Topical Melatonin for Immediate Implants in Chronically Infected Extraction Sockets

The purpose of this study is to evaluate the effect of topical 2% melatonin gel on implant stability and osseointegration of immediate implants placed in chronically infected extraction sockets. Sixty patients requiring extraction of non-restorable teeth associated with chronic apical lesions will be randomly assigned to receive either conventional immediate implant placement with bone graft only or immediate implant placement with adjunctive topical melatonin. Implant stability will be assessed using resonance frequency analysis over a 12-month follow-up period. Secondary outcomes will include marginal bone loss, peri-implant bone density, postoperative pain, soft tissue healing, postoperative infection, and implant survival.