The present study aims to evaluate and compare the clinical, radiographic, and biological peri-implant tissue outcomes of platelet-rich fibrin versus probiotics as adjuncts to immediate implant placement combined with subepithelial connective tissue grafting in adults requiring single immediate implant placement.
Adults aged 20 to 45 years.
Systemically healthy patients eligible for implant surgery.
Patients requiring extraction of a single non-restorable tooth indicated for immediate implant placement.
Implant sites located in the maxillary esthetic or para-esthetic zone.
Medically compromised patients or patients with systemic conditions that may contraindicate implant surgery or interfere with healing.
Smokers.
Pregnant or lactating women.
Patients with uncontrolled periodontal disease or poor oral hygiene.
Parallel
Platelet-Rich Fibrin
Procedure/Surgeryplatelet-rich fibrin will be prepared immediately before application using freshly drawn autologous venous blood and a standardized centrifugation protocol selected according to the equipment available in the study setting. The prepared PRF will be used as an adjunct to the immediate implant and subepithelial connective tissue grafting procedure according to the finalized protocol, either locally around the peri-implant site and/or in intimate relation to the grafted soft tissue to enhance healing and tissue maturation.
Probiotics
Procedure/SurgeryProbiotics probiotics will be administered as an adjunct to the immediate implant and subepithelial connective tissue grafting The mode of delivery, dose, and duration will be standardized for all patients allocated to this group.
evaluation of matrix metalloproteinase-8 (MMP-8) levels
Biological assessment will be performed by collecting peri-implant sulcular fluid samples for evaluation of matrix metalloproteinase-8 (MMP-8) levels. After gentle removal of supragingival plaque, the peri-implant site will be isolated with cotton rolls and dried with mild air flow. Sterile PerioPaper strips will be inserted carefully into the peri-implant sulcus until slight resistance is encountered and left in place for 30 seconds. Any strip contaminated with blood or saliva will be discarded. The collected samples will be transferred to sterile Eppendorf tubes and stored until analysis. Quantitative assessment of MMP-8 will be carried out using a human MMP-8 ELISA kit according to the manufacturer's protocol.
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