الفهرس 
Dimensional changes after dental extractionOnly 14 pages are availabe for public view
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Abstract
The present study was conducted to evaluate clinically and radiographically between immediate and immediate-delayed implant regarding replacement hopeless non- periodontaly involved tooth in premolar maxillary region. Twenty patients were selected from outpatient Clinic Oral Medicine, Periodontology, Oral Diagnosis, and Radiology, Faculty of Dentistry, Tanta University. These patients were randomly classified in two groups used sealed envelope as follows: group (1): immediate implant group (ten extracted sites). Patients scheduled for surgery after tooth extraction, the immediate implant was placed using Bio-Oss Collagen with collagen membrane adaptation. group (2): immediate-delayed implant group (ten extracted sites). Patients scheduled for tooth extraction, and after four weeks the immediate-delayed implant was performed. Comparison between the above mentioned 2 groups was assessed by the following parameters: 1) Clinical evaluation: In the present study, Patients of both groups were assessed clinically before implant placement at base line (before phase one) and reevaluation (after 4 weeks of phase one therapy) and at 9, 12 &18 months after implant placement for plaque index (PI), bleeding on probing (BOP) and probing depth (PD) while pink esthetic score (PES), implant survival (IS), and Patient‘s esthetic satisfaction were carried out 18 months post implant placement. 2) Radiographic parameters: In the current study Periapical radiographs were performed at base line prior implant placement for both groups to check any periapical infection, impression phase to check implant to confirm connection of transfer coping with implant fixture. The final radiographs were made at 18 months post implant placement to check if there was peri-implant osteolysis or implant fracture required for implant survival parameter. The cone beam computed tomography (CBCT) was performed for radiographic evaluation of facial bone prior implant placement to confirm the absence of fenestration or dehiscence and absence of periapical infection with allowing of proper treatment plane of implant selection prior surgery. Also, CBCT techniques was taken at base line (48 hours after implant placement) and after 12 months following surgery to access the facial bone thickness regarding vertical facial bone height (VFBH) and horizontal facial bone thickness (HFBT) at 0,1,2,3 from implant platform, m (middle) and a (apex) of implant fixture from coronal view between both groups. Clinical results • Comparing mean values regarding PI, BOP, PD prior implant placement there was no significant difference between immediate and immediate delayed at baseline and reevaluation. There was a significant decrease in mean value related to reevaluation in comparison to base line with intragroup comparison for both groups. • Both PI and POB showed similar results after implant placement for both groups, as intra-group comparison revealed significant increase at 12 and 18 months post implant placement in comparison with 9 months post implant placed, while there was no significant difference between 12 and 18 months post implant placement. Whereas, inter-group comparison showed no significant difference at 9, 12 and 18 months post implant placement between the two groups. • On the other hand, there was a statically significant increase of mean values of PD at 12 and 18 months post implant placement in comparison with 9 months post implant placement also, there was significant increase in mean value related to 18 months in comparison to 12 months post implant placement during intra-group comparison. While, intergroup comparison showed no significant difference at 9, 12 and 18 months post implant placement between the two groups. • Upon comparing the mean values of PES and patient‘s esthetic satisfaction at 18 months post implant placement between the 2 groups there were significant difference in favor of immediate delayed implant group when compared to immediate implant group in both parameters. • The cumulative overall of implant survival rate of both groups was 100% success without any implant failure so, there was no significant difference between both groups. Radiographical results: • Intragroup comparison of the mean values of immediate implant group showed significant VFBH and HFBT (0,1,2,3,m) bone loss at 12 months post implant placement in comparison with base line line (48 hours post implant placement). However, upon comparing mean values of HFBT (a) 12 months post implant placement with base there was no significant difference between them regarding bone loss. • Intragroup comparison of mean values of immediate-delayed implant group showed significant VFBH and HFBT (0,1,2,3mm) bone loss at 12 months post implant placement in comparison with base line . However, upon comparing mean values of HFBT (m,a) 12 months post implant placement with base line there was no significant difference between them regarding bone loss. • Both intergroup comparison of mean values at base line and 12 months post implant placement between immediate and immediate delayed implant groups showed no significant difference between them. • Intergroup comparison of dimensional changes of facial bone thickness (A12-B) showed no significant difference between them regarding VFBH(A12-B) and HFBT(A-12) at different levels from implant platform (HFBT-0,1,2,3,a). However, immediate delayed implant group showed less dimensional changes of facial bone thickness at HFBT (A- 12) at HFBT (m) than immediate implant group and it was significant difference.