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

12. mai 2026 oppdatert av: 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.

Studieoversikt

Studietype

Intervensjonell

Registrering (Antatt)

16

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studer Kontakt Backup

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

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.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Trippel

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Aktiv komparator: 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.
Eksperimentell: 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.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change in Keratinized Tissue Width
Tidsramme: 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
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Pink Esthetic Score (PES)
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

30. juni 2026

Primær fullføring (Antatt)

30. juni 2028

Studiet fullført (Antatt)

30. juni 2028

Datoer for studieregistrering

Først innsendt

12. mai 2026

Først innsendt som oppfylte QC-kriteriene

12. mai 2026

Først lagt ut (Faktiske)

19. mai 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

19. mai 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

12. mai 2026

Sist bekreftet

1. mai 2026

Mer informasjon

Begreper knyttet til denne studien

Andre studie-ID-numre

  • STUDY20252723

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Studerer et amerikansk FDA-regulert medikamentprodukt

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Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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