Overview

This randomized parallel-group clinical trial aimed to evaluate the clinical efficacy of advanced platelet-rich fibrin (A-PRF) combined with hyaluronic acid (HA) in enhancing peri-implant bone formation in patients undergoing delayed dental implant placement. Participants will be allocated to either a test group, in which A-PRF combined with HA is applied at the implant site, or a control group receiving conventional implant placement without adjunctive biomaterials. Peri-implant bone changes will be assessed using cone-beam computed tomography (CBCT), including radiographic bone density and bone volume measurements. Implant stability will also be evaluated using resonance frequency analysis at the time of implant placement and during follow-up. Additional clinical outcomes include postoperative pain and implant survival. The participants will be followed up for six months after implant placement.

Eligibility

Inclusion Criteria:

\- Adults aged 18-65 years.

Patients requiring delayed dental implant placement in a posterior mandibular edentulous site

Sufficient residual alveolar bone height and width to permit conventional implant placement without the need for simultaneous guided bone regeneration (GBR), ridge augmentation, or other bone-grafting procedures.

Good general health or a medically controlled and stable systemic condition compatible with elective implant surgery and not expected to materially compromise wound or bone healing.

Non-smokers with no current use of tobacco products.

Acceptable oral hygiene and a periodontal condition compatible with implant surgery following any required professional treatment and reassessment.

Ability and willingness to undergo the required clinical and radiographic assessments, including CBCT examinations at baseline and at the 6-month follow-up.

Ability and willingness to attend the scheduled follow-up visits and comply with the study procedures.

Provision of written informed consent before study participation.

Exclusion Criteria:

\-

Any uncontrolled systemic disease or medical condition that conensions for conventional implant placement without augmentation.

Requirement for immediate implant placement, simultaneous guided bone regeneration, ridge augmentation, or any other adjunctive bone-grafting procedure.

Inability or unwillingness to complete the required 6-month clinical and radiographic follow-up.traindicates elective implant surgery or may substantially impair wound or bone healing, including uncontrolled diabetes mellitus.

Immunocompromised status or current systemic immunosuppressive therapy.

Current or previous use of oral or parenteral bisphosphonates or other antiresorptive medications associated with a risk of medication-related osteonecrosis of the jaw.

Pregnancy at the time of screening or enrollment.

Unresolved active periodontal disease or active local infection involving the intended implant site, including suppuration.

Inadequate oral hygiene that persists after professional oral-hygiene instruction, necessary periodontal treatment, and reassessment.

Insufficient residual alveolar bone dim