatter) on the walls of the extraction site [After tooth extraction, the alveolar socket frequently has dimensions larger than the implant's diameter, creating a space between the implant's surface and the alveolar bone walls in the recipient site. This area is designated as the jumping distance or the peri-implant gap. The peri-implant gap affects osseointegration and implant stability [The buccal aspect of an implant is of great concern, especially in the aesthetic zone (between the second contralateral premolars), because the buccal bony plate is thin and its resorption can result in soft tissue recession [Defects < 2 mm can be filled with bone without the need for bone grafts or the usage of barriers. The success of immediate implant procedures may be adversely affected by large gaps, as has been reported [Regarding the best methods to achieve the following goals—optimal bone fill in the gap, the highest level of coronal bone to implant contact (BIC), the least amount of buccal bone resorption, and the least amount of soft tissue recession— the best surgical approach for treating the buccal gap is debatable and unclear [The peri-implant gap has been filled using several bone grafting materials. Autograft is the gold standard for bone grafting materials but it has some limitations such as the need of a second surgical site, limited volume and size mismatch [Growth factors, such as Platelet Rich Fibrin (PRF) and bone morphogenic proteins, have been used to stimulate bone formation in the defective sites, as has been reported in several studies [The fibrin clot formed during the production of traditional PRF or its modification, is a three-dimensional scaffold that replaces the extracellular matrix in cell regeneration and newly formed vessels. Platelets trapped between fibrin fibers, B and T lymphocytes, monocytes, stem cells and neutrophils, as well as secreted growth factors such as TGF-1, PDGF, and VEGF, play a role in healing [The purpose of this study was to compare the efficacy of different gap filling materials in immediate implant in anterior and premolar regions of maxilla. The primary objective was to assess alveolar bone loss and changes in buccal bone thickness radiologically using cone-beam computed tomography (CBCT) and the secondary objective was to assess various clinical parameters such as implant stability by measuring the changes in Resonance Frequency Analysis (RFA) and peri-implant pocket depth.The hypothesis was that the peri-implant alveolar bone loss, changes in buccal bone thickness and soft tissue health in immediate implants with a jumping distance grafted with PRF would be the same as those grafted with Xenograft or Alloplastic bone grafting materials.