Evaluation of Autogenous Bone Graft on Immediate Dental Implant Osseointegration Using Piezosurgery

This clinical study aims to evaluate the clinical and radiographic outcomes of immediate dental implant placement in mandibular premolar sites. Patients requiring extraction of mandibular premolars will receive immediate implant placement, with or without autogenous bone grafting, according to the study protocol. When indicated, autogenous bone graft will be harvested using piezosurgery during the implant procedure. Participants will be followed up clinically and radiographically to assess implant stability, marginal bone level changes, and peri-implant tissue conditions over a defined follow-up period. The results of this study may help determine the effectiveness and predictability of immediate implant placement in mandibular premolar regions.

Inclusion Criteria: * Patients requiring extraction of mandibular premolars. * Age ≥ 25 years. * Adequate oral hygiene and motivated patients for implant treatment. * Sufficient bone volume to allow immediate implant placement (with or without minor augmentation). * Patients willing to participate and attend follow-up visits for at least 6 months. * Systemically healthy patients (ASA I or II). Exclusion Criteria: * Uncontrolled systemic diseases (e.g., uncontrolled diabetes, immunocompromised patients). * Heavy smokers (e.g., \>10-15 cigarettes/day). * Active periodontal or acute infection at the implant site. * Poor oral hygiene or non-compliant patients. * Pregnancy or lactation. * History of radiotherapy in head and neck region. * Severe bone deficiency not suitable for immediate implant placement.