Jaw, Edentulous
Conditions
Keywords
Osseodensification, Piezosurgery, Magnetic mallet
Brief summary
In both complete and partial tooth loss, the use of dental implants as artificial replacements for missing teeth is a well-established and effective treatment modality, leading to high patient satisfaction and improved quality of life (1). Horizontal deficiencies of the alveolar ridge can hinder implant-supported rehabilitation due to insufficient bone volume to support implant dimensions, negatively affecting the final prosthetic outcome from both functional and esthetic perspectives (2). The split-crest technique reduces treatment time, the number of required surgical procedures, and the risk of complications, making it more acceptable to patients. Additionally, it allows for dental implant placement during the same surgical procedure and eliminates the need for a donor site for graft harvesting (3). In this study, patients with posterior tooth loss in a narrow mandibular ridge underwent dental implant rehabilitation following alveolar ridge splitting and expansion performed using osseodensification, piezosurgery, or a magnetic mallet.
Detailed description
The objective of this study is to compare ridge width gain following ridge splitting and expansion with simultaneous implant placement using osseodensification, piezosurgery, or a magnetic mallet in individuals with narrow mandibular alveolar ridges. Thirty-nine patients will be randomly allocated into three groups. In Group 1, ridge splitting and expansion will be performed using piezosurgery and bone expanders, followed by simultaneous implant placement. In Group 2, osseodensification burs will be used after ridge splitting, with simultaneous implant placement. In Group 3, a magnetic mallet will be used after ridge splitting, with simultaneous implant placement.
Interventions
PROCEDUREOsseodensification
Procedure: Two horizontal and one vertical osteotomies will be performed using piezosurgery, followed by ridge expansion with osseodensification burs. Immediate implant placement will then be performed.
PROCEDUREMagnetic mallet
Procedure: Two horizontal and one vertical osteotomies will be performed using piezosurgery, followed by ridge expansion using chisels with a magnetic mallet. Immediate implant placement will then be performed.
PROCEDUREPiezo-surgery
Two horizontal and one vertical osteotomies will be performed using piezosurgery, followed by ridge expansion using piezosurgery inserts and bone expanders. Immediate implant placement will then be performed.
Sponsors
Damascus University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Masking description
Blinding Participant and Statistician
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
1. Patients able to attend follow-up appointments. 2. Alveolar ridges with sufficient height for the placement of a standard dental implant. 3. Presence of spongy bone with at least 1 mm of width between the cortical plates. 4. Absence of systemic or local conditions that could affect bone metabolism.
Exclusion criteria
1. Severe concavity on the vestibular or palatal side of the alveolar ridge. 2. Uncontrolled periodontal disease. 3. History of radiotherapy in the head and neck region. 4. Smokers or patients with parafunctional habits.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The marginal bone loss | Assessments will be conducted 4 months after surgery and 6 months after functional loading. | Changes in bone height following ridge splitting and expansion were assessed radiographically. Measurements were performed using cone beam computed tomography (CBCT) and periapical radiography |
| The bone width gain radiographically | At baseline, after surgery, 4 months after surgery, and 6 months after functional loading. | The extent of bony expansion represents the increase in alveolar ridge width in the buccolingual direction, as determined by radiographic assessment using CBCT. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Implant stability quotients (ISQ) | Measurements will be taken at the time of surgery and again 4 months postoperatively. | The Implant Stability Quotient (ISQ), measured using the MEGA device, provides a numerical assessment of both primary and secondary stability of dental implants. The scale ranges from 1 to 100, with higher values indicating greater stability and a higher likelihood of successful osseointegration. |
| Insertion Torque | During the surgical procedure. | The implant insertion torque was measured during implant placement using a dental implant torque wrench and recorded in Newton-centimeters (N·cm). |
Countries
Syria
Outcome results
None listed