Alveolar Bone Loss, Dental Implant Failure Nos, Peri-Implantitis
Conditions
Keywords
Ridge splitting, Autogenous Tooth Graft, simultaneous implant placement
Brief summary
The aim of this study is to evaluate the radiographic and the clinical outcomes of application of the alveolar ridge splitting (ARS) in combination with ATG, associated with immediate implant placement versus ARS in combination with autogenous bone graft, associated with immediate implant placement in patients with horizontal bony insufficiency of alveolar ridges.
Detailed description
In cases of a narrow ridge, the alveolar ridge expansion technique by means of hand osteotomes with gradually increasing dimensions was introduced by Tatum and modified by Summers and it can be used regardless of the bone quality. Searching for absolute biocompatible material and taking into account the features of the enamel and dentin, using the tooth as an autologous grafting material was first advocated. Tooth and bone are sharing many characteristics, which supports the idea that tooth could be used as a grafting material. In fact, hydroxyapatite crystals make up the tooth inorganic composition (65%). Moreover, Collagen (mostly type I) and non-collagenic proteins comprised up the tooth organic component (35%). In addition, because autologous tooth graft (ATG) is denser than bone, minimal resorption rates were found to be advantageous to autobone. For the purpose of employing ATG as a grafting material, various methods and techniques have been suggested for developing undemineralized, demineralized or partially demineralized ATG.The outcomes of utilizing undemineralized autologous tooth graft (UATG) around SDIP following RSEA have not yet been evaluated. Therefore, the current trial aimed to assess the clinical and radiological performances of UATG for the treatment of horizontal alveolar ridge deficiencies using RSEA with SDIP. The aim of this study is to evaluate the radiographic and the clinical outcomes of application of the alveolar ridge splitting (ARS) in combination with ATG, associated with immediate implant placement versus ARS in combination with autogenous bone graft, associated with immediate implant placement in patients with horizontal bony insufficiency of alveolar ridges.
Interventions
PROCEDUREautogenous tooth graft
undemineralized autogenous tooth graft will augment the gap between the splitted ridge and the simultaneously \[laced implant fixture
PROCEDUREautogenous bone graft
autogenous bone graft will augment the gap between the splitted ridge and the simultaneously \[laced implant fixture
Sponsors
Kafrelsheikh University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Masking description
The present clinical trial was single-blinded one as the evaluator and the statistician were both blinded. While both the implantologist or the participant were not blinded as the interventions were dissimilar.
Intervention model description
single-center, prospective, single-blinded, randomized parallel two-arm controlled clinical trial
Eligibility
Sex/Gender
ALL
Age
18 Years to 40 Years
Healthy volunteers
Yes
Inclusion criteria
* Good general health at the time of surgery * At least 3 months of healing after tooth extraction * Horizontally compromised alveolar ridges at least 10 mm high and 3 mm wide.
Exclusion criteria
* A vertical bone defect in the edentulous ridge; * Thick cortex in the labial/buccal with less cancellous bone inside; * Obvious undercut on the labial/buccal side; * Uncontrolled periodontal conditions or other oral disorders; * A history of radiotherapy in the head and neck region
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Stability Quotient of Implants (SQI) | 12-month. | The implant stability was recorded using Osstell TM. Following implant insertion, SQI readings were taken immediately, then again after six and twelve months. |
| Horizontal bone dimensions (HBDs) | 12 months | The HBD alterations were assessed by measuring horizontal spacing between the external edges of labial and palatal bony plates at a level 2mm apical of the fixture platform. |
| Peri-implant Bone Density (PBD) | 12 months | For consistent measurement of the PBD, 1-mm-diameter Region of interest (RI) was selected and traced 1.2 mm distant from the fixture on the cross-sectional slices followed by counting the threshold pixels inside the RI. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pink esthetic score (PES) | 12 months | Digital intraoral scannings were gathered before surgery, at 6 and 12-months after implantation, to evaluate the PES changes. Seven variables were assessed in relation to a nearby reference teeth: mesial and distal papilla, soft tissue level, colour, texture and shape, and alveolar bone defects. 14 is the maximum possible value for PES. Scoring each parameter on a 0-2 scale: 0 is the minimum score and 2 is the maximum. |
Countries
Egypt
Outcome results
None listed