Immediate Implant Placement in Mandibular Molar Extraction Sockets, Jumping Gap, Tooth Loss and Rehabillitation
Conditions
Keywords
Jumping Gap, Immediate Implant Placement, Molar Extraction Sockets, Xenograft, e-PRF
Brief summary
This study aims to clinically and digitally evaluate immediate implants placed in mandibular molar extraction sockets and compare the outcomes of xenograft, e-PRF, and no grafting material within the jumping gap.
Detailed description
Following atraumatic extraction and implant site preparation within the interradicular bone, the implant will be immediately inserted. A chairside customized healing abutment will then be fabricated to seal the extraction socket. According to group allocation, the jumping gap will be filled with xenograft, e-PRF, or left unfilled before placement of the customized healing abutment. Definitive prosthetic restoration will be delivered after three months of implant insertion. 1. Clinical Evaluation: Implant stability will be assessed at implant placement and at 3 and 6 months using resonance frequency analysis with the Osstell device, with implant stability quotient (ISQ) values recorded. Peri-implant soft-tissue health will be assessed using the modified sulcus bleeding index (mSBI) at 3 and 6 months intervals. 2. Digital Evaluation: Peri-implant soft-tissue dimensional changes will be assessed using intraoral optical scans obtained preoperatively and at 1, 3, and 6 months. The resulting STL files will be superimposed using a best-fit alignment algorithm to evaluate dimensional changes in the peri-implant soft tissues. 3. Radiographic Evaluation: CBCT examinations will be obtained preoperatively, immediately after implant placement, and at 6 months. Three-dimensional superimposition of baseline and follow-up DICOM datasets will be used to evaluate hard-tissue dimensional changes.
Interventions
PROCEDUREXenograft jumping gap filling material
after tooth extraction and implant placement, xenograft particulates were placed to fill the jumping gap before sealing the socket with a chairside socket sealing abutment.
PROCEDUREe-PRF jumping gap filling material
after tooth extraction and implant placement, e-PRF was prepared from the patient's collected blood and placed to fill the jumping gap before sealing the socket with a chairside socket sealing abutment.
Sponsors
Mansoura University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Any partially dentate patients with non-restorable mandibular molar requiring dental extraction. * Extraction sockets with intact bony walls and interradicular bone. * Jumping gap more than 2mm.
Exclusion criteria
* Patients with any pathological lesion or aggressive periodontal disease at the planned surgical site impaired the immediate implant placement. * Heavy smokers (≥ pack per day) * Pregnancy. * Patients with systemic diseases that absolutely contraindicate implant placement or para-functional habits (bruxism or clenching). * Patients with poor oral hygiene or aggressive periodontal disease.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Linear and Volumetric Digital Evaluation of implant site | preoperative, 1 month, 3 months and 6 months postoperative. | Peri-implant soft-tissue dimensional changes assessment using intraoral optical scans and resulting STL files superimposition using a best-fit alignment algorithm to evaluate dimensional changes in the peri-implant soft tissues. |
| Radiographic Evaluation of Implant Site Volumetric Change | preoperatively, immediately after implant placement, and at 6 months | CBCT examinations obtained and three-dimensional superimposition of baseline and follow-up DICOM datasets used to evaluate hard-tissue dimensional changes. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Implant Stability | at implant placement, 3 months and 6 months postoperative. | Implant stability assessment using resonance frequency analysis with the Osstell device to record implant stability quotient (ISQ) values. |
| Modified Sulcus Bleeding Index | at 3 and 6 months postoperative. | Evaluation of peri-implant soft-tissue health using the modified sulcus bleeding index (mSBI). |
Countries
Egypt
Outcome results
None listed