## 4 Discussion  
This study aims to evaluate the potential advantages and morphological stability of immediate reconstruction following implant removal. Immediate reconstruction may facilitate adequate bone augmentation to support subsequent dental implant placement while maintaining dimensional stability and minimizing complications. A previous report showed that the alveolar dimensional changes after implant removal resulted in an 11.3% ridge width reduction at 1 mm below the crest and a 4.4% reduction at 3 mm below the crest [16]. Similarly, buccal and lingual ridge heights were significantly  
Figure 3: Evaluation of dimensional changes. (**A**) Change in alveolar ridge width 1 mm below the crest. (**B**) Change in alveolar ridge width 3 mm below the crest. (**C**) Change in alveolar ridge width 5 mm below the crest. (**D**) Change in alveolar ridge width 7 mm below the crest. (**E**) Change in buccal ridge height. (**F**) Change in palatal/lingual ridge height. * \(p\) < 0.05 compared to Group 1.  
reduced by 2.2% and 6.3%, respectively. Group 1, where no grafting was performed, showed the greatest reductions in ridge width and height. This outcome is consistent with well-documented post-extraction bone remodeling processes, as mentioned earlier. In this present study, the alveolar dimension at 1 mm and 3 mm below the crest was reduced by 40.2 \(\pm\) 29.5% and 30.5 \(\pm\) 17.1%, respectively. Buccal and lingual ridge heights experienced a 20.4 \(\pm\) 18.6% reduction and a 2.1 \(\pm\) 3.5% reduction, respectively. The most notable dimensional stability in ridge height was observed in the staged grafting group (Group 2). This can be mechanistically attributed to the biologically favorable conditions created by delaying bone grafting until after initial healing. Delayed reconstruction may allow resolution of local inflammation and clearance of residual infection. A previous study suggested that performing alveolar bone reconstruction at the time of implant removal minimized dimensional changes and bone gain [14]. Group 3, which received immediate bone grafting at the time of implant removal, demonstrated acceptable ridge preservation without complications. Mechanistically, immediate grafting may preserve alveolar ridge contours by occupying the extraction socket and preventing collapse of the buccal and lingual plates. The decision between no grafting and bone grafting probably should be based on clinician judgment, influenced by clinical experience and the specific clinical situation. Proper diagnosis and evaluation of the cause of implant failure, as well as a thorough assessment of the surgical site, are critical [24]. To obtain stable sites for reimplantation, bone grafting or other surgical interventions may be required as part of site preparation [25]. In cases where no significant bone loss is observed around the failed implant, additional reconstruction may not be necessary, particularly when failure results from mechanical complications, such as fixture fracture. Bone quality and quantity should be assessed both before and during implant removal [26]. In this study, immediate reconstruction did not demonstrate additional morphological stability or advantage. However, immediate reconstruction may reduce the overall treatment duration, potentially enhancing patient acceptance. Similarly, studies have shown that immediate implant placement and provisionalization can lead to high patient satisfaction and esthetic outcomes [27]. Reducing the number of surgeries through immediate reconstruction is a less invasive and more comfortable approach for the patient [28]. Additionally, minimizing treatment time may be associated with increased patient satisfaction [29]. The timing and approach to bone grafting are contingent upon individual patient factors and clinician assessment. Delayed bone grafting, performed after an adequate healing period, is advisable in the presence of infection or compromised healing at the extraction site [30].