الفهرس 
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Abstract
Aim of the study: was to assess bone and soft tissue changes after tooth extraction and immediate
implant insertion with immediate provisionalization in the anterior maxilla
Methodology: 30 immediate implants were placed in anterior maxilla, a novel synthetic bone graft
(Geistlich Bio-Oss® ) , nano bone ( Nano streams) was used to fill the gap between the implant surface
and the alveolar bone. Implants with (3.7*14) diameter compared to the size of the socket were used.
A fixed screw retained provisional restoration was provided immediately after implant placement.
Cone beam computed tomography (CBCT) scans were taken to evaluate bone changes immediate
after surgery and after 6-months follow up. To evaluate soft tissue changes, clinical vertical
measurements were performed by using PES
Result: the maen horizontal bone loss for group I was 0.671mm , for group II was 0.380mm ,and for
group III was 0.289mm . This was statistically not significant; p=0.057.the mean vertical bone loss
for group I was 0.212 mm , for group II was 0.233mm and for group III was 0.262mm. This was
statistically not significant; p=0.807.
Conclusions: •Immediate implant with immediate temporization using graft materials to augment
jumping gap is successful treatment modality for rehabilitation of hopless teeth in the esthetic
zoneThe type of graft materials doesn’t significally affect on the outcome (horizontal and vertical
bone loss) following implant installation with immediate temporization in the esthetic zone.