- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06207617
Dimensional Changes Following Immediate Implant Placement in Molar Extraction Sockets With or Without Bone Graft
Evaluation of Soft and Hard Tissue Dimensional Changes Following Immediate Implant Placement in Molar Extraction Sockets With or Without Bone Graft: A Randomized Controlled Clinical Trial
Study Overview
Status
Conditions
Detailed Description
After administration of local anesthesia, flapless atraumatic extraction will be performed using peristomes inserted along the root surface, apical pressure and rocking motion will be applied circumferentially to cut the periodontal ligaments. After initial luxation using Harpoon luxators, bayonet forceps will be used to deliver the tooth out of the socket. Often separation of the mesial and distal roots will be employed, to facilitate tooth delivery without impinging the soft and hard tissue architecture. Socket debridement will be done using socket curette and saline irrigation, to make sure the socket is thoroughly clean with no remnants of any periapical pathosis.
Immediate implant placement + customized healing abutment (Test group): After atraumatic extraction, flapless immediate implant of a suitable size will be placed using sequential drills of the Straumann implant system for osteotomy preparation. According to the prosthetically driven planned position, implant will be placed. Primary stability of the implant will be measured by rotational insertion torque, to be more than or equal 30 Ncm. All patients will receive an immediate anatomical customized healing abutment fabricated by adding flowable composite to the temporary cylindrical abutment mimicking the shape of the socket at the marginal gingiva, then it will be screwed to the implant.
Immediate implant placement + xenogeneic bone graft material + customized healing abutment (Control) After atraumatic extraction, immediate implant will be placed as mentioned-above, then particulate xenogeneic bone graft will be packed into the gap between the implant and the buccal plate mesially and distally. bone grafting will be up to the level of the buccal bone crest, followed by screwing the customized healing abutment.
Objectives:
- To compare Bucco-lingual ridge dimension between the two groups at baseline and one-year postoperative.
- To compare the volumetric changes in the labial soft tissue contour between the two groups assessed in mm and mm3.
- To assess and compare the Bucco-palatal bone width, and vertical bone changes in mm using cone beam computed tomography (CBCT) preoperative and at 12 Months.
- To evaluate mid facial gingival recession assessed in mm by the volumetric analysis.
- To assess peri-implant soft tissue parameters by plaque and bleeding indices.
- To assess any surgical or prosthetic complications.
- To assess Implant Failure and Implant Survival Rate
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Nourhan Gamal
- Phone Number: 01064249441
- Email: nourhannegamal259@gmail.com
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Adults from the age of 18 - 50 years of both genders.
- Patients with non-restorable single bounded mandibular 1st molar tooth indicated for extraction.
- Periodontally healthy patients with good oral hygiene.
- Intact interradicular bone with 2-3 mm width, assessed by CBCT.
- Thin buccal plate of bone (1 mm or less) among both of the mesial and distal root, assessed by CBCT.
- Intact gingival tissue with at least 2 mm keratinized tissue.
- Patients accepts to provide written informed consent.
Exclusion Criteria:
- Molar sites indicated for extraction with roots of close proximity to vital structures as inferior alveolar nerve.
- Pregnant females.
- Smokers as smoking is a contraindication for any plastic periodontal surgery (Khuller, 2009).
- Handicapped and mentally retarded patients.
- Patients undergoing chemotherapy and/or radiotherapy.
- Presence of systemic disease that would affect wound healing.
- Presence of active infection with soft tissue communication.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Immediate implant placement + customized healing abutment
After atraumatic extraction, flapless immediate implant of a suitable size will be placed using sequential drills of the Straumann implant system for osteotomy preparation.
According to the prosthetically driven planned position, implant will be placed.
Primary stability of the implant will be measured by rotational insertion torque, to be more than or equal 30 Ncm.
All patients will receive an immediate anatomical customized healing abutment fabricated by adding flowable composite to the temporary cylindrical abutment mimicking the shape of the socket at the marginal gingiva, then it will be screwed to the implant.
|
Immediate implant placement in fresh extraction molar sites + customized healing abutment fabricated by adding flowable composite to the temporary cylindrical abutment mimicking the shape of the socket at the marginal gingiva, then it will be screwed to the implant.
no grafting material included in this arm
Other Names:
|
Active Comparator: Immediate implant placement + xenogeneic bone graft material + customized healing abutment
After atraumatic extraction, immediate implant will be placed as mentioned-above, then particulate xenogeneic bone graft will be packed into the gap between the implant and the buccal plate mesially and distally.
bone grafting will be up to the level of the buccal bone crest, followed by screwing the customized healing abutment.
|
Immediate implant placement in fresh extraction molar sites + xenogenic bone graft + customized healing abutment fabricated by adding flowable composite to the temporary cylindrical abutment mimicking the shape of the socket at the marginal gingiva, then it will be screwed to the implant.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Bucco-lingual ridge dimension
Time Frame: 12 months
|
volumetric analysis software will calculate the overall labio-palatal ridge width (mm)
|
12 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
total buccal volume loss (mm3)
Time Frame: 12 months
|
volumetric analysis software will calculate the overall labio-palatal ridge width (mm)
|
12 months
|
Horizontal labio-palatal bone width
Time Frame: 12 months
|
A reference line will be constructed along the palatal surface of the implant on the cross-sectional cut of the postoperative CBCT volume.
Then, both initial (T0) and postoperative (T1) CBCT volumes will be superimposed on the fusion module.
The horizontal labio-palatal width will be measured from the reference line to the outer labial bone at three levels below the labial bone crest: 0mm, 2mm and 5mm at T0 and T1.
The difference between T1 and T0 will be calculated and compared to record the mm and % horizontal labio-palatal bone collapse.
|
12 months
|
Vertical crestal bone level changes
Time Frame: 12 months
|
a horizontal line will be placed to mark the crestal labial bone on both the initial and postoperative CBCT volumes separately.
Then, both initial and postoperative CBCT volumes will be superimposed on the fusion module.
A vertical linear measurement perpendicular to both lines will be done to record the mm vertical crestal bone level changes.
|
12 months
|
mid-facial recession
Time Frame: 12 months
|
using a volumetric analysis software
|
12 months
|
linear volumetric change of buccal soft tissue contour
Time Frame: 12 months
|
at 2, 4, 6mm below the free gingival margin (FGM) at baseline, 6-and 12-months postoperative.
using a volumetric analysis software
|
12 months
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
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
- IDCE.N9
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.
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