Background: Latest dentistry had been reported as fast and growing evolution. Regarding the implant-rehabilitation protocols, they had been altered in order to fulfill patient's increasing prospects in terms of ease, appealing and smaller treatment period. Aim; evaluate bone and soft tissue changes after tooth extraction and immediate implant insertion with immediate provisionalization in the anterior maxilla, Methods: Thirty immediate implants were placed in anterior maxilla, a novel synthetic bone graft (Geistlich Bio-Oss ® ), nano bone (Nano streams) was used to augment the gap between the implant and the alveolar bone interface. Implants diameter used in this study is (3.7*14) compared to the size of the socket were used. A fixed screw retained provisional restoration was delivered immediately after implant placement. Cone beam computed tomography (CBCT) scans were taken to evaluate bone changes immediate after surgery and after 6-months follow up. To assess soft tissue changes, clinical vertical measurements were performed by using pink esthetic score.Results: Mean horizontal bone loss for Group I, II and III were (0.671), (0.380) and (0.289) mm respectively. This was statistically not significant as p=0.057. Mean vertical bone loss for Group I, II and III were (0.212), (0.233) and (0.262) mm respectively. This was statistically not significant as p=0.807. Conclusion:Immediate implant with immediate temporization using graft materials to augment jumping gap is a successful treatment modality for rehabilitation of hopeless teeth in the esthetic zone. The type of graft materials doesn't significantly affect on the outcome (horizontal and vertical bone loss) following implant installation with immediate temporization in the esthetic zone.
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