Early Loading of Dental Implants: A Prospective Study in the Mandibular First Molar Area

Inclusion Criteria: 1. Patients aged 18 years or older. 2. Willingness to comply with all study requirements. 3. Partially edentulous in the in mandibular first molar with presence of the mandibular second molar 4. Patients of ASA I and ASA II group. No relevant medical conditions such as uncontrolled diabetes mellitus, osteoporosis, malignancies, irradiation and blood dyscrasias. 5. Free from soft tissue mucosal lesions, caries, and active periodontitis at the time of implant insertion. 6. Sufficient alveolar bone volume at the implant recipient site at the time of the insertion. 7. Adequate oral hygiene. Full-mouth plaque score (FMPS) (O'Leary et al. 1972) full-mouth bleeding score (FMBS) (Ainamo \& Bay 1975) record as the percentage of surfaces, four per each tooth, patients need to have controlled their periodontal conditions (FMPS 20%, FMBS 20%). Exclusion Criteria: 1. Pregnant or lactating females. 2. Systemic disease likely to compromise implant surgery; uncontrolled diabetes mellitus. 3. History of irradiation in the head and neck area. 4. Smoking. 5. Untreated periodontitis. 6. Alcohol or drug abuse. 7. History of Intravenous Bisphosphonate. 8. Previously augmented or tooth extraction at the intended implant recipient site within the last 6 months. 9. The use of regenerative procedures in conjunction with implant placement. 10. Presence of residual roots at the implant recipient site. 11. Stomatological diseases. 12. Clinical signs of bruxism. 13. Initial stability at least 30Ncm