Esthetic Zone
Conditions
Brief summary
This study aims for evaluation of A novel method for evaluating i-PRF usage in vestibular socket therapy for immediate implant in defective fresh extraction site.
Detailed description
The ultimate objective of implant treatment is providing long-lasting, healthy hard and soft tissue architecture while minimizing intraoperative surgical trauma and postoperative complications. Reducing treatment duration and providing a predictable esthetic outcome are fundamental. Immediate implant placement in fresh extraction sockets is an appealing treatment option satisfying many of these requirements. However, a major concern with immediate implant placement is the possible resorption of the facial bone plate as indicated in multiple studies. This, in turn, results in loss of proper soft tissue support, thus compromising the final esthetic outcome of the implant- supported restoration. Furthermore, post extraction bone resorption would be compounded by the presence of a thin or preexisting facial bone defect and/or a thin gingival phenotype. Multiple approaches were suggested to prevent facial bone resorption and optimize the final esthetic outcome after immediate implant placement in sockets with intact facial bone and soft tissue. These approaches include simple ones like applying a graft in the gap between the implant and the facial socket wall and more sophisticated approaches such as the socket shield technique . The presence of bone and/or soft tissue defects after tooth extraction is not an uncommon finding, further complicating immediate implant placement. Several classifications for fresh extraction sockets were proposed to facilitate the selection of optimum treatment for individual cases. Currently, a serious of studies has shown that iPRF can produce significantly greater concentrations of platelets and leukocytes when compared to the L-PRF and A-PRF.
Interventions
PROCEDUREImmediate implant with VST
Preoperative procedure: cone beam computed tomography (CBCT) scan will be used for diagnosis and treatment planning. Nonsurgical periodontal treatment including scaling and root planning will be performed as needed. Under local anesthesia sulcular incisions will be made, and then hopeless teeth will be extracted atraumatically using periotomes. Socket lavage and curettage will be done thoroughly, and dental implants will be inserted.
PROCEDUREImmediate implant with VST and i-prf
Preoperative procedure: cone beam computed tomography (CBCT) scan will be used for diagnosis and treatment planning. Nonsurgical periodontal treatment including scaling and root planning will be performed as needed. Under local anesthesia sulcular incisions will be made, and then hopeless teeth will be extracted atraumatically using periotomes. Socket lavage and curettage will be done thoroughly, and dental implants will be inserted with i-prf.
Sponsors
Al-Azhar University
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
15 Years to 50 Years
Healthy volunteers
Yes
Inclusion criteria
* Patients has one hopeless tooth in the maxillary anterior region with TYPE II according to Elian classification of sockets (10) and sufficient bone apically and palatally. * The presence of a natural contralateral tooth for the tooth being replaced.
Exclusion criteria
* Extraction sockets were grade III. * Acute infection related to hopeless tooth. * Allergy to any material or medication used in the study. * Medically compromised patients according to modified Cornell Medical Index. * Heavy smokers.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| assessment of pink aesthetic score of the gingiva | 6 and 9 months. | Assessment of clinical and aesthetic parameters after the newly proposed immediate implant placement technique. using pik aesthetic score of gingiva, The Pink Esthetic Score (PES) is a dental assessment tool scoring gingival aesthetics around implants, evaluating mesial/distal papillae, tissue level/contour/color/texture, and alveolar deficiency. Scoring System 0 (Poor): Marked deficiency or abnormality. 1. (Fair): Slight change or minor discrepancy. 2. (Excellent): Healthy, normal, ideal appearance. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Facial bone thickness | base line, 6 and 9 months. | Assessment of radiographic parameters after the newly proposed immediate implant placement technique.will be assessed from implant surface to outer surface of bone will be recorded using cone beam CT, at base line, 6 and 9 months. and will be recorded in millimeters. |
Countries
Egypt
Outcome results
None listed