Patients receiving implants today are often unaware of the original loading protocols of 3 to 6 months of load-free healing prior to restorative therapy. Often, when patients require extraction of an anterior tooth, they do not accept even the shortest period of partial edentulism. Thus, the loss of a single tooth, mainly in the aesthetic zone, and its replacement by implants has been a challenge in recent decades. There have been two main hurdles to overcome: 1. -The final aesthetic result 2. -The long waiting periods required by conventional implant protocols In the early days of implant dentistry, encapsulation by fibrous connective tissue was reported when implants were immediately loaded, while a period of stress-free healing would allow for direct bone-to-implant contact i.e. Osseointegration . Therefore the recommended waiting time, according to the original BrÃ¥nemark protocol, was at least three months in the mandible and six months in the maxilla. However, during the past three decades, technological developments and continuous clinical research have provided us with improved protocols in an attempt to meet the expectations of a shorter treatment period, improved aesthetics and more convenience for the patient. The terms “non-functional immediate loadingâ€, “immediate restoration†or “immediate provisionalization†or “immediate temporization†are used when the prosthesis is placed on implants at some point within the first 72 hours without full occlusal contact with the teeth of the opposite jaw. Keeping the provisional restoration out of occlusion has to do with the idea of controlling the load on a single tooth. Several studies have reported a high success rate on single-tooth implants placed post-extraction which received an immediate non-functional provisional crown. The most important reason of immediate implant placement with immediate temporization is that positioning an implant into a post-extractive socket can considerably reduce crestal bone resorption and at the same time provide aesthetic rehabilitation immediately after extraction of the tooth especially in the aesthetic zone. Some commonly seen advantages include better implant survival rates, improved esthetics, maintenance of the hard and soft tissues at the extraction site, and higher patient satisfaction compared with delayed implant placement. It is critical to monitor the peri-implant bone changes after immediate implant placement especially after prosthetic loading. This can be accomplished by a device that provides a three-dimensional view of the hard tissue. The recently developed cone beam computed tomography (CBCT) scan meets these requirements, with the added benefit of decreased x-ray exposure as compared to conventional CT imaging. Aim: To evaluate Peri-implant bone following immediate implant placement with immediate temporization using Cone Beam Computed Tomography (CBCT). Objectives: 1. To evaluate and compare the horizontal alveolar ridge changes on facial and palatal cortical plates following immediate implant placement with immediate temporization. 2. To evaluate and compare total bucco-lingual dimensional changes following immediate implant placement with immediate temporization. 3. To evaluate and compare the vertical buccal alveolar ridge changes following immediate implant placement with immediate temporization. |