الفهرس 
Introduction.Only 14 pages are availabe for public view
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Abstract
Tooth extraction is one of the most widely performed procedures in dentistry, and it has been historically well documented that it can induce significant dimensional changes of the alveolar ridge. Implants placed in this manner, are advocated to preserve soft tissue form and contour, preserve bone dimensions, reduce the period of edentulism, reduce the overall treatment time and to optimize esthetic results.
The concern here is for architectural changes in the alveolar bone following extraction and after implant placement. Alveolar resorption has been characterized as an inevitable and progressive process that occurred rapidly following tooth extraction. Remarkable changes in the maxillary alveolar ridges following the extraction have been reported. It has been observed that the maxillary alveolar ridge width diminishes approximately 50% following tooth extraction. The width of the buccal plate of bone may be an important determinant of bone morphologic changes following extraction.
The primary objective of this study was the radiographic evaluation of the changes in height, thickness and density of the labial plate of bone and soft tissue changes after immediate implant placement performing the Socket- Shield Technique with and without using sticky bone graft one day postoperative and after 6 months.
This prospective study included twenty patients who were categorized randomly into two groups; group A: cases were subjected to socket shield procedure followed by sticky bone graft, immediate implant placement and immediate implant loading and group B: cases were subjected to socket shield procedure followed by immediate implant placement and immediate implant loading without sticky bone graft.
All cases were subjected preoperatively to full clinical examination (plaque index, bleeding index, probing depth) and radiological assessment by CBCT to measure thickness, height and density of existent labial plate of bone at baseline and papilla height. Then cases underwent the implantation procedures, then evaluated postoperatively by CBCT after one day and six months.
Bone thickness was significantly higher in group A than group B immediately after implant placement and postoperatively and was significantly higher immediately after implant placement compared to postoperatively in group A and group B.
Bone height was comparable between both groups immediately after implant placement and postoperatively with insignificant variation between immediately after implant placement and postoperatively in both group A and B.
Bone density was significantly higher 6 months postoperatively when compared to baseline values in both group A and B. Bone density increased in both group A and B but the increase in density (mean difference) was significantly higher in group A compared to group B.
Papilla height was comparable between both groups immediately after implant placement and postoperatively. Papilla height was comparable between immediately after implant placement compared to postoperatively in group A and group B.
Probing depth was comparable between both groups immediately after implant placement and postoperatively with significant decrease to 6 months postoperatively when compared to immediately after implant placement in group B. Probing depth was insignificantly different between immediately after implant placement and postoperatively in group A.
Bleeding index was comparable between both groups immediately after implant placement and postoperatively. Bleeding index was comparable between immediately after implant placement compared to postoperatively in group A and group B.
Plaque index was comparable between both groups immediately after implant placement and postoperatively. Plaque index was comparable between immediately after implant placement compared to postoperatively in group A and group B.