Alveolar Ridge and Soft Tissue Augmentation Using Graft From the Maxillary Tuberosity

immediate implant will be placed in the anterior region with autogenous graft from the maxillary tuberosity and in the other group immediate implant will be laced with xenograft soft tissue grafting using sub-epithelial connective tissue will in both groups assessment of buccal bone thickness is the primary outcome of the study, while volumetric assessment of the soft tissue and patient satisfaction are the secondary and tertiary outcome the assessment of all outcome will be 6 months post operative the extraction socket in which the implant will be placed are class I&II

Inclusion criteria

• Systemically healthy patients (American Society of Anesthesiologists I; ASA I).
• Age range (20-40) years.
• Good compliance with the plaque control instructions following initial therapy.
• Patients diagnosed with bone defect in the maxillary anterior esthetic zone (class 1 & 2)
• Availability for follow up and maintenance program.

Exclusion criteria

• Peri apically infected teeth
• Presence of smoking habit.
• Presence of occlusal interferences.
• Pregnant females.
• Vulnerable group of patients (handicapped, mentally retarded and prisoners) (according to the recommendation of esthetical committee of Faculty of Dentistry Ain Shams University).