Autogenous Tooth Bone Graft Versus Allogeneic Bone Graft Around Dental Implant in Aesthetic Zone

24 patienta with non restorable anterior teeth underwent extraction with immediate implant installation randomized to two groups Autogenous tooth bone graft group (study group): 12 patients will have immediate implant placement with autogenous tooth bone graft.

• Allogeneic bone graft group (control group): 12 patients will have immediate implant placement with allogeneic bone graft (demineralized freeze dried bone allograft - cortico cancellous).

preparation of autogenous tooth bone graft Any restorations, caries, cementum, periodontal ligament and pulp tissue will be removed .The tooth will be grinded using dental bone mill and bone crusher Tooth particles will be sieved to particles size 300 to 1200 microns. The sorted particles will be immersed in 70 % ethanol and 5% Peracetic acid* in a sterile container for 10 minutes to remove any soft tissue remnants, bacteria and smear layer (defatting and sterilization).

Tooth particles will be demineralized using 2% HNO3for 20 minutes to expose the dentine organic matrix.

The bacteria-free particulate dentin will be washed with phosphate buffered saline‡ twice for 5 minutes to restore the PH balance to 7.4. In the same setting, surgical procedure after atraumatic extraction immediate implant willbe inserted according to dimensions taken from CBCT and jumbing gap will be filled with bone graft according to randomization

Inclusion criteria

Patients with non restorable maxillary anterior teeth need to be extracted.

• Thin labial plate of bone of the tooth to be extracted.
• Patients age above 20years old.
• Good oral hygiene.
• No signs of acute infection or inflammation

Exclusion criteria

• Prior radiation therapy.
• Soft and hard tissue pathology at the operation site.
• Any relevant systemic disease or medication that might compromise bone healing.