Alveolar Ridge Preservation, Immediate Implant Loading, Tooth Extraction
Conditions
Keywords
Socket preservation, immediate loading, autogenous dentin graft, beta-tricalcium phosphate, dental implant
Brief summary
This randomized controlled clinical trial aimed to evaluate the clinical, radiographic, and histological outcomes of immediate implant loading in extraction sockets preserved using autogenous mineralized dentin graft (AMDG), beta-tricalcium phosphate (β-TCP), or no grafting. Twenty-two patients requiring extraction of maxillary premolars were enrolled, contributing a total of 27 extraction sites. Sites were randomly allocated into three groups: AMDG, β-TCP, or ungrafted control. Following socket preservation, dental implants were placed after a 6-month healing period and immediately loaded within 48 hours. Alveolar ridge dimensional changes were assessed using cone-beam computed tomography (CBCT) between implant placement and 2 years post-loading. Implant stability, peri-implant soft tissue health, and probing depths were evaluated at loading and during follow-up visits. Histological evaluation of regenerated bone was performed at the time of implant placement. The study sought to determine whether AMDG provides comparable or superior outcomes to β-TCP and ungrafted sockets in supporting immediate implant loading.
Detailed description
Immediate implant loading requires adequate primary stability and sufficient bone volume and quality. Ridge preservation techniques are therefore critical in maintaining post-extraction socket dimensions. Autogenous dentin grafts have recently gained attention due to their osteoconductive properties, biocompatibility, and cost-effectiveness. This study compares AMDG with a commonly used synthetic graft material (β-TCP) and ungrafted sockets to assess their influence on ridge preservation, implant stability, peri-implant tissue health, and bone quality under immediate loading conditions.
Interventions
PROCEDUREAutogenous Mineralized Dentin Graft
Extraction sockets were preserved using AMDG prepared from the patient's own extracted tooth. Implants were placed 6 months post-grafting and immediately loaded within 48 hours.
PROCEDUREBeta-Tricalcium Phosphate
Extraction sockets were preserved using synthetic β-TCP bone graft. Implants were placed 6 months post-grafting and immediately loaded within 48 hours.
PROCEDUREControl (Ungrafted Socket)
Extraction sockets were left ungrafted and allowed to heal naturally. Implants were placed 6 months post-extraction and immediately loaded within 48 hours.
Sponsors
Soaad Tolba Mohammed Tolba Badawi
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Adults aged 18 years or older * Patients requiring extraction of a maxillary premolar tooth * Adequate bone height to allow delayed implant placement * Good oral hygiene and compliance with follow-up visits * Ability to understand the study procedures and provide written informed consent
Exclusion criteria
* Presence of uncontrolled systemic diseases that could affect bone healing * History of radiotherapy to the head and neck region * Heavy smoking * Active infection or untreated periodontal disease at the extraction site * History of bisphosphonate or other antiresorptive drug use * Poor oral hygiene or inability to comply with study protocol
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Alveolar Ridge Width Change | From 6 months post-extraction (implant placement) to 2 years post-loading | Dimensional changes in alveolar ridge width were assessed using CBCT at the center, mesial, and distal sections of each implant site. Measurements were compared between the grafted (AMDG and β-TCP) and control groups over the follow-up period.Unit of Measure: Millimeters (mm) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Implant Stability Quotient (ISQ) | At implant loading, 3 months, and 6 months post-loading | Implant stability was assessed using resonance frequency analysis to record ISQ values at each follow-up visit for all groups.Unit of Measure: ISQ units(0-100) |
| Modified Sulcus Bleeding Index (mSBI) | At implant loading, 3 months, and 6 months post-loading | Peri-implant soft tissue inflammation was evaluated using the mSBI at each follow-up visit for all groups. Unit of Measure: Index score (0-5 scale) |
| Probing Pocket Depth (PPD) | At implant loading, 3 months, and 6 months post-loading | Probing depth around each implant was measured using a periodontal probe to assess peri-implant tissue health across all groups.Unit of Measure: Millimeters (mm) |
| Histological Bone Quality | 6 months post-grafting (at implant placement) | Histological analysis of bone biopsies obtained from grafted and control sites was performed to evaluate bone maturity, remodeling, and osseointegration. Unit of Measure: Qualitative histological score. |
Countries
Egypt
Outcome results
None listed