Dental Implant Healing, Partial Edentulism Class 1, Partial Edentulism Class 3, Partial Edentulism Class II
Conditions
Keywords
dental implant surgery, dental implant placement
Brief summary
Heat generated during osteotomy and implant placement may cause thermal injury to bone and adversely affect healing and osseointegration. External irrigation is commonly used to reduce heat generation; however, cooling may be less effective at the drill-bone interface, particularly during guided implant surgery. Surgical guides with integrated irrigation channels have been developed to deliver coolant more directly to the osteotomy site, but clinical evidence regarding their effectiveness remains limited. This study will evaluate whether an internal irrigation surgical guide system reduces heat generation during osteotomy compared with a conventional guided implant surgery approach. The study will also assess clinical outcomes associated with implant placement. The findings may help inform safer and more effective protocols for guided dental implant surgery.
Detailed description
Heat generation during osteotomy and implant placement is a critical concern in implant dentistry, as excessive temperatures can lead to bone necrosis, impaired healing, and early implant failure. A temperature increase of 10°C can be considered a threshold for potential issues. Bone cell damage can occur if the temperature reaches 47°C.3 A temperature of 47°C for 1 minute can impair implant osseointegration. The current standard of care involves the use of external irrigation to reduce heat generation during the drilling process. However, this method has limitations including poor visibility of surgical site, uneven cooling at the drill-bone interface, and inability to directly cool in guided surgery. To address these concerns, recent innovations include surgical guides with integrated irrigation channels, which direct cooling fluid more efficiently to the drilling site and may reduce the risk of heat-induced bone injury. However, clinical evidence supporting the superiority of these advanced irrigation guides over traditional designs is still limited, highlighting the need for further research to optimize both surgical safety and outcomes. This study aims to evaluate the effectiveness of an internal irrigation surgical guide system in reducing heat generation during osteotomy and improving outcomes of dental implant surgery. The findings from this study could inform clinical practice and contribute to the development of safer, more effective implant placement protocols.
Interventions
DEVICEIrrigation-Integrated Surgical Guide
Guided implant osteotomy using a surgical guide with an integrated irrigation channel for delivery of sterile saline to the osteotomy site.
DEVICEConventional Surgical Guide
Conventional guided implant osteotomy using external sterile saline irrigation.
Sponsors
University of Maryland, Baltimore
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
25 Years to 75 Years
Healthy volunteers
Yes
Inclusion criteria
1. Patients aged 25+ 2. Patients requiring a dental implant in the maxilla or mandible 3. Patients with sufficient bone volume for implant placement. 4. Patients classified as ASA I or II based on the American Society of Anesthesiologists (ASA) physical status classification system. 5. Patients capable of providing informed consent and willing to adhere to study procedures and follow-up appointments. 6. Patients with adequate interarch space to accommodate guided implant surgery. 7. No history of implant placement at the experimental or control site.
Exclusion criteria
1. ASA class 3 or higher 2. Currently undergoing or history of bisphosphonate or antiresorptive therapy 3. Patients who have received prior radiation therapy to the head and neck. 4. Patients with contraindications for implant placement, such as active infections or severe periodontal disease. 5. Pregnant or breastfeeding 6. Patients with psychiatric or cognitive conditions impairing informed consent or compliance
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Early Implant Failure | From implant placement through 6 months postoperatively | Number and percentage of dental implants demonstrating clinical mobility or implant loss before prosthetic loading. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Early Marginal Bone Level Change | Implant placement, approximately 3 months postoperatively, and 6 months postoperatively | Change in marginal bone level measured on standardized periapical radiographs relative to the implant platform. |
| Peri-implant Radiolucency | Through 6 months postoperatively | Presence or absence of radiographic radiolucency surrounding the dental implant. |
| Persistent Peri-implant Pain or Suppuration | Through 6 months postoperatively | Number and percentage of implant sites demonstrating persistent pain or suppuration during postoperative follow-up. |
| Clinician-Reported Ease of Use | Immediately after implant placement | Clinician assessment of the ease of use, procedural efficiency, and perceived clinical benefit of the assigned surgical guide using a study-specific postoperative questionnaire. Each item is rated on a 5-point Likert scale ranging from 1 to 5, with higher scores indicating greater ease of use, efficiency, or perceived benefit. |
Countries
United States
Contacts
CONTACTRadi Masri
CONTACTHanae Saito
Outcome results
None listed