- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03973190
Evaluation of Bone Quality and Primary and Secondary Stability of Implants Installed in Alveolar Regeneration Area by Three Different Techniques
Study Overview
Status
Conditions
Detailed Description
In the present study will be collected 24 patients, with indication of extraction of premolars or upper incisors. All participants will sign a Free and Informed Consent Form (TCLE), agreeing to participate voluntarily in this research.
Patients were randomly allocated into three groups according to the following treatments:
Group RET: Closure of the alveolus by first intention through palatal flap sliding according to the technique of Khoury.
SBC Group: Fill bone alveolus with Bone Ceramic® graft (Straumann AG, Basel, Switzerland) and cover it with palatal flap according to the technique of Khoury.
PRO Group: Alveolus sealing by a temporary ovoid pony of acrylic resin.
All patients will be prescribed the use of amoxicillin 2G, dexamethasone 4 mg and dipyrone sodium 500 mg one hour before the surgical procedure. After intra- and extraoral antisepsis with 0.12% and 2% chlorhexidine respectively, the sterile surgical fields were placed. Local anesthesia was obtained with lidocaine 2% epinephrine 1: 100,000.
With the aid of a surgical guide will be collected material for histological analysis, removed using trephine drill with 2.0 mm diameter. Samples will be removed before the incision, to be defined through the presence of gingival tissue the most coronal part of the sample. They will be placed immersed in a container with 10% formalin solution.
Then a linear incision will be made on the alveolar ridge in the region and detachment of the flap. The implants and components to be used are from Neodent® (Curitiba, PR, Brazil). The diameters used were standardized in 3.5 x 11.5 mm or 3.5 x 8 mm, depending on the remaining height of the collar. The milling and insertion system of the implants will follow the protocol recommended by the manufacturer. The drill rotation of the drills does not exceed 800 rpm, as recommended for Type III and IV bones.
The initial insertion of the implant will occur with the use of the contra-angle regulated at 30 rpm, the final insertion of the implant will be performed using a manual torque wrench, to measure the insertion torque and the registered value, preferably not exceeding 60 N.cm.The prosthetic component should be installed immediately after installation with an implant with a maximum torque of 20 N and on it adapted the SmartPeg® (Integration Diagnostics AB, Göteborg, Sweden). According to the manufacturer, the device generates a series of signals with different frequencies in Hertz (Hz) and these values are immediately converted to ISQ (Implantation Stability Coefficient), providing fast and accurate monitoring. The ISQ linear scale ranges from 1 to 100, with high ISQ values assuming high quality bone implant anchors. The calibration will be performed on the buccal and palatal surfaces of the intermediaries, that is, each implant submitted to 2 readings. The readings will be captured and recorded for further analysis.
Patients who do not achieve a minimum insertion torque of 30 N will have the micro-abutments removed, the implant cover screw installed, and sutured. In these patients, they will not have the values of SSI in the period of osseointegration of the implants. Implants that presented insertion torque equal to or greater than 30 N were to be maintained with the prosthetic components in position to have the repeated evaluations at intervals of 7 to 10 days, 30 days and 60 days, for evaluation of SSI in the period of osseointegration. With the objective of not subjecting the implant to torque and torque during this period and to avoid interfering with the osseointegration process, the micro-piers will be covered with the micro-pillar protection screws with digital pressure only, and the incision will be sutured.
Patients will receive guidance regarding postoperative care. It will be prescribed amoxicillin 500mg every eight hours for seven days, nimesulide 100mg twelve in twelve hours for three days, dipyrone sodium 500mg in case of pain and mouthwashes with chlorhexidine 0.12% of twelve in twelve hours until the removal of the sutures.After the surgical procedure, periapical radiographs of the operated region will be performed to check the position of the implants.
The microCT examination of each bone sample will be performed by the Skyscan® micrograph 1272 (Skyscan, Antwerp, Belgium) to analyze the bone microarchitecture of each location from which the implants were installed. After the analysis the samples will be subimeted to immunohistochemical tests.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Minas Gerais
-
Juiz de Fora, Minas Gerais, Brazil, 36036-300
- Programa de Pós-graduação em Odontologia Faculdade de Odontologia - UFJF
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Extraction of premolars
- Canines or incisors
- Having two adjacent teet
- Due to root fracture
- Extensive cavities that do not allow restorative treatment and / or unfavorable -endodontic prognosis
- Systemically healthy
Exclusion Criteria:
- Patients who use any drug that influences bone metabolism
- Patients with a history of head and neck radiotherapy
- Patients undergoing chemotherapy for the treatment of malignant tumors at the time of the study
- Patients with severely resorbed alveoli
- Smokers
- Pregnant
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Factorial Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Placebo Comparator: RET Group
Closure of the alveolus by first intention through palatal flap sliding according to the technique of Khoury et al. (2000).
|
The extractions will be performed under local anesthesia, without making a mucoperiosteal flap, making an intraassucular incision and using appropriate periotomes, elevators and forcépes, minimizing the surgical trauma of surrounding tissues.
Thorough curettage of the alveolus will be performed at the time of extraction to ensure removal of all granulation tissue and stimulate bleeding from the bone base, to form blood clot and promote healing.
The sutures will be removed after 7 days of surgery, except for patients in group 3, in which sutures will not be made.
Other Names:
The material was collected for histological analysis, extracted with trephine drill of 2.0 mm in diameter.
Samples were removed before the incision.
A linear incision was then made on the alveolar ridge in the region and flap detachment.
The initial insertion of the implant was performed using the contra-angle at 30 rpm, the final insertion of the implant was performed with manual torque wrench, where the insertion torque was measured and the value was tabulated, not exceeding 60 N. cm.
The component was installed with a maximum torque of 20 N and SmartPeg® (Integration Diagnostics AB, Göteborg, Sweden) was adapted.
The prosthetic component was installed with a maximum torque of 20 N and SmartPeg® (Integration Diagnostics AB, Göteborg, Sweden) was adapted.
the tabulated values and the incision was sutured.
Other Names:
The prosthetic component already installed.
On it is adapted the SmartPeg® (Integration Diagnostics AB, Göteborg, Sweden).
According to the manufacturer, the device generates a series of signals with different frequencies in Hertz (Hz) and these values are immediately converted to ISQ (Implantation Stability Coefficient), providing fast and accurate monitoring.
The calibration is performed on the buccal and palatal surfaces of the intermediaries, that is, each implant was submitted to 2 readings.
The readings were captured and tabulated for further analysis.
were repeated at intervals of 7 to 10 days, 30 days and 60 days, for evaluation of SSI in the period of osseointegration.
With the objective of not subjecting the implant to torque and torque during this period and to avoid interfering with the osseointegration process, the micro-pillars were covered with the micro-pillar protection screws with digital pressure only.
Other Names:
|
Active Comparator: SBC Group
Fill bone alveolus with Bone Ceramic® graft (Straumann AG, Basel, Switzerland) and cover it with palatal flap according to the technique of Khoury et al. (2000).
|
The extractions will be performed under local anesthesia, without making a mucoperiosteal flap, making an intraassucular incision and using appropriate periotomes, elevators and forcépes, minimizing the surgical trauma of surrounding tissues.
Thorough curettage of the alveolus will be performed at the time of extraction to ensure removal of all granulation tissue and stimulate bleeding from the bone base, to form blood clot and promote healing.
The sutures will be removed after 7 days of surgery, except for patients in group 3, in which sutures will not be made.
Other Names:
The material was collected for histological analysis, extracted with trephine drill of 2.0 mm in diameter.
Samples were removed before the incision.
A linear incision was then made on the alveolar ridge in the region and flap detachment.
The initial insertion of the implant was performed using the contra-angle at 30 rpm, the final insertion of the implant was performed with manual torque wrench, where the insertion torque was measured and the value was tabulated, not exceeding 60 N. cm.
The component was installed with a maximum torque of 20 N and SmartPeg® (Integration Diagnostics AB, Göteborg, Sweden) was adapted.
The prosthetic component was installed with a maximum torque of 20 N and SmartPeg® (Integration Diagnostics AB, Göteborg, Sweden) was adapted.
the tabulated values and the incision was sutured.
Other Names:
The prosthetic component already installed.
On it is adapted the SmartPeg® (Integration Diagnostics AB, Göteborg, Sweden).
According to the manufacturer, the device generates a series of signals with different frequencies in Hertz (Hz) and these values are immediately converted to ISQ (Implantation Stability Coefficient), providing fast and accurate monitoring.
The calibration is performed on the buccal and palatal surfaces of the intermediaries, that is, each implant was submitted to 2 readings.
The readings were captured and tabulated for further analysis.
were repeated at intervals of 7 to 10 days, 30 days and 60 days, for evaluation of SSI in the period of osseointegration.
With the objective of not subjecting the implant to torque and torque during this period and to avoid interfering with the osseointegration process, the micro-pillars were covered with the micro-pillar protection screws with digital pressure only.
Other Names:
|
Active Comparator: PRO Group
Alveolus sealing by a temporary ovoid pony of acrylic resin.
|
The extractions will be performed under local anesthesia, without making a mucoperiosteal flap, making an intraassucular incision and using appropriate periotomes, elevators and forcépes, minimizing the surgical trauma of surrounding tissues.
Thorough curettage of the alveolus will be performed at the time of extraction to ensure removal of all granulation tissue and stimulate bleeding from the bone base, to form blood clot and promote healing.
The sutures will be removed after 7 days of surgery, except for patients in group 3, in which sutures will not be made.
Other Names:
The material was collected for histological analysis, extracted with trephine drill of 2.0 mm in diameter.
Samples were removed before the incision.
A linear incision was then made on the alveolar ridge in the region and flap detachment.
The initial insertion of the implant was performed using the contra-angle at 30 rpm, the final insertion of the implant was performed with manual torque wrench, where the insertion torque was measured and the value was tabulated, not exceeding 60 N. cm.
The component was installed with a maximum torque of 20 N and SmartPeg® (Integration Diagnostics AB, Göteborg, Sweden) was adapted.
The prosthetic component was installed with a maximum torque of 20 N and SmartPeg® (Integration Diagnostics AB, Göteborg, Sweden) was adapted.
the tabulated values and the incision was sutured.
Other Names:
The prosthetic component already installed.
On it is adapted the SmartPeg® (Integration Diagnostics AB, Göteborg, Sweden).
According to the manufacturer, the device generates a series of signals with different frequencies in Hertz (Hz) and these values are immediately converted to ISQ (Implantation Stability Coefficient), providing fast and accurate monitoring.
The calibration is performed on the buccal and palatal surfaces of the intermediaries, that is, each implant was submitted to 2 readings.
The readings were captured and tabulated for further analysis.
were repeated at intervals of 7 to 10 days, 30 days and 60 days, for evaluation of SSI in the period of osseointegration.
With the objective of not subjecting the implant to torque and torque during this period and to avoid interfering with the osseointegration process, the micro-pillars were covered with the micro-pillar protection screws with digital pressure only.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
ISQ analysis
Time Frame: up to the conclusion of the study, an average of 2 years
|
result and closer Immediate / at the time of surgery (values from 0-100) where 0 is closest if zero is worse the to 100 the better.After 7 days (values from 0-100) where 0 is the closest to zero the result is worse and closer to 100 the better. After 7 days (values from 0-100) where 0 is the closest to zero the result is worse and closer to 100 the better. After 30 days (values from 0-100) where 0 is the closest to zero the result is worse and closer to 100 the better. After 60 days (values from 0-100) where 0 is the closest to zero the result is worse and closer to 100 the better. |
up to the conclusion of the study, an average of 2 years
|
Collaborators and Investigators
Publications and helpful links
General Publications
- Araujo MG, Lindhe J. Dimensional ridge alterations following tooth extraction. An experimental study in the dog. J Clin Periodontol. 2005 Feb;32(2):212-8. doi: 10.1111/j.1600-051X.2005.00642.x.
- Mello CC, Lemos CAA, Verri FR, Dos Santos DM, Goiato MC, Pellizzer EP. Immediate implant placement into fresh extraction sockets versus delayed implants into healed sockets: A systematic review and meta-analysis. Int J Oral Maxillofac Surg. 2017 Sep;46(9):1162-1177. doi: 10.1016/j.ijom.2017.03.016. Epub 2017 May 3.
- Artzi Z, Tal H, Dayan D. Porous bovine bone mineral in healing of human extraction sockets. Part 1: histomorphometric evaluations at 9 months. J Periodontol. 2000 Jun;71(6):1015-23. doi: 10.1902/jop.2000.71.6.1015.
- Araujo MG, da Silva JCC, de Mendonca AF, Lindhe J. Ridge alterations following grafting of fresh extraction sockets in man. A randomized clinical trial. Clin Oral Implants Res. 2015 Apr;26(4):407-412. doi: 10.1111/clr.12366. Epub 2014 Mar 12.
- Morjaria KR, Wilson R, Palmer RM. Bone healing after tooth extraction with or without an intervention: a systematic review of randomized controlled trials. Clin Implant Dent Relat Res. 2014 Feb;16(1):1-20. doi: 10.1111/j.1708-8208.2012.00450.x. Epub 2012 Mar 8.
- Buser D, Broggini N, Wieland M, Schenk RK, Denzer AJ, Cochran DL, Hoffmann B, Lussi A, Steinemann SG. Enhanced bone apposition to a chemically modified SLA titanium surface. J Dent Res. 2004 Jul;83(7):529-33. doi: 10.1177/154405910408300704.
- Acil Y, Sievers J, Gulses A, Ayna M, Wiltfang J, Terheyden H. Correlation between resonance frequency, insertion torque and bone-implant contact in self-cutting threaded implants. Odontology. 2017 Jul;105(3):347-353. doi: 10.1007/s10266-016-0265-2. Epub 2016 Aug 18.
- Antunes AA, Grossi-Oliveira GA, Martins-Neto EC, Almeida AL, Salata LA. Treatment of circumferential defects with osseoconductive xenografts of different porosities: a histological, histometric, resonance frequency analysis, and micro-CT study in dogs. Clin Implant Dent Relat Res. 2015 Jan;17 Suppl 1:e202-20. doi: 10.1111/cid.12181. Epub 2013 Nov 28.
- Araujo M, Linder E, Lindhe J. Effect of a xenograft on early bone formation in extraction sockets: an experimental study in dog. Clin Oral Implants Res. 2009 Jan;20(1):1-6. doi: 10.1111/j.1600-0501.2008.01606.x.
- Barone A, Borgia V, Covani U, Ricci M, Piattelli A, Iezzi G. Flap versus flapless procedure for ridge preservation in alveolar extraction sockets: a histological evaluation in a randomized clinical trial. Clin Oral Implants Res. 2015 Jul;26(7):806-13. doi: 10.1111/clr.12358. Epub 2014 Mar 1.
- Bataineh AB, Al-Dakes AM. The influence of length of implant on primary stability: An in vitro study using resonance frequency analysis. J Clin Exp Dent. 2017 Jan 1;9(1):e1-e6. doi: 10.4317/jced.53302. eCollection 2017 Jan.
- Baumer D, Zuhr O, Rebele S, Hurzeler M. Socket Shield Technique for immediate implant placement - clinical, radiographic and volumetric data after 5 years. Clin Oral Implants Res. 2017 Nov;28(11):1450-1458. doi: 10.1111/clr.13012. Epub 2017 Mar 23.
- Becker W, Sennerby L, Bedrossian E, Becker BE, Lucchini JP. Implant stability measurements for implants placed at the time of extraction: a cohort, prospective clinical trial. J Periodontol. 2005 Mar;76(3):391-7. doi: 10.1902/jop.2005.76.3.391.
- Bornstein MM, Hart CN, Halbritter SA, Morton D, Buser D. Early loading of nonsubmerged titanium implants with a chemically modified sand-blasted and acid-etched surface: 6-month results of a prospective case series study in the posterior mandible focusing on peri-implant crestal bone changes and implant stability quotient (ISQ) values. Clin Implant Dent Relat Res. 2009 Dec;11(4):338-47. doi: 10.1111/j.1708-8208.2009.00148.x. Epub 2009 Apr 23.
- Bornstein MM, Valderrama P, Jones AA, Wilson TG, Seibl R, Cochran DL. Bone apposition around two different sandblasted and acid-etched titanium implant surfaces: a histomorphometric study in canine mandibles. Clin Oral Implants Res. 2008 Mar;19(3):233-41. doi: 10.1111/j.1600-0501.2007.01473.x. Epub 2008 Jan 3.
- Bouwman WF, Bravenboer N, Frenken JWFH, Ten Bruggenkate CM, Schulten EAJM. The use of a biphasic calcium phosphate in a maxillary sinus floor elevation procedure: a clinical, radiological, histological, and histomorphometric evaluation with 9- and 12-month healing times. Int J Implant Dent. 2017 Dec;3(1):34. doi: 10.1186/s40729-017-0099-x. Epub 2017 Jul 25.
- Santamaria-Arrieta G, Brizuela-Velasco A, Fernandez-Gonzalez FJ, Chavarri-Prado D, Chento-Valiente Y, Solaberrieta E, Dieguez-Pereira M, Vega JA, Yurrebaso-Asua J. Biomechanical evaluation of oversized drilling technique on primary implant stability measured by insertion torque and resonance frequency analysis. J Clin Exp Dent. 2016 Jul 1;8(3):e307-11. doi: 10.4317/jced.52873. eCollection 2016 Jul.
- Valdec S, Pasic P, Soltermann A, Thoma D, Stadlinger B, Rucker M. Alveolar ridge preservation with autologous particulated dentin-a case series. Int J Implant Dent. 2017 Dec;3(1):12. doi: 10.1186/s40729-017-0071-9. Epub 2017 Mar 30.
- Qabbani AA, Razak NHA, Kawas SA, Sheikh Abdul Hamid S, Wahbi S, Samsudin AR. The Efficacy of Immediate Implant Placement in Extraction Sockets for Alveolar Bone Preservation: A Clinical Evaluation Using Three-Dimensional Cone Beam Computerized Tomography and Resonance Frequency Analysis Value. J Craniofac Surg. 2017 Jun;28(4):e318-e325. doi: 10.1097/SCS.0000000000003569.
- Park SH, Park KS, Cho SA. Comparison of removal torques of SLActive(R) implant and blasted, laser-treated titanium implant in rabbit tibia bone healed with concentrated growth factor application. J Adv Prosthodont. 2016 Apr;8(2):110-5. doi: 10.4047/jap.2016.8.2.110. Epub 2016 Apr 21.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- 51514715.9.0000.5147
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- Statistical Analysis Plan (SAP)
- Informed Consent Form (ICF)
- Clinical Study Report (CSR)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Alveolar Osseous Loss
-
Alexandria UniversityLehigh UniversityCompletedBone Loss | Horizontal Alveolar Bone Loss | Vertical Alveolar Bone LossEgypt
-
Universidad de MurciaUnknownTooth Loss | Bone Loss, Alveolar | Bone Atrophy, AlveolarSpain
-
Pontificia Universidade Católica do Rio Grande...KU Leuven; ITI International Team for Implantology, Switzerland; Rio Grande do...Not yet recruitingAlveolar Bone Loss | Bone Loss, Alveolar | Grafting Bone | Alveolar Bone Atrophy | Bone Loss, OsteoclasticBrazil
-
Università degli Studi di FerraraAzienda USL FerraraRecruitingBone Loss, Alveolar | Dehiscence | Alveolar Ridge EnlargementItaly
-
Klinikum StuttgartKlinikum Kassel GmbH (COSS-Biobank)Not yet recruitingOsteosarcoma | High Grade Sarcoma | Recurrent Osteosarcoma | Bone Sarcoma | Undifferentiated Pleomorphic Sarcoma | Bone Tumor | Extraskeletal Osteosarcoma | Osseous Sarcoma | Parosteal Osteosarcoma | Osteoblastic Osteosarcoma | Chondroblastic Osteosarcoma | Fibroblastic Osteosarcoma | Conventional Osteosarcoma | Conventional... and other conditions
-
Johannes Gutenberg University MainzCompletedEducation | Clinical Skills | Sutures | Intra-osseousGermany
-
Postgraduate Institute of Dental Sciences RohtakNot yet recruitingBone Loss, AlveolarIndia
-
University of MichiganActive, not recruiting
-
Rio de Janeiro State UniversityCompleted
-
Esraa Salem KamalRecruiting
Clinical Trials on Immediate alveolar regeneration after exodontia
-
International Advanced Dentistry, LisbonUnknownBone Loss | Alveolar Bone Resorption
-
Cairo UniversityUnknown
-
Kafrelsheikh UniversityCompletedDental Implant | Ridge Splitting | i-PRFEgypt
-
Queen Mary University of LondonUniversity of ZurichNot yet recruitingHealing Wound | Biomarkers | Dental Implant | SalivaUnited Kingdom
-
Fundación Eduardo AnituaRecruiting
-
University Hospital, GhentRecruiting
-
University of TriesteInion OyCompleted
-
Cairo UniversityCompletedAlveolar Socket PreservationEgypt
-
Fondazione IRCCS Istituto Nazionale dei Tumori,...Morgagni Pierantoni HospitalCompleted
-
University of LiegeInstitut Straumann AGActive, not recruitingClinical and Dimensional Outcomes of Sealing Socket Abutment Combined to Alveolar Ridge PreservationNon-maintainable Posterior Tooth (Molars and Premolars)Belgium