Clinical and Radiographic Evaluation of Delayed Implant Placement Following Socket Preservation With Injectable Alloplastic Bone Graft. A Randomized Controlled Study.
Phase: NA
Conditions: Alveolar Ridge Preservation, Dental Implant Placement
Sponsor: Suez Canal University

 
 
 
 
 
 
Clinical and Radiographic Evaluation of Delayed Implant 
Placement Following  Socket Preservation with Injectable 
Alloplastic Bone Graft : A Randomized Controlled Study .  
 
A Thesis Protocol 
Submitted for partial fulfillment of the requirements of the 
Master degree in dental science 
In 
Oral and Maxillofacial Surgery 
Research code: HE 11 
Submitted By 
Ahmed Rawhy Mounir Saleh 
M.U.S Mansoura University 2019 
Dentist at The Egyptian ministry of health ,2021 
Supervisors:  
Title 
Name 
Job Title 
University 
Signature 
Prof. 
Mohamed 
Ahmed 
Elsholkamy 
Professor of Oral 
and Maxillofacial 
Surgery 
Department,Faculty 
of Dentistry 
Suez Canal 
University 
 
Dr. 
Mohamed 
Nageh Gad 
ElHak 
Lecturer in oral and 
maxillofacial 
Surgery, Faculty of 
Dentistr  
Suez Canal 
University  
 
 
Faculty of Dentistry  
Suez Canal University 
2025  
 

 
 
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 “Thesis Research Protocol” 
Student Name:  
Ahmed Rawhy Mounir Saleh 
Student 
ID: 
29605191301178 
 
 
 
 
Submission 
Date: 
4/29/2025 
 
 
Degree: 
☒ M.D.Sc. 
☐  D.D.Sc 
☐ PH.D. 
 
 
 
 
 
Department: 
Suez Canal University 
 
 
Thesis Title in 
English: 
Clinical and Radiographic Evaluation of 
Delayed Implant Placement Following  Socket 
Preservation with Injectable Alloplastic Bone 
Graft. A Randomized Controlled Trial. 
 
 
Thesis Title in 
Arabic: 
 التقييم السريري والشعاعي لوضع الغرسات المتأخرة بعد حفظ تجويف
 السن باستخدام طُعم عظمي غير عضوي
قابل للحقن– 
 دراسة عشوائية
محكمة 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
 
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1. Abstract  
Introduction: Tooth extraction leads to alveolar ridge resorption which can 
compromise future implant placement. Socket preservation using alloplastic 
bone grafts may help maintain ridge dimensions and allow for predictable 
delayed implant placement. Injectable alloplastic bone substitutes have 
gained attention due to their ease of handling and osteoconductive 
properties. Aim: To evaluate the clinical and radiographic outcomes of 
delayed implant placement after socket preservation using injectable 
alloplastic bone graft. Methodology: Twenty Implants will be placed in  20 
patients that have previously extracted a lower posterior tooth, . Group (1) : 
patients without socket preservation after extraction . Group (2): patients 
with socket preservation after extraction . Clinical outcomes including soft 
tissue healing, implant stability, and postoperative complications will be 
assessed. Radiographic evaluation using CBCT will be made before implant 
placement, and after 6 months to measure changes in ridge width and 
height. 
 
 
 
 
 

 
 
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2. Introduction and Background 
 
Tooth extraction is often associated with significant remodeling of the 
alveolar ridge. This natural biological process results in resorption of the 
alveolar bone, with the greatest volume of bone loss occurring within the 
first 3–6 months following extraction .Studies have shown that horizontal 
bone loss can reach up to 50% in width and 60% in height during this period 
(Van der Weijden et al., 2009) . 
This resorptive process is not only a physiological consequence of tooth 
loss but also a critical challenge for the prosthetically-driven placement of 
dental implants .Alveolar ridge preservation (ARP) techniques have been 
developed to mitigate this bone loss by preserving the ridge volume 
immediately following extraction .ARP commonly involves the placement 
of bone graft materials into the extraction socket, often with or without a 
barrier membrane, to support new bone formation and maintain soft tissue 
contours (Avila-Ortiz et al., 2014). 
 Multiple types of bone grafts have been introduced for this purpose, 
including autografts, allografts, xenografts, and alloplastic materials, each 
with distinct biological and handling properties .Alloplastic grafts, which 
are synthetic in nature, offer several advantages such as biocompatibility, 
lack of disease transmission risk, and ease of manipulation. Among these, 
injectable alloplastic bone substitutes have gained increasing popularity 
due to their moldability, minimally invasive application, and ability to 
conform precisely to the defect morphology (Mangano et al., 2013). 
 
These materials generally consist of calcium phosphate or sulfate 
compounds and function primarily through osteoconduction, providing a 
scaffold for bone in-growth (Jensen et al., 2006). 
Their injectable nature allows for easy delivery into the socket without 
the need for extensive surgical manipulation, thus reducing chair time and 
improving patient comfort .While immediate implant placement is 
sometimes employed in ideal conditions (i.e., intact bony walls, absence 

 
 
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of infection), it is not always feasible or advisable. Clinical situations 
involving thin biotypes, bone deficiencies, or aesthetic demands often 
necessitate a delayed implant placement protocol to allow for adequate 
tissue healing and graft maturation (Chen & Buser, 2009). 
In such scenarios, prior socket preservation may significantly influence the 
quality and quantity of bone available at the time of implant placement. 
Several clinical trials and systematic reviews have demonstrated the 
effectiveness of socket preservation procedures in reducing post-
extraction dimensional changes and enhancing the conditions for implant 
placement (Mardas et al., 2015; Vignoletti et al., 2012). 
However, the specific role of injectable alloplastic materials in socket 
preservation—particularly in terms of long-term clinical and radiographic 
outcomes—remains underexplored. Additionally, there is limited 
evidence regarding the bone quality they produce in healed sites and their 
influence on primary implant stability .Cone beam computed tomography 
(CBCT) has become the gold standard for evaluating dimensional bone 
changes due to its high accuracy and low radiation dose. It allows for 
detailed 3D assessment of bone volume, ridge width, height, and density 
(Bornstein et al., 2014). 
Upon search of literature , up-to knowledge there are insufficient studies 
assessing delayed implant placement following socket preservation with 
injectable bone graft ,hence , the aim of the present study . 
 
3. Research Q (RQ): 
In patients that require delayed implant in posterior mandible , what is the 
effect of delayed implant placement following socket preservation with 
Injectable bone graft ? Clinically regarding implant stability , soft tissue 
healing and postoperative pain. As well as radiographically regarding 
horizontal and vertical dimensional changes in the alveolar ridge? 
 
 

 
 
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4. Research Hypothesis, Aim, Objectives & Expected Outcomes 
a. Hypothesis  
Null Hypothesis (H₀): 
There is no significant difference in the effect of delayed implant 
placement following socket preservation in comparison to implant 
placement without socket preservation. 
Alternative Hypothesis (H₁): 
There is a significant difference in the behavior of delayed implant 
placement following socket preservation in comparison to implant 
placement without socket preservation . 
 
b. Aim  
To evaluate the clinical and radiographic outcomes of delayed implant 
placement after socket preservation using injectable alloplastic bone graft. 
 
c. Objectives 
Clinical parameters: 
1)Measure implant stability at the time of placement and after 
osseointegration using OSTELL .(immediately after implant placement 
and 6 month after implant placement) 
2)Assess soft tissue healing and wound dehiscence by visual inspection 
(one week after the surgery) 
 3)Monitor postoperative pain by VAS  and swelling through visual 
inspection and palpation .(Day 1, Day 3 ,and Day 7 postoperatively) 
4)Record any complications (infection, graft exposure, etc.) by visual 
inspection .(afte one week) 
Radiographic parameters : 
1)Measure horizontal and vertical dimensional changes in the alveolar 

 
 
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ridge after 6 months using CBCT. 
2)Evaluate the radiographic bone density at the grafted site (after 6 
months) 
 
 
 
 
 
 
d. Expected Outcomes  
Socket preservation using injectable alloplastic bone graft may reduce 
alveolar ridge resorption, enhance bone quality at the implant site, and 
facilitate optimal implant placement. 
 
 

 
 
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5. Research Design and Methods 
1- Materials : 
item 
Type 
Manufacturer 
Dental implant 
Titanium  
SGS Turkey  
Local anesthetic 
Articaine 4% with epinephrine 
1:100,000 
Alexadricaine 
Sutures 
4-0 or 5-0 resorbable/non-
resorbable sutures 
Asset suture 
2- Methods 
A –Study Design: 
Controlled clinical study , randomization has been done for the patients 
before extraction and socket preservation using 
http//www.randomizer.org  
B – Study Settings : 
Outpatient clinic of the Oral and Maxillofacial Surgery Department, 
Faculty of Dentistry, Suez Canal University. 
C-Study population : 
20 patients requiring delayed implant placement in posterior mandibular 
region , the patients will be divided into 2 equal groups (n = 10 per 
group). 
1-Patient selection and eligibility criteria  
Inclusion criteria: (Lin et al., 2019, Mandelli et al., 2019) 
 
• Patient aged between 40 and 60 years  
• General good health.  
• Volunteer subjects have to voluntarily sign an informed consent. 
•  Patient Indicated for single implant placement in lower posterior 
area. 
 

 
 
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Inclusion criteria for patients in group I 
• Patient with a previously extracted lower posterior tooth and the 
socket was preserved with injectable bone graft . 
Exclusion criteria: (Lin et al., 2019, Mandelli et al., 2019)  
• Patient with systemic disease affection bone metabolism .  
• Patients with contraindication to surgical treatment.  
• Patients with uncontrolled medical conditions. 
2-Patient Grouping : 
Group I (Test Group): 
Including  10 patients with extracted mandibular posterior tooth who 
undergone socket preservation with Injectable alloplastic bone graft.  
Group II (Control Group): 
Including 10 patient with extracted mandibular posterior tooth and left for 
natural healing.  
D -Methodology  
Pre-operative assessment.  
Clinical assessment will also include evaluation of soft tissue quality, 
keratinized gingiva, and occlusal considerations to ensure proper implant 
planning (Bornstein et al., 2014). 
Radiographic assessment  
Before implant placement, patients will undergo radiographic evaluation, 
including cone-beam computed tomography (CBCT) to assess alveolar 
ridge dimensions, bone density, and anatomical structures such inferior 
alveolar nerve. At 4 months post-extraction, prior to implant placement  
(baseline) 

 
 
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CBCT Equipment Specifications: 
• Device: Scanora 3D by Soredex (Tuusula, Finland) 
 Specifications 
• Imaging type: CBCT with optional high-resolution 2D panoramic 
• Fields of View (FOV): 60 × 60 mm, 75 × 100 mm, 75 × 145 mm, 
optional XL up to 130 × 145 mm 
• Voxel size: 0.4 mm 
• Scan time: 8–30 sec (effective exposure 2–7.5 sec) 
• X-ray tube: 60–90 kV, 1.0–8.0 mA, fixed anode 
• Focal spot: 0.5 mm (IEC 60336) 
• Detector: Flat panel (CBCT), CCD (panoramic) 
• Features: AutoSwitch between CBCT and panoramic 
• Dimensions: 1973 × 1600 × 1400 mm 
Patients will be scanned in a seated upright position with a rigid head 
support to minimize motion artifacts. 
Surgical Protocol: 
The dental implant placement will be performed under strict aseptic 
conditions and following standard surgical protocol for delayed 
implantation. The procedure will take place approximately 4 months 
following tooth extraction and socket preservation for patient in both 
groups. (Peitsinis et al., 2025; ITI, 2018) 
1. Preoperative Preparation (Esposito et al., 2023) : 
 • Patient will rinse with 0.12% chlorhexidine gluconate mouthwash 
for 1 minute.  
 • Extraoral skin will be disinfected with povidone-iodine.  
 • Local anesthesia will be administered using 4% Articaine with 
1:100,000 epinephrine via infiltration or nerve block as needed. 
2. Surgical Access(Misch, 2021): 
 • A mid-crestal incision will be made in the edentulous ridge using a 
scalpel blade no.15.  
 • Two small vertical releasing incisions may be added to ensure 

 
 
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adequate access, depending on tissue quality.  
 • A full-thickness mucoperiosteal flap will be reflected to expose the 
underlying alveolar bone.  
3. Osteotomy Preparation(Misch, 2021): 
Standard clinical guidelines will guide the implant position (based on 
CBCT).  
• A round bur will be used to mark the implant site. (Misch, 2021) 
 • Sequential drills of increasing diameter (pilot drill, twist drills) will 
be used at low speed (800–1200 rpm) under copious sterile saline 
irrigation to prepare the osteotomy to the desired depth and diameter 
according to the implant system used. 
  • Direction indicators or paralleling pins may be inserted 
intermittently to verify angulation and position. 
4. Implant Insertion(Misch, 2021): 
 • The titanium dental implant will be inserted into the prepared site 
using either a hand ratchet or implant motor at controlled torque 
(typically 30–45 Ncm). 
  • Primary stability will be assessed using resonance frequency 
analysis (e.g., Osstell ISQ).  
 • A healing abutment or cover screw will be placed . 
 • Flap will be repositioned and sutured using 4-0 or 5-0 non-
resorbable or resorbable sutures using interrupted or horizontal mattress 
technique. (Misch, 2021) 
5.Postoperative Instructions and Medications(Esposito et al., 2023) 
 • The patient will be instructed to maintain strict oral hygiene and 
avoid brushing near the surgical site for 7 days.  
 • Chlorhexidine mouth rinse 0.12% twice daily for 10 days will be 
prescribed. 
 • Analgesics (e.g., ibuprofen 600 mg every 8 hours as needed) and 
antibiotics (e.g., amoxicillin/clavulanic acid 1 g twice daily for 5 days) 
will be administered.  

 
 
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6. Follow-up (ITI, 2018): 
 • Sutures will be removed after 7–10 days. (Misch, 2021) 
 • Healing will be monitored clinically and radiographically. 
 
• Osseointegration will be reassessed after 3 months, and if 
satisfactory, prosthetic loading will be initiated. 
• Abutment will be placed and impression will be taken to get the final 
restoration loading. 
Post-operative Assessment  
A-Clinical Evaluations 
1-Implant Stability will be assessed using a non-invasive method based 
on resonance frequency analysis (RFA) utilizing the Osstell ISQ® device. 
This technique provides a quantitative measure of the implant's 
mechanical stability in bone and is highly predictive of osseointegration 
success (Meredith, 1998; Ostman et al., 2006). 
After implant insertion, a smart peg compatible with the implant system 
will be attached to the implant fixture using the manufacturer’s torque 
recommendation (approximately 4–6 Ncm). The Osstell probe will then 
be positioned near the peg without contact to transmit magnetic pulses. 
Measurements will be taken in two directions (buccolingual and 
mesiodistal), and the mean Implant Stability Quotient (ISQ) will be 
calculated. The ISQ scale ranges from 1 to 100, with values above 65 
generally indicating high primary stability suitable for early or immediate 
loading (Sennerby & Meredith, 2008). 
Stability will be measured at the time of implant placement and again 
after a healing period of 6 months to assess secondary (biological) 
stability. 
2-Postoperative pain will be evaluated using the Visual Analog Scale 
(VAS), a widely accepted and validated method for measuring subjective 
pain perception in clinical dental studies. The VAS is a 10-centimeter 
horizontal line with endpoints defined as “0” (no pain) and “10” (worst 

 
 
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imaginable pain). Patients will be instructed to mark the line at the point 
that best represents their pain intensity at predefined intervals:  Day 1, 
Day 3, and Day 7 postoperatively. (Alghamdi et al., 2023). 
 
 
3-Soft Tissue Healing: Careful examination of the surgical site to assess 
epithelialization, and detection of any wound dehiscence or delayed soft 
tissue healing one week after surgery (Buser et al., 2017).  
4. Complication Monitoring: Recording of any complications such as 
infection, graft exposure, hematoma, suture dehiscence, or early implant 
mobility. These events will be documented systematically for subsequent 
analysis (Esposito et al., 2013). 
B-Radiographic Assessment 
Radiographic evaluation will be performed using Cone Beam Computed 
Tomography (CBCT) to assess dimensional and qualitative changes in the 
alveolar ridge at different stages of the study. CBCT provides high-resolution 
three-dimensional imaging and has become the gold standard for quantitative 
bone analysis in implant dentistry (Gonzalez-Garcia et al., 2023). All images 
will be evaluated using dedicated on demand for consistent calibration.  
Scans will be taken at the following time points: 
•  6 months post-implantation to assess bone remodeling around the 
implant 
Parameters to be assessed include (Alssum et al., 2025; Gong et al., 
2024): 
1) Marginal bone level changes. 
2) Vertical ridge height (buccal and lingual/palatal aspects) 
3) Bone density around the implant (in Hounsfield Units) 
4) Buccal plate thickness. 
 

 
 
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6. Statistical plan 
a) Sample size calculation: 
tailed (Chan Y, 2003).
-
will be two
 
Sample size calculation  : 
The sample size for this study was calculated according to Chan, 2003 
and used the following equation: (Chan Y, 2003) 
 
𝑁= (Zα)2 ∗(𝑆)2
(𝑑)2
 
N = Total sample size, 
 
Zα= Is Standard normal variate and its equal to 1.96 at P< 0.05,
 
SD = Standard deviation of variable,  
d = Absolute error or precision  
 
Zα
 
SD
 
D
 
1.96
 
4.6
 
2
 
𝑁= (1.96)2 ∗(4.6)2
(2)2
 = 20.3 ≈20 𝑖𝑚𝑝𝑙𝑎𝑛𝑡𝑠 
The total sample size calculations revealed that the sample size should be 
20 samples 
 

 
 
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will be divided equally as follows: 
 
This sample size is in agreement with previous study that test in similar 
subject 
 
(Mandelli et al., 2019) 
Statistical analysis : 
Data will be coded and entered using the statistical package SPSS version 
22. Data will be summarized using mean and standard deviation. Data 
will be explored for normality using the Kolmogorov-Smirnov test. 
Comparisons between both groups for normally distributed data will be 
done using a t-test. P value less than or equal to 0.05 will be considered 
statistically significant. 
 
7.  Ethics consideration:  
The present research will be conducted after the approval of the Research 
Ethics Committee (REC) of the Faculty of Dentistry, Suez Canal 
University. It will be conducted on twenty patients who meet the 
inclusion criteria specified in the study. Ethical considerations regarding 
patient well-being, safety, and confidentiality will be undertaken by the 
researcher.  
An informed written consent will be signed by all subjects/patients before 
commencing the study. The consent will explain the clinical 
examinations, procedures, potential risks, benefits, and the follow-up 
Groups
 
Descriptive
 
Samples
 
Group A
 
Implants 
in 
Sockets 
preserved with IBS
 
10
 
Group B
 
 Implants 
in 
Empty 
socket
 
10
 

 
 
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required for participation in the study. explain the clinical examinations, 
procedures, potential risks, benefits, and the follow-up required for 
participation in the study. 
 
 
 
 
 
 
 
 8. Time Plan 
 Starting After approval of the Ethical Committee and faculty council. Ending: 12 Months 
Include Grant Chart as following example: 
Activity/Month  
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
11 
12 
13 
14 
15 
16 
17 
18 
19 
20 
21 
22 
23 
24 
Ethical Approval &Preparation 
☒ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Patient Selection & Consent 
☐ ☒ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Implant Placement 
☐ ☐ ☐ ☒ ☒ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Final Evaluations 
(Clinical&CBCT) 
☐ ☐ ☐ ☐ ☐ ☒ ☒ ☒ ☒ ☒ ☒ ☒ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Statistical Analysis 
☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☒ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Writing & Submission. 
☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☒ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
 
9. Research Estimated Budget in Egyptian Pound  
Supplementary 
Publications 
Total 
Radiographs 
drugs/ 
Lab chemicals 
Lab-investigations 
Software 
Material 
Others 
(mention) 
CBCT 
Antibiotics, 
analgesics, 
anti- 
inflammatory 
Drugs 
Implant systems 20 
implant 
Lancet#15, 
Suture silk 
, Local 
anesthesia, 
Saline 
      
      
      
10000 
1500 
48000 
2000 
      
2000 
63500 
 
 
 

 
 
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10. References        
 
 
 
 
 
 
 
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• Chappuis, V., Araújo, M.G. and Buser, D., 2017. Clinical relevance of dimensional 
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• Mardas, N., Trullenque-Eriksson, A., MacBeth, N. and Donos, N., 2015. Does ridge 
preservation following tooth extraction improve implant treatment outcomes? A 
systematic review. Clinical Oral Implants Research, 26(Suppl 11), pp.180–201. 
• Meredith, N., 1998. Assessment of implant stability as a prognostic determinant. 
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• Misch, C.E., 1999. Contemporary Implant Dentistry. 2nd edn. St. Louis: Mosby 
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• Peitsinis, A., Kanatas, A. and Greenwood, M., 2025. Clinical decision-making in 
immediate versus delayed implant placement: a systematic review. Journal of Oral 
Rehabilitation, 52(3), pp.321–334. 
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resonance frequency analysis: biological and biomechanical aspects and clinical 
implications. Periodontology 2000, 47(1), pp.51–66. 
• Troiano, G., Zhurakivska, K., Lo Muzio, L. and Laino, L., 2017. Combination of 
platelet-rich fibrin and bone grafts in alveolar ridge preservation: a systematic review. 
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• Van der Weijden, F., Dell’Acqua, F. and Slot, D.E., 2009. Alveolar bone 
dimensional changes of post-extraction sockets in humans: a systematic review. 
Journal of Clinical Periodontology, 36(12), pp.1048–1058. 
• Vignoletti, F., Matesanz, P., Rodrigo, D., Figuero, E., Martín, C. and Sanz, M., 
2012. Surgical protocols for ridge preservation after tooth extraction. A systematic 
review. Clinical Oral Implants Research, 23(Suppl 5), pp.22–38. 
 
 
 
 

 
 
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11. Appendices   
 
 
 
 
(Questionnaire / Consent form) 
Faculty of Dentistry Research 
Ethics Committee (REC) 
Investigator Application Form 
1- Name of researcher: Ahmed Rawhy Mounir Saleh 
 
2- Name of Department: Oral and Maxillofacial Surgery 
 
3- Address of researcher: Ibrahimia sharqia. 
a- Email: ahmedrawhi96@gmail.com 
b- Phone number: 01022552382 
 
4- Name (s) of Co-investigator (s): 
Prof. Dr. Mohamed Ahmed Elsholkamy 
Dr. MohamedNageh Gad El Hak  
 
5- Grade of protocol: 

 
 
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*M.D.Sc. (✔)  
*Ph.D. ( ) 
*Doctorate degree (D.D.Sc)  
*Other ( ) 
*Domestic ( )  
*Multi-Centre within Egypt( ) 
*International ( ) 
6-Title of the research Clinical and Radiographic Evaluation of 
Delayed Implant Placement Following  Socket Preservation with 
Injectable Alloplastic Bone Graft. 
 
 
7-Type of the research: 
*Drug trial ( ) 
*Surgical technique (✔) 
 
*Investigative technique ( ) 
*Devise study ( ) 
*Survey study ( )  
*Blood sampling ( ) 
*Review Of old records ( ) 
8 - Subjects of research  
 * Children (˂ 18 years): ( ) 
*Adults (>18 years) : (✔) 
9-Request is being made to waive(give-up) informed consent: 
 Yes (✔) No (  )  
10-The research is for the good of society: yes (✔)no (  )   
11-Study design: 
a-Phase type               I: (    )   II: (  ). III: (   )  
b-Randomization:         Yes: (  √  )   No: (    ) 

 
 
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c-Placebo:                      Yes: (   )      No: (    ) 
d-Genetic sampling:     Yes: (  )       No: ( ) 
 e-Other:   Yes: ()   No: (  ) 
 
12- Facilities for the research are available: yes (✔) No: ( ) 
 
 
 
 
 
 
 
 
13-List the risks of the study: 
  
1. Infection at the surgical site. 
2. Pain or swelling during the healing phase. 
3. Graft failure or insufficient bone regeneration. 
4. Allergic reaction or sensitivity to the graft material (rare). 
5. Implant failure due to poor osseointegration (in rare cases). 
 
14-List the potential benefits, if any, to the subjects:  
 
1. Preservation of bone volume after tooth extraction, reducing 
the risk of future bone loss. 
2. Improved implant stability due to better bone quality. 
3. More predictable implant placement with proper bone 
dimensions. 
4. Enhanced aesthetic outcomes, especially in visible areas. 
5. Minimally invasive handling of the graft material (injectable). 
6. Reduced need for additional bone grafting procedures later. 
7. Better healing of soft tissues due to ridge preservation. 
 
15-Are the risks reasonable to the potential benefits to the 
subjects, if any, or to the knowledge to be gained? Yes: (✔) 

 
 
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No: ( ) 
) ( 
) No:
✔
Yes: (
 
assured
 
are
 
of subjects
 
confidentiality
 
and
 
Privacy
-
16
 
17-The subject of the research could quit at any time without penalty 
or loss of any benefits to which they would otherwise be entitled:
 
)
 ( 
) No:
✔
Yes:  (
 
18- All surgeries will done under supervision of professors 
 
 
Signature of the principal investigator:                   Date: