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Treatment of Peri-implantitis With or Without Simultaneous Soft Tissue Augmentation

25. marts 2020 opdateret af: Lucrezia Paternò Holtzman, George Eastman Dental Hospital, Italy

Surgical Reconstructive Treatment of Peri-Implantitis With or Without Simultaneous Soft Tissue Augmentation: a Multi-center Randomized Controlled Trial

The study will aim to compare two modalities in the reconstructive treatment of peri-implantitis defects. More specifically, the control group will be a reconstructive approach (xenograft bone graft granules and collagen membrane, BioOss and BioGide, Geistlich, Wolhusen). The test group will be the same with the exception of an autologous sub-epithelial connective tissue palatal graft, sutured beneath the flap, which will be used in addition to grafting materials.

Outcomes will include CAL, PD, MR, defect resolution, PI, BoP, SUPP, patient-reported outcome measures including an aesthetic self-evaluation.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

The study will aim to compare two modalities in the reconstructive treatment of peri-implantitis defects.

More specifically, the control group will be a "pure" reconstructive approach (xenograft bone graft granules and reservable collagen membrane, BioOss and BioGide, Geistlich, Wolhusen). This is in accordance with gold standard practices of reconstructive therapy of peri-implant defects.

The test group will be treated with the same approach and materials, with the exception of an autologous sub-epithelial connective tissue palatal graft, sutured beneath the flap, which will be used in addition to the grafting materials. The graft will be harvested from the homolateral palate (molar region).

Outcomes will include CAL, clinical attachment level (primary outcome), PD or probing depth, MR or mucosal recession, defect resolution (composite outcome made up of simultaneous absence of PD>5 mm, BOP/SUP and bone level changes >0.5 mm, PI, BoP or bleeding upon probing, suppuration SUP on probing, SUP on palpation, patient-reported outcome measures including an aesthetic self-evaluation.

The measures will be recorded at baseline, 6-, 12-, 18- and 24 months. Radiographic bone levels will be compared with 2 week image at 12 and 24 months

Undersøgelsestype

Interventionel

Tilmelding (Forventet)

32

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Undersøgelse Kontakt Backup

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ja

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • · Be able and willing to provide consent and sign the informed consent form.

    • Be able and willing to comply with study procedures and follow-up appointments required by the study protocol.
    • Age>18 years
    • Presence of at least one implant affected with peri-implantitis, defined as the following con-dition: at least one site presenting peri-implant probing depth (PPD) >6 mm and simultane-ous presence of profuse BoP/SUP and a radiographically documented change in bone level greater than initial bone remodeling. In the likely event that a baseline radiographic image is absent, the bone level will be compared to where it would likely have been at the time of implant insertion and a difference of >3 mm from that level will be considered.
    • Implants in function (i.e. loaded) for at least 1 year.
    • Screw- and cement-retained suprastructures for both fixed and removable prostheses.

Exclusion Criteria:

  • Compromised systemic health which contraindicates the study procedures.
  • Pregnant or nursing women.
  • Cigarette smoking>5 per day
  • Systemic conditions compromising healing (i.e. diabetes mellitus). Patients with diabe-tes mellitus types I or II will be asked to provide information regarding their most re-cent HbA1c values. Only patients with HbA1c<7% will be enrolled.
  • Patients taking medications known to interfere with gingival or bone metabolism.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Xenograft+collagen membrane
Reconstructive approach (Xenograft+collegen membrane)
Procedure: Peri-implantitis reconstructive surgery

For both arms (excluding the already included information): defect debridement, removal of debris using titanium curettes, titanium brushes on the implant surface, irrigation with saline, application of sterile cotton pellets with saline solution. Grafting with (experimental) xenograft and soft tissue, or xenograft alone (control). Suture.

Specific to control group (active comparator): the peri-implant defect will be filled with xenograft, and a collagen membrane will be fitted and trimmed to the defect area.

Specific to test/experimental group: same as above (for control). In addition a soft tissue graft will be harvested from the palate and sutured to the buccal flap. The entire flap will then be sutured to the lingual flap.
Eksperimentel: Xenograft+collagen membrane+autologous soft tissue graft
Reconstructive approach (Xenograft+collegen membrane) plus soft tissue graft (autologous, harvested as FGG)
Procedure: Peri-implantitis reconstructive surgery

For both arms (excluding the already included information): defect debridement, removal of debris using titanium curettes, titanium brushes on the implant surface, irrigation with saline, application of sterile cotton pellets with saline solution. Grafting with (experimental) xenograft and soft tissue, or xenograft alone (control). Suture.

Specific to control group (active comparator): the peri-implant defect will be filled with xenograft, and a collagen membrane will be fitted and trimmed to the defect area.

Specific to test/experimental group: same as above (for control). In addition a soft tissue graft will be harvested from the palate and sutured to the buccal flap. The entire flap will then be sutured to the lingual flap.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Clinical attachment level
Tidsramme: change from baseline to: 6, 12, 18, 24 months
linear distance (mm) from the implant platform to the bottom of the pocket
change from baseline to: 6, 12, 18, 24 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Probing depth
Tidsramme: 6, 12, 18, 24 months
linear distance (mm) from the gingival margin to the bottom of the pocket
6, 12, 18, 24 months
Disease resolution
Tidsramme: 6, 12, 18, 24 months
No PD greater than or equal to 5 mm and simultaneous absence of BOP/SUP and no more than 0.5 mm change between 2 weeks and 12 and 24 months on radiograph
6, 12, 18, 24 months
Mucosal recession
Tidsramme: 6, 12, 18, 24 months
linear distance (mm) from the implant platform to the gingival margin
6, 12, 18, 24 months
plaque index (minimum value 0, maximum 1)
Tidsramme: 6, 12, 18, 24 months
binary outcome: yes/ no detected running the probe into the peri-implant sulcus
6, 12, 18, 24 months
profuse bleeding
Tidsramme: 6, 12, 18, 24 months
abundant bleeding evoked upon probing immediately after
6, 12, 18, 24 months
BOP
Tidsramme: 6, 12, 18, 24 months
bleeding upon probing: bleeding evoked upon probing after 1 second
6, 12, 18, 24 months
suppuration
Tidsramme: 6, 12, 18, 24 months
Binary: yes or no, detected upon probing or digital palpation
6, 12, 18, 24 months
Gingival thickness
Tidsramme: 6, 12, 18, 24 months
Measured in a horizontal direction at 1 mm from the gingival margin
6, 12, 18, 24 months
Patient-reported outcome measures
Tidsramme: 6, 12, 18, 24 months
pain-bleeding-aesthetic self-evaluation-swelling-discomfort
6, 12, 18, 24 months
Radiographic bone levels
Tidsramme: 2 weeks, 12 months, 24 months
radiographic bone level changes between the 2 week and 12 and 24 month follow-ups
2 weeks, 12 months, 24 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

George Eastman Dental Hospital, Italy

Samarbejdspartnere

University of Belgrade

Efterforskere

  • Ledende efterforsker: Luca Cordaro, MD, PhD, G. Eastman Dental Hospital Rome, Italy

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Forventet)

1. september 2020

Primær færdiggørelse (Forventet)

1. september 2021

Studieafslutning (Forventet)

1. december 2023

Datoer for studieregistrering

Først indsendt

23. marts 2020

Først indsendt, der opfyldte QC-kriterier

25. marts 2020

Først opslået (Faktiske)

26. marts 2020

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

26. marts 2020

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

25. marts 2020

Sidst verificeret

1. marts 2020

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 18117 (Anden identifikator: City of Hope Medical Center)

Plan for individuelle deltagerdata (IPD)

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