A Study on Lower Jaw Dental Implants Using Different Tooth-Based Bone Graft Methods.

INTERVENTION: Intervention1: Partially demineralized dentin matri X(PDDM) with Novel i‐PRF ‐ HNO3 protocol: Mandibular molar immediate implant sites grafted with partially demineralized dentin matri X(PDDM) mixed with Novel i‐PRF using 0.6N HCL demineralizing agent. Intervention2: Preparation of PDDM using 2% Nitric Acid (HNO3).: The mandibular molar tooth indicated for extraction followed by immediate implant placement will be selected. The tooth will be extracted under local anesthesia. The tooth will be pulverized into smaller particles using a bone mill. The particles will be demineralized with 2% HNO3 (nitric acid) for 15 minutes, followed by multiple washes with normal saline to obtain the partially demineralized dentinal matri X(PDDM). This will be mixed with injectable platelet‐rich fibrin (i‐PRF) prepared from the same patient using the novel i‐PRF protocol. For this, 10 ml of venous blood will be collected from patients in silica‐coated vacutainer tubes and immediately centrifuged at 2000 g for 3 minutes to obtain i‐PRF. The PDDM and the novel i‐PRF will be used for grafting the jumping space in the molar extraction socket after immediate implant placement. Control Intervention1: Partially demineralised dentin matri X(PDDM) with I‐PRF ‐ HCL PROTOCOL: Mandibular molar immediate implant sites grafted with partially demineralized dentin matri X(PDDM) mixed with Novel i‐PRF using 0.6N HCL demineralizing agent. Control Intervention2: partially demineralized dentin matri X(PDDM) mixed with i‐PRF ‐ HCL PROTOCOL: Mandibular molar immediate implant sites grafted with partially demineralized dentin matri X(PDDM) mixed with Novel i‐PRF using 0.6N HCL demineralizing agent. Control Intervention3: Preparation of PDDM using 0.6N Hydrochloric Acid (HCl).: The mandibular molar tooth indicated for extraction followed by immediate implant placement will be selected. The tooth will be extracted under local anesthesia. The tooth will be pulverized into smaller particles using a bone mill. The particles will be demineralized with 0.6 N HCl (Hydrochloric acid) for 15 minutes, followed by multiple washes with normal saline to obtain the partially demineralized dentinal matri X(PDDM). This will be mixed with injectable platelet‐rich fibrin (i‐PRF) prepared from the same patient using the novel i‐PRF protocol. For this, 10 ml of venous blood will be collected from patients in silica‐coated vacutainer tubes and immediately centrifuged at 2000 g for 3 minutes to obtain i‐PRF. The PDDM and the novel i‐PRF will be used for grafting the jumping space in the molar extraction socket after immediate implant placement. CONDITION: Health Condition 1: K084‐ Partial loss of teeth PRIMARY OUTCOME: Evaluation of Implant stability using Resonance frequency analysis (RFA) ; Timepoint: Baseline and 6 months post operative. ; SECONDARY OUTCOME: Evaluation of soft tissue healingTimepoint: 1,3, 7, and 14 days postoperatively Pain using VAS scaleTimepoint: 1,3, 7, and 14 days done postoperatively Radiographic Evaluation of Bone width, Marginal bone loss and bone densityTimepoint: Baseline and 6 months post operative. INCLUSION CRITERIA: Smith and Tarnow Classification of Molar sockets, Class A and Class B. Presence of at least 1/3rd height of the Remaining Buccal bone. Presence of more than 2mm jumping distance. Systematically healthy individuals older than 18 years of age with good oral hygiene and plaque inde X(Silness‐Low Plaque index) score of 2 or lesser. Patients requiring at least one mandibular Molar tooth extraction with periodontally healthy adjacent teeth. If two adjacent molars are to be extracted and both of class A or B, then consider the best outcome ones. Teeth that would require extraction if they were non restorable due to tooth fracture, unfavorable crown root ratio and extensive caries.