Infected Extraction Sockets
Conditions
Brief summary
Background: Dental implantology offers reliable tooth replacement options, but infections in extraction sockets can compromise osseointegration. Conventional disinfection methods, such as chlorhexidine, often fail to completely eliminate pathogenic microorganisms and may impair tissue healing. Photoactivated disinfection (PAD) and laser disinfection have emerged as promising alternatives. PAD employs a light-activated photosensitizer to generate reactive oxygen species (ROS), effectively disrupting bacterial membranes while preserving host cell viability. In parallel, laser disinfection utilizes focused light energy to eliminate bacterial biofilms and contaminated tissue with minimal thermal damage. In this study, we specifically utilize the Er,Cr:YSGG laser, which operates at a water-absorbing wavelength to induce micro-explosions that mechanically disrupt biofilms and promote a cleaner socket environment for improved osseointegration. Aim of the study: To compare the effectiveness of photoactivated disinfection (PAD), Er,Cr:YSGG laser disinfection, and conventional disinfection with chlorhexidine in decontaminating infected extraction sockets prior to immediate implant placement, promoting bone healing, and improving the osseointegration and stability of immediate implants placed in infected extraction sockets.
Interventions
Standard treatment + Toluidine blue + Light activation + Immediate implant placement
OTHEREr,Cr:YSGG laser disinfection
Standard treatment + Er,Cr:YSGG laser application + Immediate Implant placement
OTHERChlorohexidine disinfection
Standard treatment + Chlorohexidine Irrigation + Immediate Implant placement
Sponsors
Alexandria University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Patients having posterior tooth/teeth indicated for extraction * Patients must exhibit radiographic evidence of infection, defined as chronic periapical pathology (radiolucency) * The extraction site should have intact surrounding alveolar bone * There must be at least 2 mm of sound bone beyond the root apex * Patients must be in overall good health and free from uncontrolled systemic conditions
Exclusion criteria
* History of radiation therapy in the head and neck region * Pregnant or lactating women * Patients on long-term antibiotic therapy, as it could influence the outcomes * Heavy Smoking: More than 10-15 cigarettes per day. * Significant bruxism or parafunctional habits affecting implant stability.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| implant stability | 6 months | Resonance Frequency Analysis (RFA) using Osstell ISQ: Implant Stability Quotient (ISQ) values will be recorded at 6 months after implant placement. Values from 1 to 100, the higher the ISQ, the higher the stability of the implant. |
| change in bone density | baseline and 6 months | Bone density assessment using radiographs immediately post-operative and at 6 months. |
| change in marginal bone loss | baseline and 6 months | Marginal Bone Loss (MBL) assessment using radiographs immediately postoperative and at 6 months. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| change in pain scores | up to 7 days | Post-operative pain will be assessed through a 10-point visual analogue scale (VAS). (0-1 = No pain, 2-4 = mild pain, 5-7 = moderate pain, 8-10 = severe pain). |
| change in post-operative edema | up to 7 days | Post-operative edema will be assessed as follows None (no swelling), Mild (intra oral swelling confined to surgical field), Moderate (extra oral swelling in the surgical zone), Severe (extra oral swelling spreading beyond the surgical zone) |
Countries
Egypt
Outcome results
None listed