Immediate implant placement (IIP) Oral Health
Conditions
Interventions
All enrolled participants (single-arm cohort) will undergo atraumatic, flapless extraction of the designated unrestorable mandibular or maxillary molar using sectioning techniques to preserve all four
Sponsors
Damascus University
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Presence of a permanent first mandibular molar indicated for extraction and immediate implant placement, with the extraction socket classified as Class I according to Elian et al. (2007) 2. Age =18 years 3. Presence of adjacent teeth to the tooth indicated for extraction. 4. Tooth indicated for extraction is free from acute infection (no periapical swelling or fistula) 5. Intact buccal plate at the extraction site, either before or after extraction 6. Absence of dehiscence or fenestration defects 7. Presence of =2 mm width of keratinized mucosa at the extraction/implant site 8. Good oral hygiene (plaque index =20% according to the O’Leary index)
Exclusion criteria
Exclusion criteria: 1. Systemic conditions: uncontrolled diabetes, bleeding or coagulation disorders, history of head and neck radiotherapy or chemotherapy within the last 6 months 2. Current use of medications affecting bone healing or oral surgery (e.g., corticosteroids, oral anticoagulants) 3. Patients who are smokers or alcohol-dependent 4. Pregnant or breastfeeding women
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Implant success rate measured by the dental researcher 4 months after the first surgical stage, according to the Pisa consensus criteria of the International Congress of Oral Implantologists (ICOI) | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Implant survival rate measured by the dental researcher, defined as the proportion of implants remaining functional and in situ (not lost or failed), during the study period 2. Days of impaired daily activity, measured using self-reported in a diary as the number of days the patient was unable to fully or partially perform daily activities, during the first postoperative week 3. Postoperative pain was assessed by measuring daily pain levels using a Visual Analogue Scale (VAS), and self-reporting of the number of analgesic tablets consumed, during the first postoperative week 4. Postoperative swelling (edema) was measured using a 4-point scale (0: none, 1: mild, 2: moderate, 3: severe) during the first postoperative week 5. Surgical and postoperative complications were assessed by measuring: 5.1. Intraoperative: bleeding, injury to adjacent structures, implant displacement, buccal plate integrity (yes/no, reported by clinician/patient). 5.2. Postoperative: early implant loss, bleeding, soft tissue dehiscence or infection at 1 week, 2 weeks, and 4 months 6. Marginal bone level (MBL): Measured mesially and distally using standardized digital radiographs (parallel technique with sensor holder), immediately after placement and after 4 months. Bone loss calculated with ImageJ software 7. Insertion torque: Maximum torque value recorded during implant placement (N·cm) 8. Implant stability (Resonance Frequency Analysis, RFA): Implant Stability Quotient (ISQ) values measured at 4 sites (mesial, distal, buccal, lingual) immediately after placement and at 4 months, averaged per implant 9. Osseointegration: measured using a reverse torque test (=32 N·cm) after 4 months 10. Patient satisfaction: measured using a 5-point Likert scale (1: strongly agree, 5: strongly disagree) at 4 months post-surgery 11. Soft tissue biotype: Thin vs thick biotype assessed by probe transparency test at baseline and 4 months 12. Height of attached mucosa: Measured with periodontal probe at bas | — |
Countries
Syria
Contacts
Public ContactFouad Agha
Outcome results
None listed