## 4 Discussion
This strategy allows resolution of inflammation and a healthier environment for graft placement and reduced risk of complications [31; 32]. Conversely, immediate bone grafting at the time of implant removal is recommended when significant bone loss is anticipated or when the alveolar ridge needs to be preserved for future implant placement [33]. This approach can effectively maintain bone volume and prevent resorption, facilitating optimal conditions for subsequent implant procedures [34]. Ultimately, the decision between immediate and delayed bone grafting should be individualized, considering the patient's clinical circumstances and practitioner expertise. The following recommendations are proposed to optimize outcomes during implant removal and subsequent site management. Care must be taken to preserve the surrounding bone and soft tissue by employing minimally invasive techniques during implant extraction [26]. Utilizing commercially available implant removal kits can facilitate the removal of failed implants from various systems with minimal tissue injury [8]. Thorough debridement of the implant removal site is essential to eliminate residual debris or granulation tissue, reducing the risk of infection and promoting optimal healing [35]. Implementing these practices can enhance the preservation of alveolar bone and soft tissue integrity, improving the prognosis for future restorative procedures [36]. It should also be emphasized that successful immediate reconstruction may require a skilled operator. The present study has certain limitations that warrant consideration. A notable limitation is the relatively small sample size, which may affect the generalizability of the results to a broader patient population [37]. Additionally, as a retrospective study focusing on short-term postoperative morphological assessments, it may not capture long-term outcomes [38]. In addition to the small sample size, the lack of randomization and the observational nature of group allocation introduce potential selection bias. Treatment decisions were based on clinical judgment and case-specific factors, which may have influenced outcomes independently of the grafting protocol. For example, patients with more favorable anatomical conditions may have been selected for immediate grafting, while more complex or infected cases may have been assigned to staged grafting. This inherent bias limits the ability to draw causal inferences from group comparisons. Patient characteristics such as age and sex may affect clinical outcomes. The choice of graft materials, including bone and membranes, can significantly influence postoperative results [39; 40]. Another limitation of this study is the lack of detailed reporting on critical confounding variables such as smoking status, alcohol consumption, systemic health conditions, periodontal history and oral hygiene. The absence of this information limits the ability to adjust for or interpret their potential effects on the outcomes. Therefore, further research with larger sample sizes, extended follow-up periods, comprehensive baseline data collection, and stratified analysis is necessary to confirm these findings and to better understand how patient-level variables interact with treatment protocols and dimensional outcomes. Treatment with delayed bone augmentation after implant removal showed the greatest dimensional stability during healing. Immediate reconstruction after implant removal proceeded without complications, potentially reducing the overall treatment duration. It is important to emphasize that the approach to dental implant reinstallation should be tailored to patient needs and the circumstances surrounding their implant failure. Factors such as extent of bone loss and patient overall health significantly influence the treatment strategy.