Azento IIS 3 Year Outcomes Implant Study

July 6, 2023 updated by: Christopher Barwacz

Clinical, Radiographic, and Histomorphometric Analysis of AstraTech Implant EV Placed and Immediately Provisionalized Into Preserved Alveolar Ridges: A Prospective 3-Year Outcomes Study

The purpose of this research study is to compare and evaluate the implant-body stability, survival rate, bone level changes and the implant's soft-tissue outcomes over a three year follow-up around AstraTech Implant System (ATIS) Evolution (EV) implants placed and immediately temporized with an artificial prosthetic tooth in ridges that have healed following ARP-SG for different time intervals.intervals.

Patients participating in this study are expected to return to the University of Iowa College of Dentistry for a total of 9 visits. The estimated study length per subject will vary between 42 to 48 months depending on group allocation.

Study Overview

Detailed Description

Group 1: 3 months after ARP-SG, a dental implant will be placed using Azento® with an AstraTech Implant System EV and an immediate implant temporary crown using Azento®. After 3 months with the temporary crown, a definitive all-ceramic crown, made using a digital workflow will be placed.

Group 2: 6 months after ARP-SG, a dental implant will be placed using Azento® with an AstraTech Implant System EV and an immediate temporary crown using Azento®. After 3 months with the temporary crown, a definitive all-ceramic crown, made using a digital workflow will be placed.

Group 3: 9 months after ARP-SG, a dental implant will be placed using Azento® with an AstraTech Implant System EV and an immediate temporary crown using Azento®. After 3 months with the temporary crown, a definitive all-ceramic crown, made using a digital workflow will be placed.

SCREENING - Visit 1 After reading and signing the informed consent form, participants will complete a detailed medical and dental history form. The investigators will review the form with the participant to ensure they can safely participate in the study. Participants will also have an oral exam to determine if the participant qualifies for the study

VISIT 2: Abutment & Crown Placement Group 1 (TE + 14 weeks) Group 2 (TE + 26 weeks) Group 3 (TE + 38 weeks)

Intra-oral photographs of the sites of interest will be obtained. Participants may or may not have had their implant and bone core biopsy completed as part of their participation in IRB 201806050, Clinical, radiographic and histomorphotmetric analysis of healing dynamics in human extraction sockets grafted with Bio-Oss Collagen®: A prospective 3-year post-loading study or the participants routine clinical care. At the same visit when the implant is surgically installed, the investigators will then place a prosthetic abutment and temporary crown. Participants will also receive home care instructions before they leave. This visit will last about between 1.5 to 2 hours.

VISIT 3, 4, 5: Postop (2, 6, 12 week follow-ups after implant placement) Participants will return to the clinic at 2, 6 and 12 weeks which is standard of care in many cases for implant follow-up and restoration. At this time the investigators will update medical and dental histories. Photographs and intra-oral scans (multiple digital photographs) will be taken. The investigators will review any xrays on file to assess bone levels around the implant. Sutures will be removed. Participants will be asked some questions regarding their pain and level of satisfaction in addition to the healing status of their wound. The sites will be debrided (cleaned) and oral hygiene instructions will be reviewed. At visit 4 the shade of their new permanent crown will be selected. These visits will last approximately 30-60 minutes.

VISIT 6: Final Restoration Delivery (Implant Placement + 16 weeks) The investigators will update medical and dental histories. The abutment and crown will be examined. The temporary crown will be replaced with a permanent crown. Photographs and intra-oral scans (multiple digital photographs) will be taken. The participant will be asked some questions regarding pain and level of satisfaction in addition to the healing status of their wound. This visit will last approximately 60-90 minutes.

VISIT 7, 8 & 9: Implant Follow-ups #1, 2 & 3 (1, 2 & 3 years after delivery of final restoration) The participant will return to the clinic at 1, 2 and 3 years after delivery of the final restoration which is standard of care in many cases for implant restoration. At these times the investigators will update medical and dental histories . Photographs and intra-oral scans (multiple digital photographs) will be taken. An oral exam will be completed. Plaque will be removed if necessary, and oral hygiene instructions will be reviewed. Clinical measurements will be recorded. The investigators will review any xrays on file to assess bone levels around the implant. These visits will last approximately 60 minutes. Visit 9 will be the last visit.

Study Type

Interventional

Enrollment (Estimated)

42

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Iowa
      • Iowa City, Iowa, United States, 52242
        • University of Iowa

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria: patients participating in University of Iowa IRB approved study 201806050 or

  • Subjects may identify as either male, female, or intersex
  • Age: 18 years or older
  • Subjects with a healed, single-rooted tooth (except mandibular incisors) that has previously undergone ARP-SG with anorganic bovine bone mineral graft
  • Subjects must have stable occlusion, with absence of caries or other known acute pathology (i.e., untreated endodontic lesion, periodontal abscess, external/internal resorption, etc.) on teeth proximal to the implant site that would negatively influence implant outcomes
  • Must be in adequate physical and mental health to undergo routine dental treatment including the surgical procedures associated tooth extraction and implant placement
  • Subjects' treatment plan must include replacement of the tooth to be extracted with dental implant supported fixed restoration
  • Subjects must have read, understood and signed an informed consent form
  • Subjects must be willing to return for the required number of visits

Exclusion Criteria:

  • - Acute infection associated with the tooth to be extracted or with adjacent teeth
  • Unstable occlusion, presence of caries or other acute pathology on teeth adjacent to the implant site
  • History of significant heart, stomach, liver, kidney, blood, immune system disease, or other organ impairment or systemic diseases that would prevent undergoing the proposed treatment or may result in compromised healing (e.g. poorly controlled diabetes, active heavy tobacco use [>10 cigs/day])
  • Subjects with uncontrolled and/or severe metabolic bone diseases or disorders, such as osteoporosis, thyroid disorders or Paget's disease
  • Subjects taking any medication or supplement known to largely influence bone metabolism, such as IV bisphosphonates, long-term history of oral bisphosphonates or chronic intake of glucocorticoids
  • Pregnant women or nursing mothers
  • Subjects that are unwilling or unable to sign the informed consent
  • History of lack of compliance with dental visits
  • Subjects unwilling to return for the required number of visits

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Group 1
Group 1: 3 months post-ARP-SG and dental implant placement using Azento® with an Astra Tech Implant® EV implant and immediate implant provisionalization using Azento®. At 3 months post-DIP&P, a definitive all-ceramic crown, fabricated using a digital workflow (CoreFile), will be placed
A gold-hue titanium Atlantis abutment will be connected and secured to the implant fixture, and a provisional screwmentable PMMA crown seated to verify marginal adaptation, proximal contact intensity, and occlusion. Upon any necessary modifications and adjustments to the provisional crown, the abutment and crown will be cemented extraorally, disinfected ultrasonically in 0.12% chlorohexidine gluconate, and torqued to 25N/cm2, and screw-access channel obturated with polytetrafluorethylene (PTFE) tape and resin composite.
Intra-oral photographs of the sites of interest will be obtained
modifications and adjustments to the provisional crown, the abutment and crown will be cemented extraorally, disinfected ultrasonically in 0.12% chlorohexidine gluconate, and torqued to 25N/cm2, and screw-access channel obturated with polytetrafluorethylene (PTFE) tape and resin composite.
medical history updated to medical record
dental history updated to medical record
sutures will be removed
An intra-oral digital scan of the arch will be obtained using an intra-oral scanner
Visual assessment of the healing status will be made using a wound healing index (WHI)
Participants will be asked to report pain in terms of function, comfort and esthetics (PROMs).
Participants will be asked to report level of satisfaction in terms of function, comfort and esthetics (PROMs).
wound will be debrided
oral hygiene instructions will be given
definitive shade selection will occur at this appointment, and a final monolithic screwmentable all-ceramic zirconium-oxide crown will be fabricated from the original Atlantis CoreFile
Intra-oral photographs will be obtained using a dSLR camera
removal of plaque on crown and surrounding teeth
probing depths will be measured
bleeding on probing will be recorded
recession respective to the incisal/occlusal plane
keratinized mucosa height
plaque index
gingival index
Active Comparator: Group 2
Group 2: at 6 months post-ARP-SG and dental implant placement using Azento® with an Astra Tech Implant® EV implant and immediate implant provisionalization using Azento®. At 3 months post-DIP&P, a definitive all-ceramic crown, fabricated using a digital workflow (CoreFile), will be placed.
A gold-hue titanium Atlantis abutment will be connected and secured to the implant fixture, and a provisional screwmentable PMMA crown seated to verify marginal adaptation, proximal contact intensity, and occlusion. Upon any necessary modifications and adjustments to the provisional crown, the abutment and crown will be cemented extraorally, disinfected ultrasonically in 0.12% chlorohexidine gluconate, and torqued to 25N/cm2, and screw-access channel obturated with polytetrafluorethylene (PTFE) tape and resin composite.
Intra-oral photographs of the sites of interest will be obtained
modifications and adjustments to the provisional crown, the abutment and crown will be cemented extraorally, disinfected ultrasonically in 0.12% chlorohexidine gluconate, and torqued to 25N/cm2, and screw-access channel obturated with polytetrafluorethylene (PTFE) tape and resin composite.
medical history updated to medical record
dental history updated to medical record
sutures will be removed
An intra-oral digital scan of the arch will be obtained using an intra-oral scanner
Visual assessment of the healing status will be made using a wound healing index (WHI)
Participants will be asked to report pain in terms of function, comfort and esthetics (PROMs).
Participants will be asked to report level of satisfaction in terms of function, comfort and esthetics (PROMs).
wound will be debrided
oral hygiene instructions will be given
definitive shade selection will occur at this appointment, and a final monolithic screwmentable all-ceramic zirconium-oxide crown will be fabricated from the original Atlantis CoreFile
Intra-oral photographs will be obtained using a dSLR camera
removal of plaque on crown and surrounding teeth
probing depths will be measured
bleeding on probing will be recorded
recession respective to the incisal/occlusal plane
keratinized mucosa height
plaque index
gingival index
modifications and adjustments to the provisional crown, the abutment and crown will be cemented extraorally, disinfected ultrasonically in 0.12% chlorohexidine gluconate, and torqued to 25N/cm2, and screw-access channel obturated with polytetrafluorethylene (PTFE) tape and resin composite.
Active Comparator: Group 3
Group 3: 9 months post-ARP-SG and dental implant placement using Azento® with an Astra Tech Implant® EV implant and immediate implant provisionalization using Azento®. At 3 months post-DIP&P, a definitive all-ceramic crown, fabricated using a digital workflow (CoreFile), will be placed
A gold-hue titanium Atlantis abutment will be connected and secured to the implant fixture, and a provisional screwmentable PMMA crown seated to verify marginal adaptation, proximal contact intensity, and occlusion. Upon any necessary modifications and adjustments to the provisional crown, the abutment and crown will be cemented extraorally, disinfected ultrasonically in 0.12% chlorohexidine gluconate, and torqued to 25N/cm2, and screw-access channel obturated with polytetrafluorethylene (PTFE) tape and resin composite.
Intra-oral photographs of the sites of interest will be obtained
modifications and adjustments to the provisional crown, the abutment and crown will be cemented extraorally, disinfected ultrasonically in 0.12% chlorohexidine gluconate, and torqued to 25N/cm2, and screw-access channel obturated with polytetrafluorethylene (PTFE) tape and resin composite.
medical history updated to medical record
dental history updated to medical record
sutures will be removed
An intra-oral digital scan of the arch will be obtained using an intra-oral scanner
Visual assessment of the healing status will be made using a wound healing index (WHI)
Participants will be asked to report pain in terms of function, comfort and esthetics (PROMs).
Participants will be asked to report level of satisfaction in terms of function, comfort and esthetics (PROMs).
wound will be debrided
oral hygiene instructions will be given
definitive shade selection will occur at this appointment, and a final monolithic screwmentable all-ceramic zirconium-oxide crown will be fabricated from the original Atlantis CoreFile
Intra-oral photographs will be obtained using a dSLR camera
removal of plaque on crown and surrounding teeth
probing depths will be measured
bleeding on probing will be recorded
recession respective to the incisal/occlusal plane
keratinized mucosa height
plaque index
gingival index
modifications and adjustments to the provisional crown, the abutment and crown will be cemented extraorally, disinfected ultrasonically in 0.12% chlorohexidine gluconate, and torqued to 25N/cm2, and screw-access channel obturated with polytetrafluorethylene (PTFE) tape and resin composite.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Implant survival
Time Frame: 3 years post implant loading
did the implant survive
3 years post implant loading

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
% of vital bone via histomorphotmetric evaluation of bone core biopsies at 3 months
Time Frame: 3 months
% of vital bone
3 months
% of vital bone via histomorphotmetric evaluation of bone core biopsies at 6 months
Time Frame: 6 months
% of vital bone
6 months
% of vital bone via histomorphotmetric evaluation of bone core biopsies at 9 months
Time Frame: 9 months
% of vital bone
9 months
Insertion torque values
Time Frame: 3 months
resonance frequency analysis (RFA) measured by implant stability quotient (ISQ)
3 months
Insertion torque values
Time Frame: 6 months
resonance frequency analysis (RFA) measured by implant stability quotient (ISQ)
6 months
Insertion torque values
Time Frame: 9 months
resonance frequency analysis (RFA) measured by implant stability quotient (ISQ)
9 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Christopher Barwacz, DDS, University of Iowa

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 29, 2020

Primary Completion (Estimated)

December 31, 2025

Study Completion (Estimated)

December 31, 2025

Study Registration Dates

First Submitted

January 31, 2020

First Submitted That Met QC Criteria

February 3, 2020

First Posted (Actual)

February 5, 2020

Study Record Updates

Last Update Posted (Actual)

July 7, 2023

Last Update Submitted That Met QC Criteria

July 6, 2023

Last Verified

July 1, 2023

More Information

Terms related to this study

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

Yes

product manufactured in and exported from the U.S.

Yes

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.

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