Implant Site Reaction
Conditions
Keywords
immediate posterior implants, socket sealing abutments
Brief summary
One of the major challenges one clinician can face while performing immediate placement on posterior area, is the ability of obtaining a hermetic primary closure of the soft tissue. The use of socket sealing abutment may provide advantages in maintaining the existing soft tissue architecture, preserving crestal bone height and reducing the risk of premature loading of the immediate implant during healing
Detailed description
One of the major challenges one clinician can face while performing immediate placement on posterior area, is the ability of obtaining a hermetic primary closure of the soft tissue. This technical skill is nearly always combined with invasive surgical procedures and significant post op recovery (displacement of the muco-gingival line, periosteal releasing incision, flaps, sutures, membrane stabilization, …).the use of customized healing abutment may provide advantages in maintaining the existing soft tissue architecture, preserving crestal bone height and reducing the risk of premature loading of the immediate implant during healing. Moreover, customized healing abutment can passively accommodate the definitive prosthesis with minimal or no pressure placement preventing biological or mechanical trauma during the prosthetic phases. This may lead to better long-term tissue stability and avoid the pain perceived by the patients from compression of tissues in case of standard healing abutment. the primary aim of this randomized controlled clinical study is to clinically evaluate and compare the soft tissue outcomes of final immediate implant restorations placed in maxillary posterior sites that were conditioned by CAD/CAM fabricated socket sealing abutments versus standard healing abutments. The secondary aim of this study is to radiographically assess peri-implant bone level changes of the final immediate implant restorations placed in maxillary posterior sites for the two experimental groups.
Interventions
PROCEDUREcad/cam socket sealing abutment
Anatomically formed healing abutments that can solve many of the problems inherent to immediate posterior implant placement and to optimize the conditioning of supra implant tissue architecture enhancing the emergence profile of the final implant restoration
PROCEDUREstandard healing abutment
Standard healing abutment will be inserted after removal of cover screw after immediate implant insertion and then a muco-periosteal flap will be reflected for the primary closure of the socket and sutured around the standard healing abutment.
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* 1\. The patients ≥18 years old. 2. Non-restorable maxillary posterior teeth with intact adjacent teeth. 3. Sufficient bone to insert a dental implant with a minimum length of 8 mm and at least 3.5 mm in diameter. 4\. Type1 extraction socket according to Elian et al, 200742 (Labial bone plate and associated soft tissues are completely intact). 5\. Sufficient mesio-distal, bucco-lingual, and inter-occlusal space for placement of the definite restoration. 6\. Adequate oral hygiene (full mouth plaque score \< 25% and full mouth bleeding score \< 25%). 7\. Patients capable of understanding and giving informed consent.
Exclusion criteria
* 1\. Alcohol or drug abusers. 2. Heavy smokers (\> 10 cigarettes/day). 3. Presence of acute periapical infections. 4. Radiotherapy to the head and neck region for malignancy. 5. Bruxism or TMJ dysfunction. 6. Intake of drugs affecting bone metabolism. 7. Uncontrolled diabetic patients. 8. Pregnant women.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pink esthetic score | one year of follow up | clinical evaluation of soft tissue profile around the implant restorations with minimum score of 0 and maximum score of 10 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Functional implant prosthodontic score | one year of follow up | clinical evaluation of implant restoration assembly and radiographic crestal bone loss with minimum score of 0 and maximum score of 10 |
Countries
Egypt
Outcome results
None listed