Rotary Versus Manual Degranulation in Alveolar Ridge Preservation

Inclusion Criteria: * Patients will be recruited from those attending the outpatient clinics of the College of Dentistry. * Systemically healthy adults aged 18-65 years who present with teeth indicated for extraction due to chronic periapical pathology (e.g., periapical granuloma or cystic lesion) confirmed clinically and radiographically. * All cases must be verified with a tooth-specific, limited field-of-view cone-beam computed tomography (CBCT) scan to minimize radiation exposure and to demonstrate the presence of periapical pathology with intact socket walls and sufficient residual alveolar bone to allow for ridge preservation. * Only teeth with single or multi-rooted lesions indicated for atraumatic extraction without excessive bone removal will be considered. * Participants must also be capable of providing informed consent, demonstrate adequate oral hygiene, and be willing to return for scheduled follow-up visits. Exclusion Criteria: * Acute odontogenic infection at the extraction site. * Thin buccal bone (\< 1mm on CBCT). * Severe periodontal breakdown with more than 50% bone loss. * Grade III mobility. * Root morphology that limits instrument accessibility. * Uncontrolled systemic diseases (e.g., diabetes, immunocompromised status). * Pregnant or lactating women. * Medications known to affect bone metabolism such as long-term corticosteroids or bisphosphonates. * Self-reported or documented allergy to penicillin or amoxicillin. * Poor oral hygiene, inability to maintain adequate postoperative care, or unwillingness to attend scheduled follow-up visits.