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Apically Positioned Flap vs Rolled Flap for Soft Tissue Management During Implant Second-Stage Surgery

12 mei 2026 bijgewerkt door: Ohio State University

Peri-Implant Soft Tissue Management During Second-Stage Surgery With Two Different Flap Techniques: A Randomized Controlled Study

Patients are being asked to consider joining a research study that looks at two different ways dentists uncover dental implants during a small gum surgery. To join this study, Patients must have two dental implants that are ready to be uncovered. Both uncovering methods used in this research are normal, safe procedures that dentists already use every day. The purpose of this study is to learn which method helps the gums heal better, stay thicker, and look more natural over time.

If patients decide to participate, the dentist will use one method on one implant and the other method on the second implant so we can compare how each implant heals. The study lasts about one year and includes the uncovering surgery plus scheduled follow-up visits. At these visits, the dentist will gently measure your gums, take pictures, take routine dental X-rays, and use a small camera scanner to check how the gum tissue changes. Patients will also be asked to rate any pain or swelling after surgery.

Patients may have soreness, swelling, or minor bleeding-these are the same risks patients would have during normal implant care. Patients may or may not personally benefit, but the extra monitoring may help us track the healing closely, and patients' participation can help dentists improve care for future patients.

Patients can receive regular implant treatment without joining the study. The goal of this summary is to help you think about the pros and cons and decide what feels right for patients.

Studie Overzicht

Studietype

Ingrijpend

Inschrijving (Geschat)

16

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Contact Back-up

  • Naam: Guo-Liang Cheng, DDS, MS
  • Telefoonnummer: 6142924641
  • E-mail: cheng.712@osu.edu

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Volwassen
  • Oudere volwassene

Accepteert gezonde vrijwilligers

Nee

Beschrijving

Inclusion Criteria:

  1. Patients between the ages of 18-80.
  2. Non-smokers or former smokers with at least a 5-year successful cessation history.
  3. Patients with normal systemic health (ASA-I) or well-controlled/stable systemic conditions (ASA-II), such as diabetes with HbA1c < 7.0%, no recent acute myocardial infarction or cerebrovascular accidents within 6 months, or any contraindication for periodontal or implant surgery.
  4. Patients who had, or plan to have, 2 non-adjacent implants of the same system placed under a two-stage implant protocol.
  5. The diameter discrepancy of the 2 target implants must be less than 1 mm.

Exclusion Criteria:

  1. Current smokers, or smokers who have quit <5 years prior to study entry.
  2. Pregnant or lactating women
  3. Patients with substance or alcohol abuse
  4. Patients with a history of antiresorptive therapy, head and neck radiotherapy, and chemotherapy for malignant tumors
  5. Other systemic conditions or medication affecting wound healing.
  6. Poor plaque control with plaque score > 20%
  7. Active/untreated odontogenic and periodontal infections
  8. Implants placed, or planned to be placed, with one-stage implant protocol.
  9. The diameter discrepancy of the 2 target implants is equal to or greater than 1 mm (≥ 1 mm).
  10. Implants showing signs of early peri-implant bone loss or infection.
  11. Severe loss of keratinized tissue (> 50%) at the implant site
  12. Non-English speaking individuals for studies involving informed consent.

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Verdrievoudigen

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Actieve vergelijker: Apically Positioned Flap (APF)
During implant second-stage surgery, a crestal incision with vertical releases is used to elevate a flap that is repositioned apically and buccally to increase the width of keratinized tissue around the implant, followed by placement of a healing abutment and suturing.
A flap design used during implant second-stage surgery in which a crestal incision with vertical releases is performed, and the flap is repositioned apically and buccally to increase the width of keratinized tissue around the implant.
Experimenteel: Rolled Flap Technique (RFT)
During implant second-stage surgery, a full-thickness flap is elevated, and a pedicled connective tissue portion is de-epithelialized and rolled toward the buccal aspect to increase peri-implant soft tissue thickness, followed by placement of a healing abutment and suturing.
A flap design used during implant second-stage surgery in which a pedicled connective tissue portion of the flap is de-epithelialized and rolled toward the buccal aspect to increase peri-implant soft tissue thickness.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Change in Keratinized Tissue Width
Tijdsspanne: Baseline (second-stage surgery) to 12 months after surgery
Keratinized tissue width will be measured clinically in millimeters at the mid-buccal aspect of the implant using a periodontal probe at prespecified follow-up visits.
Baseline (second-stage surgery) to 12 months after surgery
Change in Peri-Implant Mucosal Thickness
Tijdsspanne: Baseline (second-stage surgery) to 12 months after surgery
Peri-implant mucosal thickness will be assessed by superimposing serial intraoral scan data to quantify changes in buccal soft tissue thickness at implant sites over time.
Baseline (second-stage surgery) to 12 months after surgery

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Pink Esthetic Score (PES)
Tijdsspanne: 3, 6, and 12 months after second-stage surgery
Peri-implant soft tissue esthetics will be evaluated using the Pink Esthetic Score based on standardized clinical photographs, assessing papilla, tissue contour, color, and texture.
3, 6, and 12 months after second-stage surgery
Change in Peri-Implant Soft Tissue Volume
Tijdsspanne: Baseline to 3, 6, and 12 months after second-stage surgery
Three-dimensional soft tissue volume changes will be quantified by superimposing serial intraoral scan data obtained at baseline and follow-up visits.
Baseline to 3, 6, and 12 months after second-stage surgery
Early Wound Healing Index
Tijdsspanne: 1 and 2 weeks after second-stage surgery
Early wound healing will be assessed using a standardized healing index based on tissue color, bleeding, granulation tissue, and epithelialization.
1 and 2 weeks after second-stage surgery
Plaque Index (PI)
Tijdsspanne: 1 week, 2 weeks, 1 month, 3 months, 6 months, and 12 months after second-stage surgery
Oral hygiene status will be assessed using the plaque index based on clinical examination at peri-implant sites.
1 week, 2 weeks, 1 month, 3 months, 6 months, and 12 months after second-stage surgery
Modified Sulcular Bleeding Index (mSBI)
Tijdsspanne: 1 week, 2 weeks, 1 month, 3 months, 6 months, and 12 months after second-stage surgery
Peri-implant soft tissue inflammation will be assessed using the modified sulcular bleeding index during clinical examination.
1 week, 2 weeks, 1 month, 3 months, 6 months, and 12 months after second-stage surgery
Postoperative Pain Score
Tijdsspanne: 1 and 2 weeks after second-stage surgery
Participant-reported pain will be measured using a visual analog scale (VAS, 0-100), where higher scores indicate greater pain intensity.
1 and 2 weeks after second-stage surgery
Postoperative Swelling Score
Tijdsspanne: 1 and 2 weeks after second-stage surgery
Participant-reported swelling will be assessed using a visual analog scale (VAS, 0-100), where higher scores indicate greater perceived swelling.
1 and 2 weeks after second-stage surgery
Change in Peri-Implant Bone Level
Tijdsspanne: Baseline to 12 months after second-stage surgery
Peri-implant marginal bone levels will be assessed using standardized periapical radiographs and compared between baseline and follow-up.
Baseline to 12 months after second-stage surgery

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Geschat)

30 juni 2026

Primaire voltooiing (Geschat)

30 juni 2028

Studie voltooiing (Geschat)

30 juni 2028

Studieregistratiedata

Eerst ingediend

12 mei 2026

Eerst ingediend dat voldeed aan de QC-criteria

12 mei 2026

Eerst geplaatst (Werkelijk)

19 mei 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

19 mei 2026

Laatste update ingediend die voldeed aan QC-criteria

12 mei 2026

Laatst geverifieerd

1 mei 2026

Meer informatie

Termen gerelateerd aan deze studie

Andere studie-ID-nummers

  • STUDY20252723

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

ONBESLIST

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

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