Accuracy of Tooth Guided Immediate Implant Placement at Molar Region

Introduction: The concept of immediate implant placement has become popular due to reduced trauma and reduced overall treatment time. Removal of molar teeth provides a challenging and intriguing dilemma due to multiple root morphology. In cases of extraction and immediate placement of implants in the molar region, removal of the inter-radicular septum should be avoided to attain initial implant stability at the time of placement, and prevent slipping of the implant into the extraction socket. Following this technique prevents the slippage of the implant and allows the implant to be guided into the inter-radicular septum.

Objectives: To assess the accuracy of implant placement using the remaining roots of multi-radicular mandibular molars, evaluate bone density around implants and implant stability in fresh extracted site.

Materials and Methods: A prospective study was done on 10 patients with badly destructed mandibular molars. The technique of implant insertion consisted of a progressive preparation of the implant site using the anatomy of the root of the multi-radicular mandibular molars to be extracted as a reference and as an aid to engage the inter-radicular septum.

Study Overview

• Status: Completed
• Conditions: Immediate Implant Placement Guided by the Roots of Multiradicular Teeth
• Intervention / Treatment: Procedure: Tooth guided immediate implant placement

• Study Type: Interventional
• Enrollment (Actual): 10
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Alexandria, Egypt
    • faculty of dentistry Alexandria university

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years to 45 years (Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Badly destructed mandibular molar teeth.
• Integrity of the roots.
• Bone coverage of 2/3 of the root.
• Sufficient bone volume.
• Adequate interocclusal distance >7mm.
• Adequate amount of keratinized mucosa.
• Age ranging from 20-45 years.
• Medically fit patients.

Exclusion Criteria:

• Unfavorable position of the tooth or remaining roots.
• Molars with Fused roots.
• Root ankylosis.
• Patients with systemic conditions known to affect the periodontal status and healing such as uncontrolled diabetes and osteoporosis.
• Patients receiving chemotherapy or radiotherapy.
• Heavy smokers.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: tooth guided immediate implant placement group	Procedure: Tooth guided immediate implant placement; The technique of implant insertion consisted of a progressive preparation of the implant site using the anatomy of the root of the multi-radicular mandibular molars to be extracted as a reference and as an aid to engage the inter-radicular septum

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
implant stability quotient	implant stability quotient will be assessed using Osstell device.	3 months
Implant position accuracy using cone beam computed tomography	Immediate postoperative and a preoperative conebeam CT will be done. The preoperative and postoperative scans will then be over¬lapped using a dedicated algorithm, which will allow the comparison of the virtually planned and the actual implant positions. Three deviation parameters between each planned and placed implant will be measured. All measurements will be performed using Mimics Innovation Suite 19 ™ software (Materialise Mimics software 3D Medical Imaging, Belgium). For analyzing the accuracy, the planned position of the implant will be compared with the actual position of the implant after insertion. Several measuring points will be measured: Horizontal deviation at coronal side of the implant.; Horizontal deviation at apex of the implant.; Angular deviation.	immediately
Bone density around implant		6 months

Collaborators and Investigators

• Sponsor: Abdelrhman Tarek Sahry Abdelazim
• Investigators: Study Director: Samraa Elsheikh, PhD, Alexandria University

Publications and helpful links

General Publications

• Mahesh L, Kurtzman GM, Schwartz D, Shukla S. Residual Roots as an Anatomical Guide for Implant Placement: Case Series With Two-Year Follow-up. J Oral Implantol. 2016 Jun;42(3):285-8. doi: 10.1563/aaid-joi-D-15-00101. Epub 2015 Sep 21.
• Rodriguez-Tizcareno MH, Bravo-Flores C. Anatomically guided implant site preparation technique at molar sites. Implant Dent. 2009 Oct;18(5):393-401. doi: 10.1097/ID.0b013e3181b4b205.

Study record dates

Study Major Dates

• Study Start (Actual): June 15, 2018
• Primary Completion (Actual): October 15, 2018
• Study Completion (Actual): October 10, 2019

Study Registration Dates

• First Submitted: December 5, 2019
• First Submitted That Met QC Criteria: December 6, 2019
• First Posted (Actual): December 10, 2019

Study Record Updates

• Last Update Posted (Actual): December 10, 2019
• Last Update Submitted That Met QC Criteria: December 6, 2019
• Last Verified: December 1, 2019

More Information

Terms related to this study

• Other Study ID Numbers: Tooth guided immediate implant

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No