Evaluation of Enamel Matrix Derivative in Immediate Dental Implants in the Mandibular Molar Region

Immediate dental implant placement following tooth extraction is a commonly used treatment approach, but achieving predictable osseointegration and preservation of peri-implant bone remains challenging, particularly in the presence of jumping gaps. Enamel matrix derivative is a biologically active material that has been shown to enhance periodontal and bone healing, but its effects around immediate dental implants are not fully established.

This randomized clinical trial will be conducted at the Outpatient Clinic of the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University. Twenty-four patients requiring extraction of a single non-restorable mandibular molar will be enrolled and randomly allocated into two equal groups. In the test group, immediate dental implants will be placed with the application of enamel matrix derivative, while in the control group implants will be placed without enamel matrix derivative.

Clinical outcomes will include implant stability measured using resonance frequency analysis and peri-implant soft tissue health assessed by modified sulcus bleeding index. Radiographic outcomes will be evaluated using cone beam computed tomography to assess peri-implant bone dimensional changes, marginal bone loss, and bone density. Assessments will be performed at baseline and during follow-up visits up to six months after implant placement.

Inclusion criteria

• Patients with non-restorable mandibular molar requiring dental extraction.
• Patient medically free from systemic diseases that absolutely contraindicate implant surgery.
• Age range: from (18 to 45) years.
• Adequate inter-arch relation and inter-occlusal space to accommodate the prosthetic restoration (8-12mm).
• Extraction sockets with intact bony walls and interradicular bone.
• Jumping gap more than 2mm.
• Patients with good oral hygiene.
• Patients willing to participate in the study's follow-up intervals.

Exclusion criteria

• Patients with any pathological lesion or aggressive periodontal disease at the planned surgical site impaired the immediate implant placement.
• smoker patients.
• Pregnant patients.
• Patients with para-functional habits (bruxism and clenching)