3D-Printed PLA Guide Versus Resin Guide in Mandibular Molar Implant Placement (CGIIPMM-PLA-MR)

September 12, 2026 updated by: Mohamed Esmail Ahmed Hassan

Computer Guided Immediate Implant Placement in Mandibular Molars Using Patient Specific 3D Printed Polylactic Acid Guide Versus Modified Resin Guide

This randomized clinical trial compares two tooth-supported computer-guided surgical guide systems for immediate implant placement in mandibular molar extraction sockets: a patient-specific 3D-printed PLA guide system and a modified resin guide system. The study evaluates implant positioning accuracy, primary implant stability, and surgical time.

Study Overview

Detailed Description

This randomized clinical trial compares two tooth-supported computer-guided surgical guide systems for immediate implant placement in mandibular molar extraction sockets: a patient-specific 3D-printed polylactic acid (PLA) guide system and a modified resin guide system. Preoperative CBCT and digital intraoral scans were used for prosthetically driven virtual implant planning and fabrication of the surgical guides.

Implant positioning accuracy was assessed by comparing the planned and actual implant positions using preoperative and postoperative CBCT datasets. Angular deviation, coronal deviation at the implant platform, and apical deviation were recorded.

Primary implant stability was assessed immediately after implant placement using Implant Stability Quotient (ISQ) measurements obtained with an Osstell device. Surgical time was recorded from seating of the surgical guide and initiation of osteotomy until completion of implant insertion.

The study was designed to compare the performance of the two guide systems in immediate mandibular molar implant placement.

Study Type

Interventional

Enrollment (Actual)

20

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

    • New Cairo
      • Cairo, New Cairo, Egypt, 11511
        • Future University in Egypt (FUE)

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

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Age 20-50 years.
  • Non-restorable mandibular first molar indicated for extraction.
  • Sufficient bony support for implant placement without the need for significant bone augmentation.
  • Good oral hygiene and motivation.
  • Adequate prosthetic space.
  • Ability and willingness to undergo the surgical procedure and follow-up.
  • Suitable for computer-guided, tooth-supported implant placement.

Exclusion Criteria:

  • Uncontrolled systemic diseases that may impair healing (e.g., uncontrolled diabetes or hypertension).
  • Severe periodontal disease.
  • Patients undergoing chemotherapy or radiotherapy.
  • Insufficient prosthetic space.
  • Heavy smokers.

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
Experimental: patient specific 3d printed PLA guide
Immediate implant placement in mandibular molar extraction sockets using a patient-specific tooth-supported 3D-printed PLA surgical guide system. Preoperative CBCT and digital intraoral scans were used for prosthetically driven virtual implant planning and guide fabrication. The guide was fabricated from PLA according to the planned implant position. Following atraumatic tooth extraction and socket preparation, the guide was seated and osteotomy preparation was performed through the guide's guiding channel according to the planned trajectory, followed by immediate implant insertion. Primary implant stability was assessed using an Osstell device and Implant Stability Quotient (ISQ) measurements.
Preoperative virtual planning was performed using CBCT data and digital intraoral scans. The datasets were used for prosthetically driven implant planning and fabrication of a patient-specific 3D-printed PLA surgical guide. Following atraumatic tooth extraction and socket preparation, the guide was seated and osteotomy preparation was performed through the guiding channel according to the planned implant position and trajectory. The implant was then immediately inserted. Primary implant stability was assessed using an Osstell device and Implant Stability Quotient (ISQ) measurements.
Active Comparator: Modified Resin guide
Immediate implant placement in mandibular molar extraction sockets using a tooth-supported modified resin surgical guide system. Preoperative CBCT and digital intraoral scans were used for prosthetically driven virtual implant planning and guide fabrication. The guide was fabricated from light-cured surgical-guide resin according to the planned implant position. Following atraumatic tooth extraction and socket preparation, the guide was seated and osteotomy preparation was performed through the guide's guiding channel according to the planned trajectory, followed by immediate implant insertion. Primary implant stability was assessed using an Osstell device and Implant Stability Quotient (ISQ) measurements.
Preoperative virtual planning was performed using CBCT data and digital intraoral scans. The datasets were used for prosthetically driven implant planning and fabrication of a tooth-supported modified resin surgical guide. Following atraumatic tooth extraction and socket preparation, the guide was seated and osteotomy preparation was performed through the guiding channel according to the planned implant position and trajectory. The implant was then immediately inserted. Primary implant stability was assessed using an Osstell device and Implant Stability Quotient (ISQ) measurements.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
accuracy of implant position
Time Frame: Assessed within 1 week postoperatively, following acquisition of the postoperative CBCT scan.
Accuracy of implant placement will be evaluated by comparing the planned implant position from the preoperative digital plan with the actual implant position obtained from the postoperative CBCT scan. Deviations will be assessed in three dimensions, including angular deviation (degrees), coronal deviation (platform) (mm), and apical deviation (mm). Measurements will be performed using specialized implant-planning software by superimposing the preoperative and postoperative datasets. Lower deviation values indicate greater agreement between the planned and actual implant positions.
Assessed within 1 week postoperatively, following acquisition of the postoperative CBCT scan.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
primary implant stability by osstell
Time Frame: Measured immediately at the time of implant placement during the surgical procedure.
Primary implant stability will be assessed using an Osstell device, which measures Implant Stability Quotient (ISQ) values through resonance frequency analysis. A SmartPeg will be attached to the implant, and ISQ readings will be taken in two perpendicular directions (buccolingual and mesiodistal). Higher ISQ values indicate greater mechanical stability. The mean ISQ value for each implant will be recorded and used for analysis
Measured immediately at the time of implant placement during the surgical procedure.
surgical time
Time Frame: Assessed intraoperatively, measured during the surgical appointment, and recorded immediately after surgery
Surgical time will be recorded to evaluate the procedural efficiency of guided immediate implant placement. Time will be measured from seating of the surgical guide and initiation of osteotomy until completion of implant insertion. The total duration will be recorded in minutes.
Assessed intraoperatively, measured during the surgical appointment, and recorded immediately after surgery

Collaborators and Investigators

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

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.

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)

November 2, 2025

Primary Completion (Actual)

August 10, 2026

Study Completion (Actual)

September 10, 2026

Study Registration Dates

First Submitted

September 12, 2026

First Submitted That Met QC Criteria

September 12, 2026

First Posted (Actual)

September 17, 2026

Study Record Updates

Last Update Posted (Actual)

September 17, 2026

Last Update Submitted That Met QC Criteria

September 12, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared because of participant privacy and confidentiality considerations. Only aggregate study results will be reported.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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