Immediate Molar Implants With Customized Healing Abutments in Different Post-Extraction Socket Classes (IMPLA-CHA)
Evaluation of the Success of Immediate Implants in the Molar Region Using Individually Fabricated Healing Abutments (Sulcus Formers) in Different Classes of Post-Extraction Sockets: A Prospective Cohort Study
Immediate implant placement into a fresh extraction socket shortens overall treatment time and reduces the number of surgical procedures, but the fit between the implant and the socket walls, and the resulting soft-tissue contour, differ substantially between socket types. This study evaluates immediate implant placement in the molar and posterior region combined with an individually fabricated (customized) healing abutment, or sulcus former, that seals the socket and shapes the emergence profile from the day of surgery.
Consecutive patients with a non-restorable posterior tooth are treated with flapless atraumatic extraction, immediate implant placement, grafting of the residual gap, and a chairside customized healing abutment fabricated on a titanium temporary abutment. Participants are grouped by the class of the post-extraction socket (A, B or C) according to the interradicular septal bone available for primary stability.
Outcomes are preservation of peri-implant soft-tissue volume assessed with an intraoral scanner, preservation of alveolar bone volume assessed on cone-beam computed tomography, implant stability measured by resonance frequency analysis (ISQ) at placement and before loading, and time to definitive loading. Early wound healing on the Landry index, the degree of bone corticalization before loading, implant survival, healing-abutment complications and analgesic requirement are also recorded.
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Studientyp
Studientyp
Einschreibung (Geschätzt)
Einschreibung
Kontakte und Standorte
Studienkontakt
Studienkontakt
- Name: Lyubomir Chenchev, DMD, PhD
- Telefonnummer: +359 887 102 516
- E-Mail: lyubomir.chenchev@mu-plovdiv.bg
Studienorte
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Plovdiv, Bulgarien, 4000
- Rekrutierung
- Department of Dental Implantology, Faculty of Dental Medicine, Medical University - Plovdiv
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Kontakt:
- Lyubomir Chenchev, DMD, PhD
- Telefonnummer: +359 887 102 516
- E-Mail: lyubomir.chenchev@mu-plovdiv.bg
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Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
- Erwachsene
- Älterer Erwachsener
Akzeptiert gesunde Freiwillige
Probenahmeverfahren
Studienpopulation
Beschreibung
Inclusion Criteria:
- Age 18 years or over
- ASA physical status I or II
- A non-restorable posterior tooth (premolar or molar) indicated for extraction: clinically unrestorable crown, advanced chronic periodontitis, failed or untreatable endodontic therapy, or vertical root fracture
- Residual bone permitting implant placement with adequate primary stability
- Able and willing to give written informed consent and to attend the follow-up schedule
Exclusion Criteria:
- ASA physical status III or higher
- Pregnancy or lactation
- Uncontrolled diabetes mellitus
- Smoking more than 10 cigarettes per day
- Drug or alcohol abuse
- Current or previous bisphosphonate or other antiresorptive therapy
- Head and neck radiotherapy
- Immunosuppression
- Anticoagulant or antiplatelet therapy where the required pre-operative preparation is declined
- Psychiatric conditions preventing compliance with the study procedures
- Known titanium allergy
- Severe bruxism
- Acute infection at the surgical site
- Advanced alveolar resorption precluding immediate implant placement
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
Anzahl der Gruppen / Kohorten
Kohorten und Interventionen
Gruppe / KohorteGruppe / Kohorte |
Intervention / BehandlungIntervention / Behandlung |
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Socket class A
Posterior extraction socket in which the interradicular septal bone is sufficient to house the implant, giving circumferential bone contact along its coronal part.
Because a molar socket is frequently 10 mm or more across, a residual void commonly remains around the implant within the socket.
Participants receive immediate implant placement with a chairside customized healing abutment.
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Flapless atraumatic extraction with tooth sectioning and root-by-root removal, socket debridement and saline irrigation, followed by immediate placement of a MegaGen AnyRidge implant (MegaGen Implant Co., Daegu, South Korea; diameter 4.0-5.5 mm, length 8.5-11.5 mm) in a subcrestal position at the level of the septal bone.
Where insertion torque of at least 35 Ncm and an implant stability quotient of at least 65 are achieved, the residual gap is grafted with equine-derived xenograft granules of 0.25 mm (Maggi Biotechnology, Andezeno, Italy) and a customized healing abutment is fabricated chairside from flowable composite on a titanium temporary abutment (Spider Web technique), hand-tightened and left free of occlusal contact.
No barrier membrane is used.
Definitive loading is planned at three months.
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Socket class B
Posterior extraction socket in which the septal bone is sufficient to stabilise the implant but not to house it, so that part of the implant surface faces the socket rather than bone.
Participants receive immediate implant placement with a chairside customized healing abutment.
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Flapless atraumatic extraction with tooth sectioning and root-by-root removal, socket debridement and saline irrigation, followed by immediate placement of a MegaGen AnyRidge implant (MegaGen Implant Co., Daegu, South Korea; diameter 4.0-5.5 mm, length 8.5-11.5 mm) in a subcrestal position at the level of the septal bone.
Where insertion torque of at least 35 Ncm and an implant stability quotient of at least 65 are achieved, the residual gap is grafted with equine-derived xenograft granules of 0.25 mm (Maggi Biotechnology, Andezeno, Italy) and a customized healing abutment is fabricated chairside from flowable composite on a titanium temporary abutment (Spider Web technique), hand-tightened and left free of occlusal contact.
No barrier membrane is used.
Definitive loading is planned at three months.
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Socket class C
Posterior extraction socket with little or no septal bone, so that primary stability must be obtained from the peripheral socket walls and/or the bone apical to the socket.
Participants receive immediate implant placement with a chairside customized healing abutment.
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Flapless atraumatic extraction with tooth sectioning and root-by-root removal, socket debridement and saline irrigation, followed by immediate placement of a MegaGen AnyRidge implant (MegaGen Implant Co., Daegu, South Korea; diameter 4.0-5.5 mm, length 8.5-11.5 mm) in a subcrestal position at the level of the septal bone.
Where insertion torque of at least 35 Ncm and an implant stability quotient of at least 65 are achieved, the residual gap is grafted with equine-derived xenograft granules of 0.25 mm (Maggi Biotechnology, Andezeno, Italy) and a customized healing abutment is fabricated chairside from flowable composite on a titanium temporary abutment (Spider Web technique), hand-tightened and left free of occlusal contact.
No barrier membrane is used.
Definitive loading is planned at three months.
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Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Change in peri-implant soft-tissue volume
Zeitfenster: Baseline, 3 months after placement (before loading), and 2 weeks after loading
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Volumetric change of the peri-implant soft tissue relative to the pre-extraction baseline, measured in cubic millimetres by superimposition of intraoral scans.
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Baseline, 3 months after placement (before loading), and 2 weeks after loading
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Time to definitive loading
Zeitfenster: Up to 6 months after implant placement
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Interval in months from implant placement to definitive prosthetic loading, determined by the pre-loading radiographic assessment and the implant stability quotient.
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Up to 6 months after implant placement
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Implant stability quotient (ISQ)
Zeitfenster: At implant placement and at 3 months after placement (before loading)
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Implant stability measured by resonance frequency analysis on the ISQ scale from 1 to 100, where higher values indicate greater stability.
Stability before loading is the criterion that determines whether the implant is loaded at three months.
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At implant placement and at 3 months after placement (before loading)
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Change in alveolar bone volume
Zeitfenster: Baseline and 3 months after placement (before loading)
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Volumetric change of the peri-implant alveolar bone relative to the pre-extraction baseline, measured in cubic millimetres on cone-beam computed tomography.
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Baseline and 3 months after placement (before loading)
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Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Early wound healing
Zeitfenster: Days 7 and 14 after surgery
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Early wound healing graded on the Landry Wound Healing Index from 1 to 5, where higher values indicate better healing.
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Days 7 and 14 after surgery
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Analgesic requirement
Zeitfenster: First 5 days after surgery
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Number of participants taking the prescribed analgesic (ibuprofen L-arginine 600 mg twice daily as needed) after surgery.
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First 5 days after surgery
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Customized healing abutment complications
Zeitfenster: From surgery to definitive loading, up to 4 months
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Number of participants with abutment screw loosening, fracture of the composite healing abutment, or peri-implant infection, each recorded as present or absent.
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From surgery to definitive loading, up to 4 months
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Implant survival
Zeitfenster: Up to 24 months after implant placement
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Proportion of implants in situ and functional at the latest follow-up visit.
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Up to 24 months after implant placement
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Peri-implant bone corticalization
Zeitfenster: 3 months after placement (before loading)
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Degree of corticalization of the peri-implant bone, assessed on cone-beam computed tomography using a radiological corticalization index.
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3 months after placement (before loading)
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Mitarbeiter und Ermittler
Sponsor
Sponsor
Ermittler
Ermittler
- Hauptermittler: Tasho Gavrailov, DMD, PhD, Medical University of Plovdiv
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Studienbeginn
Primärer Abschluss (Geschätzt)
Primärer Abschluss
Studienabschluss (Geschätzt)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- NO-18/2025
- R-KNE-55/10.11.2025 (Andere Kennung: Committee on Scientific Ethics, Medical University of Plovdiv)
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Beschreibung des IPD-Plans
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Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt
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