
Purpose: The purpose of this study was to evaluate the marginal bone loss around immediate dental implants with synthetic Hydroxyapatite graft. Materials and Methods: Twenty- four implants in the premolar area of maxilla in 15 patients were included in this study. 12 implants placed immediately after extraction with synthetic hydroxyapatite graft (group I) and 12 without using hydroxyapatite graft served as control (group II). Implant success, plaque index PI, and bleeding index BI, and marginal bone loss MBL were evaluated. Results: Complete soft tissue healing had occurred in all patients and all the implants were successfully osseointegrated over 18 months. The results of the present study showed that at 18 months the mean values of MBL were 1.30±0.21mm at control site and 0.68±0.13mm at the test site, there were no statistical differences between the test and control group regarding, BI, PI, while there was statistical differences between the test and control regarding MBL through follow- up periods. Conclusions: Using synthetic hydroxyapatite graft with immediate placement of dental implants into Fresh Extraction sockets significantly reduces marginal bone loss around the implants.