Objective: the present study was performed to evaluate Mineralized Plasmatic Matrix (MPM) as a grafting material around immediate dental implant in mandibular posterior teeth. Subjects and Methods: Eight patients were selected for immediate dental implant in mandibular posterior teeth and use MPM as a grafting material around the implant. After surgery each patient were evaluated clinically at the following interval immediate, one week, two weeks, and three months postoperatively for:: Presence of infection, Edema, Graft exposure and/or loss, Soft tissue dehiscence, Pain, Nerve injury and Implant stability, and radiographically immediate and three months postoperatively interval by CBCT for: Bone density around the dental implant and Horizontal bone loss around the dental implant. Results: All patients hadn't any infection, nerve injury, Graft exposure and /or loss, soft tissue dehiscence and facial edema throughout the study till three months. Osstel at 3 months (81.0±7.68) was higher than immediately (63.40±4.16). Bone density at 3 months (447.0± 28.64) was higher than immediately (243.0±17.18). Patients experienced mild to moderate pain after surgery, at the surgical sites which decrease gradually during four days postoperatively then disappeared completely at the 7 th day. Conclusion: The use of MPM with immediate implant reduces postoperative infection, edema, pain, graft exposure and/or loss and soft tissue dehiscence. Use of MPM with immediate implant enhances the implant stability, improves bone density around it and decrease marginal bone loss around the immediate implant.

Objective: The objective of this study was designed to evaluate bone augmentation of posterior alveolar mandibular ridge using 3D computer guided ceramic sheets as a membrane in GBR. Subjects and Methods: Seven patients were included in the present study. Preoperative clinical evaluation, and CBCT scan for ridge evaluation and planning, all patient clinically suffering from severed resorbed posterior alveolar ridge of the mandible. Measuring height and width of right and left residual alveolar ridge was performed in CBCT software viewer base on this digital model 3D zirconia sheet was designed and plan on patient CBCT then milled on CAD/ CAM 5 axis machine to the desired macroscopic shape. After surgery, clinical evaluations were done at intervals of 2 weeks, first month, 3 rd and 6 th month and directed toward the observation of the healing process, signs of inflammation, infection soft tissue dehiscence, Zirconia exposure or any complications of wound. Second surgical intervention was to remove the screws and Zirconia sheet with CBCT evaluation to measure alveolar ridge on both sides. Results: Results of the current showing that customized Zr sheet can use successfully to obtain vertical and horizontal bone augmentation well compatible with soft tissue without exposure. Conclusion: Customized Zirconia sheet act as a perfect barrier and space maintaining in GBR procedures with precise fit, and good soft tissue acceptance to Zirconia. Customized Zirconia sheet reduce chairing time and amount of graft. More predictable results can obtained by using xenograft under Zirconia sheet.