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Loss of Teeth Due to ExtractionNCT01963884

Relate Tooth Alveolar Extraction Socket Anatomy to Alveolar Remodeling Rate

An observational study of Loss of Teeth Due to Extraction and Alveolar Bone Loss, run by Implantology Institute at 1 site in Portugal.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

In patients that are going to be subjected to a tooth extraction in the anterior maxillary (from canine to canine) does the position of the intact alveolar socket related to maxillary basal bone interferes with the rate of resorption and remodeling process of the alveolar ridge ? Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
What is being tested?
Tooth Extraction, Cone-Beam technology evaluation and Measure Alveolar Socket Remodeling
Type of treatment
Surgery or procedure
How many people
45 participants
Where
1 sitePortugal
Study dates
Jan 2014to Aug 2016
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: Patients that require at least on tooth extraction of the upper anterior jaw (maxilla) canine, central incisor and lateral incisor.

Who may be able to join

  • Patient that require a maxillary anterior extraction
  • Sign Informed Consent
  • Indication for a two-stage implant placement

Who cannot join

  • Indication for immediate implants
  • Indication for alveolar socket preservation or bone regeneration
  • Indication for soft tissue graft
  • Diabetes
  • taking oral or intravenous biphosphonates

Trial locations and contacts

1 site in 1 country.

André Chen, Msc contact

00351919774343

tsouchen@gmail.com

Elena Cervino, Msc contact

00351919074338

elecer@gmail.com

Portugal1 site
  • Instituto de Implantologia

    Lisbon, Lisbon District, 1500-662

    joana velez, joana.velez@institutodeimplantologia.com

    Andre Chen, Msc

Other trials in Portugal

About this study

Official title: Study of Tooth Alveolar Extraction Socket Anatomy and Its Relation to Alveolar Post-extraction Changes

In patients that are going to be subjected to a tooth extraction in the anterior maxillary (from canine to canine) does the position of the intact alveolar socket related to maxillary basal bone interferes with the rate of resorption and remodeling process of the alveolar ridge ?

Read the detailed description

We intend to demonstrate the physiologic process of the post-extraction socket and we hypothesized that the position of the socket in relation to basal bone, may project the remodeling process through three different equations.

A- tooth-periodontal apparatus is placed buccally of the basal bone - Equation 1

Anatomy Features- only 1-2 mm of lamina dura on the buccal part, 1-2mm of lamina dura on the palatal, plus basal bone.

Physiologic features - when the alveolar apparatus remodels, after tooth extraction, the amount that we project for resorption is : 1-2 mm of buccal lamina dura, the buccal-palatal dimension of the tooth that was extracted plus the 1-2 mm of palatal lamina dura.

At 6 month we hypothesized that 3 mm of trabecular bone may be present, so we may account for 2-3 mm more.

Due to conical anatomy of anterior teeth, the amount of trabecular bone will be more pronounced in the coronal area than in apical area, so we also account for that variation.

At this stage we project that the amount of ridge dimension will be :

buccal soft tissue (BST) + trabecular alveolar bone (ATB) + basal bone (BB) + palatal soft tissue (PST) Equation at 6 Month = (BST + ATB + PST).

But at 1 year the trabecular bone may be absent, so we project that the equation will be :

buccal soft tissue+basal bone+palatal soft tissue. Equation at 1 Year (BST + BB + PST)

at the end, ridge dimension will be : palatal basal bone plus soft tissue buccally and palatally.

Numbers for Buccal placed alveolus apparatus :

At Pre-extraction appointment (estimate) :

BST+ Lamina Dura Buccal + tooth buccal lingual dimension + palatal lamina dura + BB + PST (3mm + 1mm + X+ 1mm + Y + 3mm) = 8 mm + X (a or b or c) + Y (a or b or c)

X = For Anterior Teeth= 3 measures = coronal (Xa) + middle (Xb) + apical (Xc) Y- Basal bone is genetically predetermined and vary from person to person but geometrically can have two measures one middle (Ya) and one apical (Yb)

Note : the buccal-lingual dimensions vary from coronal to apical (either in the tooth root and in basal bone), so we hypothesize that the subtraction from pre-extraction values to post-extraction will more pronounced in coronal area than in the apical area.

At 6 month post-extraction :

BST+ ATB (varies coronal (a) , middle (b) , apical (c)) + BB + PST (3mm + ATB (a or b or c) + Y + 3mm) = 6 mm + ATB (a or b or c) + Y (a or b)

At 1 Year post-extraction

BST + BB + PST (3mm + X1 + 3mm) = 6 mm + Y (a or b )

Example For Central Incisor :

Before Extraction (estimate)

at coronal part pre-extraction : 3 + 1 + 10 (Xa) + 1 + 3 (Ya) + 3 = 21 mm at middle part pre-extraction : 3 + 1 + 5 (Xb) + 1 + 5 (Yb) + 3 = 18 mm at apical part pre-extraction : 3 + 1 + 2 (Xc) + 1 + 8 (Yc) + 3 = 18 mm

After Extraction 6 month (estimate)

at coronal part post-extraction : 3 + 3 (ATBa) + 3 + 3 = 12 mm at middle part post-extraction : 3 + 2 (ATBb) + 5 + 3 = 13 mm at apical part post-extraction : 3 + 1 (ATBc) + 8 + 3 = 15 mm

Variation expected (estimate) from Pre-extraction to 6 month post-extraction in buccally placed alveolar socket will be (estimate):

At coronal part ⨺ (variation) = 9 mm (43% reduction) at middle part ⨺ (variation) = 5 mm (28% reduction) at middle part ⨺ (variation) = 3 mm (17% reduction)

After Extraction 1 Year (estimate)

at coronal part post-extraction : 3 + 3 + 3 = 9 mm at middle part post-extraction : 3 + 5 + 3 = 11 mm at apical part post-extraction : 3 + 8 + 3 = 14 mm

Variation expected (estimate) from Pre-extraction to 1 year post extraction in buccally placed alveolar socket will be:

At coronal part ⨺ (variation) = 12 mm (57% reduction) at middle part ⨺ (variation) = 7 mm (39% reduction) at middle part ⨺ (variation) = 4 mm (22% reduction)

B- Tooth-periodontal apparatus is inferior of the basal bone (true socket) - Equation 2

Anatomy features- only 1-2 mm of lamina dura on the buccal and palatal part, no basal bone palatal, the basal bone is superior to the alveolar process.

Physiologic features - when the alveolar apparatus remodels after tooth extraction we project that the amount of resorption will be 1-2 mm of buccal lamina dura, the buccal-palatal dimension of the tooth that was extracted, plus the 1-2 mm of palatal lamina dura.

At 6 month, we hypothesized that 3 mm of trabecular bone may be present, so we may account for 2-3 mm more. At this stage the amount of ridge dimension will be composed by :

buccal soft tissue (BST) + trabecular alveolar bone (ATB) + palatal soft tissue (PST), (BST+ATB+PST).

note : lamina dura disappears, but because periosteum has to adhere to bone an outer cortical forms that surrounds remaining trabecular bone.

Numbers for Inferior placed alveolus apparatus :

At Pre-extraction appointment (estimate) :

BST+ Lamina Dura Buccal + tooth buccal-lingual dimension + palatal lamina dura + PST Equation = (3mm + 1mm + X+ 1mm + 3mm) = 8 mm + X (a or b or c)

X = For Anterior Teeth = 3 measures = coronal (Xa) + middle (Xb) + apical (Xc)

note : the buccal-lingual dimensions vary from coronal to apical (either in the tooth root and in basal bone), so we hypothesize that the subtraction from pre-extraction values to post-extraction will more pronounced in coronal area than in the apical area

At 6 month post-extraction (estimate) :

BST+ ATB (varies coronal (a) , middle (b) , apical (c) + PST Equation = (3mm + ATB (a or b or c) + 3mm) = 6 mm + ATB (a or b or c)

At 1 Year post-extraction (estimate)

BST + ATB (a or b or c) + PST (3mm + X1 + 3mm) = 6 mm + ATB (a or b or c)

Example For Central Incisor :

Before Extraction (estimate)

at coronal part pre-extraction : 3 + 1 + 10 (Xa) + 1 + 3 = 18 mm at middle part pre-extraction : 3 + 1 + 5 (Xb) + 1 + 3 = 13 mm at apical part pre-extraction : 3 + 1 + 2 (Xc) + 1 + 3 = 10 mm

After Extraction 6 month (estimate)

at coronal part post-extraction : 3 + 3 (ATBa) + 3 = 9 mm at middle part post-extraction : 3 + 2 (ATBb) + 3 = 8 mm at apical part post-extraction : 3 + 1 (ATBc) + 3 = 7 mm

Variation expected (projected) from Pre-extraction to 6 month post-extraction in inferior placed alveolar socket will be (estimate):

At coronal part ⨺ (variation) = 9 mm (43% reduction) at middle part ⨺ (variation) = 5 mm (28% reduction) at middle part ⨺ (variation) = 3 mm (17% reduction)

After Extraction 1 Year (estimate)

at coronal part post-extraction : 3 + 2 + 3 = 8 mm at middle part post-extraction : 3 + 2 + 3 = 8 mm at apical part post-extraction : 3 + 2 + 3 = 8 mm

Variation expected (estimate) from Pre-extraction to 1 year post-extraction in inferior placed alveolar socket will be:

at coronal part ⨺ (variation) = 10 mm (57% reduction) at middle part ⨺ (variation) = 5 mm (38% reduction) at middle part ⨺ (variation) = 2 mm (20% reduction)

C- tooth-periodontal apparatus is in (imbedded) the basal bone - Equation 3

Anatomy features- only 1-2 mm of lamina dura on the buccal part, 1-2mm of lamina dura on the palatal plus basal bone on the buccal and on the lingual part.

Physiologic features - when the alveolar apparatus remodels after tooth extraction, we project that the amount of resorption will be 1-2 mm of buccal lamina dura the buccal-palatal dimension of the tooth that was extracted plus the 1-2 mm of palatal lamina dura.

At 6 month, we hypothesized that 3 mm of trabecular bone may be present so we may account for 2-3mm more. At this stage the amount of ridge dimension will be composed by:

buccal soft tissue (BST) + Buccal basal bone (BBB) + trabecular alveolar bone (ATB)+ palatal basal bone (LBB)+ palatal soft tissue (PST), Equation = (BST+BBB+ATB+PBB+PST)

Numbers for Imbedded alveolus apparatus :

At Pre-extraction appointment (estimate):

BST+ BBB (Y1 a or b or c) + Lamina Dura Buccal + tooth buccal lingual dimension (X a or b or c) + palatal lamina dura + PBB (Y2 a or b or c or d) + PST (3mm + 1mm + X+ 1mm + 3mm) = 8 mm +Y1 + X (a or b or c or d) +Y2

X = For Anterior teeth = 3 measures = coronal (Xa) + middle (Xb) + apical (Xc)

Y1- Buccal Basal bone is genetically predetermined and vary from person to person geometrically 3 measures coronal (a) middle (b) and apical (c)

Y2- Palatal Basal bone (PBB) is genetically predetermined and vary from person to person geometrically 3 measures coronal (a) middle (b) and apical (c)

note : the buccal-lingual dimensions vary from coronal to apical (either in the tooth root and in basal bone), so we hypothesize that the subtraction from pre-extraction values to post-extraction will more pronounced in coronal area than in the apical area

At 6 month post-extraction (estimate):

BST+ BBB (Y1 a or b or c) + ATB (varies coronal (a) , middle (b) , apical (c)) + PBB (Y2 a or b or c) + PST (3mm + Y1+ ATB (a or b or c) + Y2 + 3mm) = 6 mm + ATB (a or b or c)

At 1 Year post-extraction (estimate)

BST+ BBB (Y1 a or b or c) + ATB (a or b or c) + PBB (Y2 a or b or c) + PST (3mm + X1 + 3mm) = 6 mm + Y1 (a or b or c) + ATB (a or b or c) + + PBB (Y2 a or b or c)

Example For Central Incisor :

Before Extraction (estimate)

at coronal part pre-extraction : 3 + 3 + 1 + 10 (Xa) + 1 + 3 + 3 = 24 mm at middle part pre-extraction : 3 + 5 + 1+ 5 (Xb) + 1 + 5 + 3 = 23 mm at apical part pre-extraction : 3 + 8 + 1 + 2 (Xc) + 1 + 8 + 3 = 26 mm

After Extraction 6 month (estimate)

at coronal part post-extraction : 3 + 3 + 10 (ATBa) + 3 + 3 = 22 mm at middle part post-extraction : 3 + 5 + 5 (ATBb) + 5 + 3 = 21 mm at apical part post-extraction : 3 + 8 + 2 (ATBc) + 8 + 3 = 24 mm

Variation expected (estimate) from Pre-extraction to 6 month post-extraction in imbedded placed alveolar socket will be:

At coronal part ⨺ (variation) = 2 mm (8% reduction) at middle part ⨺ (variation) = 2 mm (8% reduction) at middle part ⨺ (variation) = 2 mm (8% reduction)

After (estimate) Extraction 1 Year

at coronal part post-extraction : 3 + 3? + 10 + 3 ?+ 3 = 14 mm at middle part post-extraction : 3 + 5?+ 5 + 5? + 3 = 18 mm at apical part post-extraction : 3 + 8 ? + 2 + 8? + 3 = 8 mm

Variation expected (estimate) from Pre-extraction to 1 year post-extraction in imbedded placed alveolar socket will be:

At coronal part ⨺ (variation) = 2 mm (8% reduction) at middle part ⨺ (variation) = 2 mm (8% reduction) at middle part ⨺ (variation) = 2 mm (8% reduction)

Being tested
Tooth Extraction, Cone-Beam technology evaluation, Measure Alveolar Socket Remodeling
Keywords
Extraction Sockets, Ridge dimensions, Dental Alveolar Anatomy, Dental Implants, Bone Physiology
Medical subject headings
Alveolar Bone Loss, Bone Resorption

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Tooth ExtractionProcedure or surgery

    Tooth from the maxillary anterior area extracted and alveolar socket remains intact

  • Cone-Beam technology evaluationRadiation

    Also called Computerized Tomography, Imaging exams

    Patient is submitted to a localized cone-beam image before tooth extraction and 6 month later, prior to implant installation.

  • Measure Alveolar Socket RemodelingOther

    Also called Digital Measurements

    In a computer, cone-beam images are superimposed to measure total the amount of ridge dimension

Study groups in NCT01963884
Study groupRoleWhat they receive
Alveolar Socket Below Basal BoneTooth and the alveolar socket are positioned below basal bone. Measure Alveolar Socket remodeling, after Tooth Extraction with cone-beam technology evaluation
Receives: Procedure: Tooth Extraction; Radiation: Cone-Beam technology evaluation; Other: Measure Alveolar Socket Remodeling
Alveolar Socket in Basal Bone (imbedded)Tooth and alveolar socket are positioned in basal bone. Measure Alveolar Socket remodeling, after Tooth Extraction with cone-beam technology evaluation
Receives: Procedure: Tooth Extraction; Radiation: Cone-Beam technology evaluation; Other: Measure Alveolar Socket Remodeling
Alveolar Socket Buccal to Basal BoneTooth and alveolar socket are positioned buccally in relation to maxillary basal bone. Measure Alveolar Socket remodeling, after Tooth Extraction with cone-beam technology evaluation
Receives: Procedure: Tooth Extraction; Radiation: Cone-Beam technology evaluation; Other: Measure Alveolar Socket Remodeling

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Changes in alveolar ridge dimensions

    report the change in alveolar extraction socket dimensions from tooth extraction to 1 year, measured in digital computer, from Cone-Beam originated images.

    Measured: From Tooth extraction (baseline T0) to T1 (6 month) to T2 (12 month)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Oct 2013 (estimated)
  2. Study startJan 2014
  3. Primary completionJan 2016 (estimated)
  4. Study completionAug 2016 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
45 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01963884
Sponsor's protocol ID
II-04
Status last verified
Oct 2013
First submitted
12 Oct 2013
Last updated
16 Oct 2013
Results posted
No
Data monitoring committee
No

Questions about this trial

What is this clinical trial studying?

An observational study of Loss of Teeth Due to Extraction and Alveolar Bone Loss, run by Implantology Institute at 1 site in Portugal.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 16 Oct 2013. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Portugal. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact André Chen, Msc (00351919774343, tsouchen@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Changes in alveolar ridge dimensions (time frame: From Tooth extraction (baseline T0) to T1 (6 month) to T2 (12 month)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Oct 2013.

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