E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated | Men and women aged 18 years or more requiring jaw bone reconstruction prior to dental implant placement based on clinical and radiological examinations (CBCT Cone beam CT imaging). Areas suitable for reconstruction correspond to the mandible areas behind the canine teeth affected by lateral or vertical bone loss (focusing lateral bone loss). They must receive clear information about the study and give their informed consent to participate in the study. | |
E.1.1.1 | Medical condition in easily understood language | Men and women aged 18 years or more requiring jaw bone reconstruction prior to dental implant placement. They must receive information, and sign informed consent to participate in the study. | |
E.1.1.2 | Therapeutic area | Diseases [C] - Mouth and tooth diseases [C07] |
MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial | The principal objective is to assess it is possible to insert an implant in the reconstructed area 4 months after the grafting procedure. The decision will be made based on a clinical and radiological examination. | |
E.2.2 | Secondary objectives of the trial | The following secondary objectives will be assessed based on: Clinical results Subjective clinical appraisal of the quality of the newly formed bone after incision of the mucosa before implant placement (using the Likert scale) Implant stability measurement the using the Ostell /ISQ system Evaluation of pain, scar, functional limitations Evaluation of study related complications. Radiological results Height and width of the reconstructed ridge Quality of the newly formed bone (centralized biopsies analysis) Histological results Qualitative / quantitative assessment of the newly formed bone(centralized biopsies analysis ) | |
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria | Local criteria: o Patients presenting with an indication for an implant and wanting implant-borne prosthetic restoration. o Patients presenting with lateral or vertical bone loss (focusing lateral bone loss) of the mandible behind the canine tooth. o Lateral (width 5 mm or less) bone loss preventing the insertion of an implant without prior bone augmentation. o Endentate for more than 6 months in the region requiring reconstruction. o Endentate concerning at least 2 missing teeth in the region requiring reconstruction. o Absence of clinical signs of infection in the region requiring reconstruction. o Patients presenting with good dental hygiene (subjective criteria) o Patients not presenting with any major oral pathologies. o Dental crest size less than 5 mm. General criteria: o Adult patients over 18 and under 80 years of age. o Patients in good general health presenting with a complete blood count and renal and hepatic function values within normal limits (confirmed by local laboratory tests). o Patients with the capacity to understand medical information and give their informed consent. | |
E.4 | Principal exclusion criteria | Local criteria: o Patients presenting with clinical or radiological signs of bone infection (acute or chronic osteomyelitis). o Residual dentition close to the area requiring reconstruction with untreated endodontic disorder (apical granuloma or apical cyst). o Untreated oral infection (cellulitis, periodontitis). o Patients with poor hygiene (subjective criteria). o Surgical procedure undertaken in the area requiring reconstruction less than 6 months prior to the bone graft. o History of malignant tumors of the upper airways / digestive tract or of the jaw. o History of or scheduled cervico-facial radiation therapy. General criteria : o the patient suffer from any serious coagulation disorders that could require substitution therapy o the patient is receiving VKA therapy, which should be adjusted if necessary so that the INR does not exceed 2.5 o the patient has history of allergy to iodine or to local anesthetics (sulfites, etc.)., or a history of hematoma, or hemorrhage or blood coagulation disorders o the patient has received localized iliac crest radiotherapy contraindicating withdrawal from the irradiated site o the patient has major skin lesions or diseases. o Patients presenting with bone metabolism disorders: hypophosphatemia, primary parathyroid osteitis or that is secondary to chronic renal insufficiency or osteomalacia, Paget’s disease, vitamin D-related disorders, osteoporosis. o Pregnant or breastfeeding women or women not using effective contraception if they are of childbearing age. o Patients presenting with cancerous disorders (carcinoma, sarcoma, leukemia, lymphoma) or psychiatric disorders or with uncontrolled systemic diseases (diabetes, hypertension), or chronic renal disease. o Severe bruxism. o History of chemotherapy. o Smoking or alcohol addiction. Occasional consumption of alcohol and/or smoking will be noted in the case report form. o Patients with an ASA score of 0 or 1, incapable of tolerating general anesthesia. o Immunosuppression o Body mass index outside the normal range, particularly > 30 because of increased surgical risk at the time of BM harvesting from the iliac crest. o Risk of remote infection (orthopedic prosthesis implanted in the previous 6 months, patients presenting with a high risk of infective endocarditis, presence of pulmonary arteriovenous shunt, etc.). o HIV, HTLV and/or syphilis seropositivity. o Hepatitis B or C infection. o Active autoimmune disease. o History of immunosuppressant treatment or bone marrow treatment. o Administration of treatment interfering with bone metabolism. o Patients requiring antibiotic prophylaxis before any dental procedure o Concomitant treatments: history of treatment or current treatment with bisphosphonates, long term corticosteroid treatment. o Minor(s) or persons of full age under tutorship. Tests are left to the discretion of the physician | |
E.5 End points |
E.5.1 | Primary end point(s) | At the end of the healing period (4-6 months), radiological and clinical examinations will be performed to determine whether or not the patient may have one or more implants inserted. | |
E.5.1.1 | Timepoint(s) of evaluation of this end point | |
E.5.2 | Secondary end point(s) | Clinical and radiological follow-up is programmed for 12 months after the implant loading. It includes subjective satisfaction assessment, a clinical examination, implant stability measurement by Resonance Frequency Analysis and x-ray examination of the implant. | |
E.5.2.1 | Timepoint(s) of evaluation of this end point | |
E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | No |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 1 |
E.8.3 | The trial involves single site in the Member State concerned | Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 3 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 | Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial | |
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 3 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |