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Dental Implant FailedNCT05060055

Digital Assessment at Peri-implant Tissues After Immediate Implants With Customized Healing Abutments and Connective Tissue Grafts

A study testing Immediate dental implant placement in people with Dental Implant Failed, run by Universidade Católica Portuguesa at 1 site in Portugal.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

After a single-tooth extraction, physiological remodeling processes are unavoidable which leads to a total loss of the periodontal ligament and resorption of the bundle bone. Immediate implant placement associated with bone substitutes and customized healing abutments seems to reduce the amount of resorption at… Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Dental Implant Failed
What is being tested?
Immediate dental implant placement
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
32 participants
Where
1 sitePortugal
Study dates
1 Oct 2021to 9 Nov 2022
Phase
Interventional
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

Who may be able to join

  • 1) ≥18 years of age; 2) patients who had a failing tooth and needed an implant placing therapy in the aesthetic zone (between 15-25); 3) the failing tooth has adjacent and opposing natural teeth; 4) sufficient mesial-distal and inter-occlusal space for placement of the implant and definitive restoration; 5) had an intact socket wall previously to the extraction; 6) had sufficient apical bone to place an immediate implant with minimum primary stability of 30 N/cm.

Who cannot join

  • individuals diagnosed with periodontal disease; medical and general contraindications for the surgical procedure; heavy smokers (> 10 cigarettes/day); an active infection at the implant site.

Trial locations and contacts

1 site in 1 country.

Portugal1 site
  • Universidade Católica Portuguesa

    Viseu, 3500

Other trials in Portugal

About this study

Official title: Volumetric Digital Analysis on the Effect of a Customized Healing Abutment With or Without Connective Tissue Graft at Maxillary Immediate Implant Sites - A Randomized Clinical Trial

After a single-tooth extraction, physiological remodeling processes are unavoidable which leads to a total loss of the periodontal ligament and resorption of the bundle bone. Immediate implant placement associated with bone substitutes and customized healing abutments seems to reduce the amount of resorption at peri-implant areas. Recently, studies evaluating the use of a connective tissue grafts are being conducted in order to assess possible final outcome advantages in immediate implant procedures. This study aims to evaluate peri-implant tissue dimensional changes after the use of a customized healing abutment with or without connective tissue graft in flapless maxillary immediate implant placement.

Read the detailed description

The present study was designed as a prospective, controlled clinical trial with a parallel-group design and balanced randomization (ratio 1:1) to document the peri-implant tissues response in using a customized healing abutment with a connective tissue graft (Test group) or without a connective tissue graft (Control group) xenogeneic collagen matrix (Group CM) or a customized healing abutment (Group CA) in flapless maxillary immediate implants. The protocol was reviewed and approved by the Institute of Bioethics of the Catholic University of Portugal (Project nº 139) and the patients included will be previously informed to participate in this investigation signing an informed consent considering the 1975 Declaration of Helsinki, revised in 2013. Group designation will be kept in opaque-sealed envelopes that will be opened after implant insertion by an investigator (D.F), not involved in surgical procedures, randomly allocating participants to one of the two treatment groups. Patients' inclusion criteria are: 1) ≥18 years of age; 2) patients who had a failing tooth and needed an implant placing therapy in the aesthetic zone (between 15-25); 3) the failing tooth has adjacent and opposing natural teeth; 4) sufficient mesial-distal and inter-occlusal space for placement of the implant and definitive restoration; 5) had an intact socket wall previously to the extraction; 6) had sufficient apical bone to place an immediate implant with minimum primary stability of 30 N/cm. Exclusion criteria are: individuals diagnosed with periodontal disease; medical and general contraindications for the surgical procedure; heavy smokers (> 10 cigarettes/day); an active infection at the implant site. A CONSORT 2010 check-list will be also performed in order to consider an appropriate guideline for the present randomized trial study.

All surgical procedures will be conducted under appropriate local anesthesia 4% articaine with adrenaline 1:100000 (UbistesinTM, 3M-ESPE, St. Paul, MN, USA). In both groups, flapless tooth extractions will be performed after sectioning the tooth, followed by the use of periotomes and elevators to separate the two parts of the tooth, avoiding damage to the buccal and palatal bone plates. All patients will be treated with cylindrical shape implants (OsseoSpeed EV™, AstraTech Implant System, Dentsply Implants, Möhndal, Sweden) with a narrow diameter internal connection platform following the surgical sequence protocol provided by the manufacturer. Both groups will receive a customized healing abutment made of polymethyl methacrylate (PMMA) material, designed and fabricated accordingly with the gingival contour of the original tooth. Patients included in the Test group will receive connective tissue grafts harvested using the single incision technique.

A protocol was elaborated to study the variables of interest. One examiner, blinded for the surgical procedure, will be calibrated through an intra-examiner test (Dahlberg d-value), consisting in a double consecutive data collection of 10 randomly chosen patients included in this study.

Data collection will be performed in four appointments. A Cone Beam Computer Tomography (CBCT) evaluation (Ortophos XG 3D®, Sirona Dental Systems GmbH, Bensheim, Germany) will be performed before tooth extraction and implant placement (T0). At this point, two clinical parameters will be assessed with a periodontal probe (PCB 12; Hu-Friedy, Chicago, IL, USA) to the nearest millimeter: BID (distance between implant shoulder and the buccal bone plate) and KM (distance between the gingival groove and the mucogingival junction). Digital impressions (Cerec Omnicam®, Sirona Dental Systems GmbH, Bensheim, Germany) will be taken prior to extraction (T0), one month (T1), four months (T2) and 12 months (T3) after implant insertion allowing to superimpose the digital files and to evaluate volumetric changes between different time points at peri-implant tissue areas like Buccal Volume Variation (BVv) and Total Volume Variation (TVv). Mucosa variation between T0 and T3 will be digitally computed assessing the papilla presence at mesial (MPHv) and distal (DPHv) sites and the mucosa height (MGHv). Mean values will be compared and statistical significance will be at 0,05.

Being tested
Immediate dental implant placement
Keywords
autografts, wound healing, three-dimensional imaging, treatment outcome, dental implants, alveolar ridge augmentation, alveolar bone loss
Medical subject headings
Alveolar Bone Loss

What participants receive

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

  • Immediate dental implant placementProcedure or surgery

    Immediate dental implant placement

Study groups in NCT05060055
Study groupRoleWhat they receive
Test GroupExperimentalCustomized healing abutment inserted in immediate implant placement in association with the use of a connective tissue graft.
Receives: Procedure: Immediate dental implant placement
Control GroupActive comparatorCustomized healing abutment inserted in immediate implant placement.
Receives: Procedure: Immediate dental implant placement

What is being measured

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

  1. Buccal volume variation (BVvT0)

    Variation of the alveolar volume at the buccal aspect. The 3D-analysis was conducted with "Boolean" functions, which allowed researchers to obtain the volume variation in each time point from different variables like the Buccal Volume Variation (BVv0-1, BVv0-2, and BVv0-3), computed in cubic millimetres (mm3) and To allow a direct comparison of different sites at different time points, relative percentages of these variables were calculated based on the ROI volume at T0.

    Measured: Baseline (T0); 1 month (T1); 4 months (T2) and 12 months (T3)

  2. Buccal volume variation (BVvT1)

    Variation of the alveolar volume at the buccal aspect. The 3D-analysis was conducted with "Boolean" functions, which allowed researchers to obtain the volume variation in each time point from different variables like the Buccal Volume Variation (BVv0-1, BVv0-2, and BVv0-3), computed in cubic millimetres (mm3) and To allow a direct comparison of different sites at different time points, relative percentages of these variables were calculated based on the ROI volume at T0.

    Measured: 1 month (T1)

  3. Buccal volume variation (BVvT2)

    Variation of the alveolar volume at the buccal aspect. The 3D-analysis was conducted with "Boolean" functions, which allowed researchers to obtain the volume variation in each time point from different variables like the Buccal Volume Variation (BVv0-1, BVv0-2, and BVv0-3), computed in cubic millimetres (mm3) and To allow a direct comparison of different sites at different time points, relative percentages of these variables were calculated based on the ROI volume at T0.

    Measured: 4 months (T2)

  4. Buccal volume variation (BVvT3)

    Variation of the alveolar volume at the buccal aspect. The 3D-analysis was conducted with "Boolean" functions, which allowed researchers to obtain the volume variation in each time point from different variables like the Buccal Volume Variation (BVv0-1, BVv0-2, and BVv0-3), computed in cubic millimetres (mm3) and To allow a direct comparison of different sites at different time points, relative percentages of these variables were calculated based on the ROI volume at T0.

    Measured: 12 months (T3)

  5. Total volume variation (TVvT0)

    Variation of the alveolar volume at the buccal and palatal side. The 3D-analysis was conducted with "Boolean" functions, which allowed researchers to obtain the volume variation in each time point from different variables like the Total Volume Variation (TVv0-1, TVv0-2, e TVv0-3), computed in cubic millimetres (mm3) and To allow a direct comparison of different sites at different time points, relative percentages of these variables were calculated based on the ROI volume at T0

    Measured: Baseline (T0); 1 month (T1); 4 months (T2) and 12 months (T3)

  6. Total volume variation (TVvT0)

    Variation of the alveolar volume at the buccal and palatal side. The 3D-analysis was conducted with "Boolean" functions, which allowed researchers to obtain the volume variation in each time point from different variables like the Total Volume Variation (TVv0-1, TVv0-2, e TVv0-3), computed in cubic millimetres (mm3) and To allow a direct comparison of different sites at different time points, relative percentages of these variables were calculated based on the ROI volume at T0

    Measured: Baseline (T0)

  7. Total volume variation (TVvT1)

    Variation of the alveolar volume at the buccal and palatal side. The 3D-analysis was conducted with "Boolean" functions, which allowed researchers to obtain the volume variation in each time point from different variables like the Total Volume Variation (TVv0-1, TVv0-2, e TVv0-3), computed in cubic millimetres (mm3) and To allow a direct comparison of different sites at different time points, relative percentages of these variables were calculated based on the ROI volume at T0

    Measured: 1 month (T1)

  8. Total volume variation (TVvT2)

    Variation of the alveolar volume at the buccal and palatal side. The 3D-analysis was conducted with "Boolean" functions, which allowed researchers to obtain the volume variation in each time point from different variables like the Total Volume Variation (TVv0-1, TVv0-2, e TVv0-3), computed in cubic millimetres (mm3) and To allow a direct comparison of different sites at different time points, relative percentages of these variables were calculated based on the ROI volume at T0

    Measured: 4 months (T2)

  9. Total volume variation (TVvT3)

    Variation of the alveolar volume at the buccal and palatal side. The 3D-analysis was conducted with "Boolean" functions, which allowed researchers to obtain the volume variation in each time point from different variables like the Total Volume Variation (TVv0-1, TVv0-2, e TVv0-3), computed in cubic millimetres (mm3) and To allow a direct comparison of different sites at different time points, relative percentages of these variables were calculated based on the ROI volume at T0

    Measured: 12 months (T3)

Secondary outcomes (1)
  1. Buccal wall thickness (BT)

    measurement of the facial bone wall. The acquisition of radiographic images was performed with a volumetric dimension of 8 x 8 cm for 14s with the XG 3D tomography acquisition protocol, with a voxel size of 0.1 mm in HD mode. BT was measured 1 mm above the coronal bone margin using a central slice, as well at the mesial and distal slices, ranging 1 mm from the central slice. Mean BT values were obtained as the average values of the three slices. Measurements were made in mm.

    Measured: Baseline

Timeline

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

  1. First posted28 Sep 2021
  2. Study start1 Oct 2021
  3. Primary completion4 Nov 2022
  4. Study completion9 Nov 2022

Resources

More details

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

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
The present study was designed as a prospective, controlled clinical trial with a parallel-group design and balanced randomization (ratio 1:1)
Masking
Single blind
Who is masked
Investigator
Enrolment
32 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05060055
Sponsor's protocol ID
UCatolicaPortuguesa
Status last verified
Nov 2022
First submitted
26 Jul 2021
Last updated
15 Nov 2022
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Fernandes D, Marques T, Borges T, Montero J. Volumetric analysis on the use of customized healing abutments with or without connective tissue graft at flapless maxillary immediate implant placement: A randomized clinical trial. Clin Oral Implants Res. 2023 Sep;34(9):934-946. doi: 10.1111/clr.14119. Epub 2023 Jun 29.

    PubMed 37386752

Questions about this trial

What is this clinical trial studying?

A study testing Immediate dental implant placement in people with Dental Implant Failed, run by Universidade Católica Portuguesa 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 1 inclusion and 1 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: finished, as of the sponsor's last update on 15 Nov 2022. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Buccal volume variation (BVvT0) (time frame: Baseline (T0); 1 month (T1); 4 months (T2) and 12 months (T3)). The study lists 9 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05060055, which also lists 1 linked publication.

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 15 Nov 2022.

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