الفهرس 
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Abstract
The present study was conducted to evaluate and compare clinically and radiographically by cone beam computed tomography the efficacy of bone augmentation around immediate implant placement in severely periodontally involved anterior teeth using pericardium collagen membrane with xenogenic ring block graft versus autogenous ring block graft harvested from retromolar area. Eleven female patients were selected from outpatient clinic of the Department of Oral Medicine, Periodontology, Oral Diagnosis, and Radiology, Faculty of Dentistry, Tanta University to participate in the present study. Among these patients, 20 sites of anterior maxillary periodontally hopeless teeth were selected and classified randomly into two groups by using sealed envelopes. • group (A) (Xenogenic group): 10 immediate implants were simultaneous installed using xenogenic bone block graft and covered with pericardium collagen membrane. • group (B) (Autogenous group): 10 immediate implants were placed using autogenous bone block graft harvested from the retromolar area and covered with pericardium collagen membrane. Comparison between the groups were assessed by the following parameters I) Clinical parameters Plaque index (PI), probing depth (PD) and bleeding on probing (BOP) were carried out for each patient in both groups before implant placement (before phase I & after reevaluation) and after implant placement at 6, 9 and 12 months. While other clinical parameters were carried out at different periods; implant mobility at 6 and 12 months, pink esthetic score (PES) at 9 and 12 months and patient’s esthetic satisfaction at 12 months. II) Radiographic assessment Cone beam computed tomography (CBCT) were done at twenty four hours after surgery, at 6 and 12 months after implant placement. ➢ Clinical results • Intragroup comparison of the mean values of PI and BOP throughout the follow up period of the 2 groups, there were significant improvement after 9 and 12 months compared to 6 months post implant placement. While comparing mean values of 9 months and 12 months post implant placement there were no statistical significance difference. Furthermore intergroup comparison of PI and BOP showed that at 6, 9 and 12 months post implant placement there were no statistical significance difference between group A and group B. • On the other hand, intragroup comparison of the mean values of PD throughout the follow up period of the 2 groups, there were statistically significant difference in favor of 6 and 9 months when compared to 12 months post implant placement. While comparing the mean value of 6 months versus 9 months there were no statistically significant difference in both groups. While intergroup comparison of the mean values of PD between group A and group B, there were statistical significant difference at 12 months in favor of group B. • Both groups showed no mobility associated with the implant at 6 and 12 months post implant placement. • Regarding the mean values of pink esthetic score of the 2 groups, results of intragroup comparison showed statistically significant increase of the 2 groups at 9 and 12months. While upon intergroup comparison, there was statistical significant difference in favor of group B when compared to group A. • comparing the mean values of patient’s esthetic satisfaction between the two groups, results showed significant difference in favor of group B when compared to group A. ➢ Radiographic results: • The intragroup comparison of the mean values of the average crestal bone height (CBH) throughout the follow up period of the 2 groups, there were statistically significant decrease of the CBH when comparing base line (at implant placement) and 6 months to 12 months post implant placement. And upon intergroup comparison of the mean values of CBH between group A and group B at base line, 6 and 12 months post implant placement there were statistical significance difference at 12 months in favor of group B. • Regarding bone density at the ring alveolus interface and bone density at the ring implant interface, upon intragroup comparison in group A and group B, both showed statistical increase of the mean values of bone density when comparing the mean value at 6 and 12 month with the mean value at the base line. And upon intergroup comparison between the 2 groups, the mean values of bone density showed that there were statistically significant difference at base line, 6 and 12 months in favor of group B.