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Effect of Collagen Membrane on Ridge Preservation

2. juni 2026 opdateret af: Debora Dias

Effect of Collagen Membrane on Ridge Preservation for Delayed Implant Placement in Sites With Absent Buccal Bone Wall: A Randomized Controlled Trial

This study will evaluate whether adding a resorbable collagen membrane to an anorganic bone-collagen composite (ABCC) graft improves ridge preservation after tooth extraction. Ridge preservation is a procedure used to maintain the shape and volume of the jawbone following tooth removal, which is important for future dental implant placement.

Participants will be randomly assigned to receive either ABCC alone or ABCC combined with a collagen membrane. Healing outcomes will be assessed after approximately 4 months using three-dimensional cone beam computed tomography (CBCT) scans.

The primary outcome is the change in horizontal ridge dimension (width). Secondary outcomes include vertical and contour changes in ridge dimensions, changes in soft tissue contour assessed with digital scans, postoperative healing and complications (such as wound dehiscence, swelling, or infection), and patient-reported outcomes, including pain and satisfaction. In a subset of participants, bone healing will also be evaluated using laboratory and imaging analyses of bone samples obtained at the time of implant placement. The study will additionally assess whether the treatment allows implant placement in the ideal position without the need for further bone grafting.

Studieoversigt

Detaljeret beskrivelse

This study is a clinical trial that evaluates two different approaches to preserve the jawbone after tooth extraction in areas where part of the bone is already missing. Preserving the bone is important to support future dental implants.

Participants will be randomly assigned (like flipping a coin) to receive one of two treatments: a bone graft material alone, or the same bone graft combined with a protective collagen membrane placed over it.

Tooth extraction and follow-up care will be performed in the same manner for all participants. After approximately 4 months of healing, participants will return for dental implant placement.

During the healing period and at the time of implant placement, the research team will evaluate how well the bone and gums have healed. This will include three-dimensional CBCT scans, digital intraoral scans, and clinical measurements. In some participants, a small sample of bone will be collected at the time of implant placement to study bone healing.

The study will compare how effectively each treatment maintains the shape and volume of the jawbone, the quality of soft tissue healing, the risk of complications, patient-reported outcomes (PROs), including comfort and satisfaction, and whether additional procedures are required prior to implant placement.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

30

Fase

  • Ikke anvendelig

Kontakter og lokationer

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

Studiekontakt

  • Navn: Carla Sanchez, MS
  • Telefonnummer: 4126241179
  • E-mail: cab28@pitt.edu

Undersøgelse Kontakt Backup

Studiesteder

    • Pennsylvania
      • Pittsburgh, Pennsylvania, Forenede Stater, 15213
        • Rekruttering
        • University of Pittsburgh School of Dental Medicine, Department of Periodontics and Preventive Dentistry
        • Kontakt:
        • Ledende efterforsker:
          • Debora R Dias, DDS, PhD
        • Kontakt:

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

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Adults aged 18-80
  • Indicated for extraction of a single-rooted maxillary tooth
  • ≥ 50% buccal bone dehiscence confirmed by CBCT reconstructions
  • Presence of both adjacent teeth
  • No interproximal bone loss
  • ASA I-II health status
  • Ability to comply with required procedures, including attending required number of clinic visits

Exclusion Criteria:

  • Patients diagnosed with periodontitis adjacent to the area to be treated
  • History of allergic reactions to local anesthetics or bone graft material (self-reported);
  • Current heavy smokers (≥ 10 cigarettes/day) or those who quit smoking recently (self-reported; last 6 months);
  • Diagnosis of diabetes mellitus, liver or kidney failure (self-reported);
  • Presence of active infectious diseases of any kind;
  • History of chemotherapy or radiation therapy to the head or neck within the past 5 years (self-reported);
  • Severe hematologic disorders (risk for hemorrhage)(self-reported);
  • Assumption of corticosteroids, IV bisphosphonates or immunosuppressive drugs;
  • Any history of alcohol or drug abuse (self-reported);
  • Pregnancy or plans to become pregnant within 4 months of study enrollment (self-reported);

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: Dobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Control group (bone graft only)
Control group (bone graft only): The socket will be grafted with ABCC alone. The socket entrance will be covered with a collagen sponge, which will be secured with passive cross-mattress polytetrafluoroethylene sutures (PTFE) without attempting primary closure.
Tooth extraction will be performed by a calibrated periodontist using a minimally invasive, flapless, atraumatic technique with periotomes and elevators to preserve socket architecture. Granulation tissue will be carefully removed without flap elevation.
The extraction socket will be grafted with ABCC (SigmaGraft®).
Eksperimentel: Test group (bone graft + collagen membrane)
Test group (bone graft + collagen membrane): A buccal pouch will be created on the buccal aspect, between the bone and the buccal flap, using tunneling instruments to accommodate the resorbable collagen membrane (InterCollagen® Guide, SigmaGraft). The socket will then be grafted with ABCC. The socket entrance will be covered with a collagen sponge, which will be secured with passive cross-mattress PTFE sutures without attempting primary closure.
Tooth extraction will be performed by a calibrated periodontist using a minimally invasive, flapless, atraumatic technique with periotomes and elevators to preserve socket architecture. Granulation tissue will be carefully removed without flap elevation.
The extraction socket will be grafted with ABCC (SigmaGraft®).
A buccal pouch will be created on the buccal aspect, between the bone and the buccal flap, using tunneling instruments to accommodate a resorbable collagen membrane (InterCollagen® Guide; SigmaGraft®). The membrane will be positioned in the buccal tunnel to replace the missing buccal bone wall and provide graft containment.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Horizontal dimensional changes (%)
Tidsramme: Baseline and 4 months
Change in horizontal ridge width at 3 mm apical to the crest, measured on CBCT scans and expressed in percentage change.
Baseline and 4 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Horizontal dimensional changes (%)
Tidsramme: Baseline and 4 months
Change in horizontal ridge width at 1 mm apical to the crest, measured on CBCT scans and expressed in percentage change.
Baseline and 4 months
Horizontal dimensional changes (%)
Tidsramme: Baseline and 4 months
Change in horizontal ridge width at 5 mm apical to the crest, measured on CBCT scans and expressed in percentage change.
Baseline and 4 months
Vertical dimensional changes (%)
Tidsramme: Baseline and 4 months
Change in vertical ridge height at the midbuccal aspect, measured on CBCT scans and expressed in percentage change.
Baseline and 4 months
Vertical dimensional changes (%)
Tidsramme: Baseline and 4 months
Change in vertical ridge height at the mid palatal aspect, measured on CBCT scans and expressed in percentage change.
Baseline and 4 months
Volumetric dimensional changes (%)
Tidsramme: Baseline and 4 months
Change in the volume of the alveolar process (mm3), measured on CBCT scans in comparison to baseline and expressed in percentage change.
Baseline and 4 months
Mid-buccal soft tissue contour change (mm)
Tidsramme: Baseline and 4 months
Linear measurement (mm) of mid-buccal soft tissue profile change assessed by superimposition of stereolithography (STL) datasets. Adjacent teeth are used as reference for alignment. A positive value indicates soft tissue gain; a negative value indicates recession.
Baseline and 4 months
Mid-buccal soft tissue volume change (%)
Tidsramme: Baseline and 4 months
Volumetric change (mm³) in mid-buccal soft tissue contour calculated by superimposition of STL datasets and expressed in percentage. Color-coded deviation maps will illustrate areas of soft tissue collapse or gain.
Baseline and 4 months
Interproximal papilla height change (mm)
Tidsramme: Baseline and 4 months
Linear measurement (mm) of interproximal papilla height change assessed by superimposition of STL datasets in comparison to baseline. A positive value indicates papilla gain; a negative value indicates papilla loss.
Baseline and 4 months
Wound healing (Wound Healing Index)
Tidsramme: 1 week, 2 weeks, 1 month, 4 months
Wound healing quality assessed using the Wound Healing Index (WHI), a 3-point ordinal scale where 1 = uneventful healing (complete soft tissue coverage, no complications), 2 = normal healing with minor complications, and 3 = poor healing (dehiscence, exposure, or infection requiring intervention). Lower scores indicate better healing.
1 week, 2 weeks, 1 month, 4 months
Incidence of postoperative complications (Percentage)
Tidsramme: 1 week, 2 weeks, 1 month, 4 months
Proportion of participants experiencing at least one postoperative complication (edema, erythema, suppuration, graft exposure, or wound dehiscence) at any follow-up visit. Complications will be recorded by a blinded clinical examiner at each scheduled visit.
1 week, 2 weeks, 1 month, 4 months
Postoperative pain
Tidsramme: Day 1, Day 3, 1 week
Numeric scale (0-10) for pain after the extraction and ridge preservation procedure.
Day 1, Day 3, 1 week
Oral health-related quality of life (OHIP-14)
Tidsramme: Baseline, 2 weeks, 4 months
Oral health-related quality of life assessed using the Oral Health Impact Profile - 14 (OHIP-14), a validated 14-item questionnaire.
Baseline, 2 weeks, 4 months
Feasibility of prosthetically ideal implant placement without additional augmentation
Tidsramme: 4 months
Ability to place the implant in a prosthetically ideal three-dimensional position at reentry without the need for additional hard-tissue augmentation.
4 months
Histological Outcomes
Tidsramme: 4 months
In a subset of patients, a bone core biopsy will be obtained. Percent area of new bone, residual graft, and marrow spaces assessed by histomorphometric analysis of bone core biopsies obtained at the time of implant placement.
4 months
Patient satisfaction (VAS)
Tidsramme: 4 months
Visual analogue scale (0-100) of patient satisfaction with the appearance of the soft tissues
4 months

Samarbejdspartnere og efterforskere

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

Sponsor

Samarbejdspartnere

Efterforskere

  • Ledende efterforsker: Debora R Dias, DDS, PhD, University of Pittsburgh, Department of Periodontics and Preventive Dentistry

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

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 (Faktiske)

26. maj 2026

Primær færdiggørelse (Anslået)

31. oktober 2027

Studieafslutning (Anslået)

31. oktober 2027

Datoer for studieregistrering

Først indsendt

10. april 2026

Først indsendt, der opfyldte QC-kriterier

6. maj 2026

Først opslået (Faktiske)

12. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

4. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

2. juni 2026

Sidst verificeret

1. juni 2026

Mere information

Begreber relateret til denne undersøgelse

Plan for individuelle deltagerdata (IPD)

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INGEN

IPD-planbeskrivelse

Individual participant data will not be shared outside the primary research group due to concerns regarding participant privacy and confidentiality, as approved by the University of Pittsburgh Institutional Review Board.

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