Edentulism in Lower Jaw

This randomized clinical study will compare the accuracy of immediate implant placement performed using three different surgical approaches: freehand surgery, conventional tooth-supported static computer-guided surgery, and a tooth- and socket-supported static surgical guide. Patients requiring extraction of a mandibular first or second molar, or a retained root in the same region, followed by immediate implant placement will be enrolled. All participants will undergo three-dimensional preoperative treatment planning using cone-beam computed tomography and intraoral scanning. Participants will then be randomly allocated to one of three groups according to the assigned surgical technique. The primary outcome will be the three-dimensional accuracy of implant placement, determined by comparing the virtually planned implant position with the clinically achieved implant position. Coronal, apical, angular, and depth deviations will be evaluated using postoperative three-dimensional imaging. The study will determine whether the use of conventional tooth-supported or tooth- and socket-supported static surgical guides results in different implant positioning accuracy compared with freehand immediate implant placement.

Patients will be selected from the outpatient clinic of Removable Prosthodontic Department. Faculty of Dental Medicine for Girls, Al-Azhar University.. Each patient will be assessed for eligibility and Informed consent will be obtained from patient after explanation of the treatment protocols and expected outcomes or alternative management.