Hyaluronic Acid Combined With Xenograft Versus Xenograft Alone in Immediate Implant Placement

This randomized controlled clinical trial aims to compare the clinical and radiographic outcomes of immediate implant placement using xenograft combined with hyaluronic acid versus xenograft alone in the esthetic zone. Patients requiring extraction of a non-restorable tooth followed by immediate implant placement will be randomly allocated to two groups. In the intervention group, the jumping gap between the implant and facial bone wall will be grafted with xenograft combined with hyaluronic acid, while in the control group, xenograft alone will be used. The primary outcome is the radiographic change in the labio-palatal ridge width. Secondary outcomes include pink esthetic score, implant stability, crestal bone loss, and the amount of bone labial to the implant. Patients will be followed for up to 12 months postoperatively.

Inclusion Criteria: * Non-restorable tooth in the esthetic zone. * Thin labial plate of bone (≤1 mm) maintained after tooth extraction. * Teeth with no acute inflammation. * Thick soft tissue biotype. * Patients free from any systemic condition that may affect the healing. * Availability of bone apical and palatal to the socket to provide primary stability for the immediate implant (Morton et al. 2014). * Good oral health. * Willingness to sign the informed consent form. * Adult patients more than 18 years of age. Exclusion Criteria: * Heavy smoker (\>10 cigarettes/day) (Lambert et al. 2000). * Pregnant females. * Contraindication for implant surgery. * Patients with poor oral hygiene. * Acute inflammation in the site of implantation and adjacent tissue. * A history of radiotherapy in the head or neck region. * Patients with systemic disease like uncontrolled diabetes mellitus, coagulation disorders, alcohol or drug abuse not suitable for implantation (Wu et al. 2019).