Rotary Versus Manual Degranulation in Alveolar Ridge Preservation

After a tooth is taken out, the empty socket needs to heal. Sometimes unhealthy soft tissue (called granulation tissue) is left behind and can slow down healing. This study compares two ways to clean the socket:

1. Manual method: a hand instrument (curette) 2. Rotary method: a small rotating dental bur

Both methods are standard in dental practice. The study will see which method is faster, causes less pain, and leads to better bone healing. After cleaning, all patients will receive a routine bone graft to protect the jawbone for a possible future dental implant.

The study will measure:

* How long (in seconds) it takes to clean the socket * Whether the socket is completely clean, checked with a harmless blue stain (Toluidine Blue) * Changes in the bone at 3 and 6 months, measured by a special three-dimensional X-ray (cone-beam computed tomography, CBCT) * Pain and swelling reported by patients in the first week after the procedure * Any side effects or healing problems

Patients are randomly assigned to one of the two cleaning methods (like flipping a coin). The surgeon knows which method is used, but the person analyzing the X-rays does not, to keep the results fair.

The study will include 58-60 adult patients who need a tooth removed because of a long-term infection at the root. It is being conducted at the College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.