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Immediate ImplantsNCT06478511

Subepithelial Connective Tissue Graft Versus Socket Shield Technique In Immediately Placed Implants

A study testing Classic Immediate implant, Immediate implant combined with subepithelial connective tissue graft and Immediate dental implant placement using socket shield technique in people with Immediate Implants, run by Mansoura University at 1 site in Egypt.

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

The purposes of study are: 1. To assess the efficacy of immediate implant placement in preserving hard and soft tissue around implants clinically and radiographically. 2. To assess the efficacy of immediate implant placement combined with subepithelial connective tissue graft in preserving hard and soft tissue around… Read more about this study

Who is it for?
Ages 20 to 50 yearsHealthy volunteers can take part
Conditions the study is for
Immediate Implants
What is being tested?
Classic Immediate implant, Immediate implant combined with subepithelial connective tissue graft and Immediate dental implant placement using socket shield technique
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
33 participants
Where
1 siteEgypt
Study dates
5 Dec 2020to 20 Apr 2024
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 20 to 50 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Male/female patients, age: >18 years.
  • Healthy periodontium with gingival biotype at least 2mm.
  • Extraction socket with four intact walls.
  • Adequate native bone to achieve good primary stability.
  • No untreated carious lesions.
  • Missing anterior (incisor/canine) with healthy adjacent teeth bilaterally.
  • Useless broken single-tooth with only lingual root fracture caused by trauma.

Who cannot join

  • History of systemic disease (excluding well-controlled diabetes).
  • Recent infectious diseases or surgical treatment within 30 days.
  • Smokers (≥10 cigarettes a day).
  • Pregnancy or lactation.
  • Patients on regular medications affecting periodontal healing (e.g., phenytoin, dihydropyridines, calcium antagonists, and cyclosporine) or anticoagulant therapy with warfarin, clopidogrel, ticlopidine, and aspirin.
  • Presence of pathological lesions around the surgical area.
  • Severe mental disorders or uncooperative patients.

Trial locations and contacts

1 site in 1 country.

Egypt1 site
  • Faculty of Dentistery

    Al Mansurah, 35516

Other trials in Egypt

About this study

Official title: Subepithelial Connective Tissue Graft Versus Socket Shield Technique In Immediately Placed Implants In Maxillary Esthetic Region: A Randomized Controlled Study

The purposes of study are:

  1. To assess the efficacy of immediate implant placement in preserving hard and soft tissue around implants clinically and radiographically.
  2. To assess the efficacy of immediate implant placement combined with subepithelial connective tissue graft in preserving hard and soft tissue around implants clinically and radiographically.
  3. To assess the efficacy of implants installed immediately using Socket Shield Technique in preserving hard and soft tissue around implants clinically and radiographically.
  4. To compare immediate implant placement versus implants installed immediately using Socket Shield Technique in preserving hard and soft tissue around implants clinically and radiographically.
Read the detailed description

Patient's selection:

Patients in this study will be selected from the outpatient clinic of Oral Medicine and Periodontology department, Faculty of Dentistry, Mansoura University.

Patients participating in this study will sign an informed consent demonstrating the purpose of this study, treatment procedure, probable risks and benefits from this treatment procedure. The study proposal will be reviewed by the faculty's Research Ethics Committee.

All the selected patients will receive full mouth scaling, preoperative periapical x-ray and cone beam computed.

Surgical procedures:

Before surgery, Preoperative antibiotics will be given orally one hour prior to surgery (amoxicillin, 2g, or clindamycin, 600 mg, for patients allergic to penicillin) the patients will be advised to rinse for one minute with chlorhexidiene mouthwash. After local anesthesia administration, In group 1, the teeth will be extracted gently using periotomes, in an attempt to preserve facial and lingual bone plates. The sockets will be debrided of soft tissue and irrigated. Then all walls of the socket will be inspected and checked for the presence of fenestration or dehiscence defects in bone. The length and width of extracted roots will be measured to determine the length and diameter of implants placed. The osteotomy sites will be prepared and the drills will be used in proper sequence according to manufacturer's instructions, with maximum use of bone apical to the extraction sockets. The drills will extend 3 to 5 mm beyond the apex of the socket to ensure primary stability after placement, taking care of the anatomical boundaries. After the osteotomy sites had been prepared, the implants will be placed.

In group 2, concerning the donor site of the connective tissue, connective tissue graft was harvested from palate using trap door technique (27) utilizing a horizontal incision 3-4 mm away from the gingival margin with two vertical incisions on the either end of the first incision, creating a door, the door is then undermined and opened using a sharp dissection, the underlying connective tissue is then harvested using a periosteal elevator, and the door was then sutured using 4 0 silk sutures Finally, the connective tissue graft was immediately placed into the recipient site after a tunneling procedure and sutured with 6-0 nonresorbable monofilament sutures.

In group 3, the crown of the involved tooth will be removed and the root will be then sectioned in a mesiodistal direction along its long axis as far apical as was possible using a long shank fissure bur coupled to a hydrated high-speed handpiece. Sectioning will divide the tooth root into facial and palatal halves with the intention of preserving the facial root section unmanipulated and attached to the tooth socket. Periotomes will be then inserted between the palatal root section and the alveolar socket wall to sever the PDL and this section of root will be then carefully delivered with so as not to disturb the facial root section.

The remaining root section will be then reduced coronally to 1 mm above the alveolar crest, and will be thinned slightly to a concave contour by careful application in an apico-coronal and mesiodistal direction with a long shanked round diamond. The tooth socket's palatal wall and apex will be then curetted to remove any tissue or infective remnants and the root section will be checked for immobility with a sharp probe. With the preparation steps complete, the tooth root hereafter will be known as the socket-shield. An osteotomy will be then sequentially prepared and internal conical connection implant was inserted palatal to the socket shield with the implant 2 mm below the facial crest.

Immediate temporary dentures were fabricated using plastic and inserted on the day of implantation. Patients were instructed to consume soft food for eight weeks. Following a healing period of 6 months, the final restorations will be delivered.

Being tested
Classic Immediate implant, Immediate implant combined with subepithelial connective tissue graft, Immediate dental implant placement using socket shield technique
Keywords
Immediate implants,Socket shield technique

What participants receive

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

  • Classic Immediate implantProcedure or surgery

    The teeth will be extracted gently using periotomes to preserve facial and lingual bone plates. All walls of the socket will be inspected and checked for the presence of fenestration or dehiscence defects in bone. The length and width of extracted roots will be measured to determine the length and diameter of implants placed. The osteotomy sites will be prepared and the drills will be used in proper sequence according to manufacturer's instructions, with maximum use of bone apical to the extraction sockets. The drills will extend 3 to 5 mm beyond the apex of the socket to ensure primary stability after placement, taking care of the anatomical boundaries. The implants will be placed.

  • Immediate implant combined with subepithelial connective tissue graftProcedure or surgery

    Connective tissue graft was harvested from palate using trap door technique utilizing a horizontal incision 3-4 mm away from the gingival margin with two vertical incisions on the either end of the first incision, the door is then undermined and opened using a sharp dissection, the underlying connective tissue is then harvested using a periosteal elevator, and the door was then sutured using 4 0 silk sutures Finally, the connective tissue graft was immediately placed into the recipient site after a tunneling procedure and sutured with 6-0 nonresorbable monofilament sutures.

  • Immediate dental implant placement using socket shield techniqueProcedure or surgery

    The crown of the involved tooth will be removed and the root will be then sectioned in a mesiodistal direction along its long axis as far apical as was possible using a long shank fissure bur. Preserving the facial root section unmanipulated and attached to the tooth socket. Periotomes will be then inserted between the palatal root removed gentelly.The remaining root section will be then reduced coronally to 1 mm above the alveolar crest.The tooth socket's palatal wall and apex will be then curetted to remove any tissue or infective remnants and the root section will be checked for immobility with a sharp probe. With the preparation steps complete, the tooth root hereafter will be known as the socket-shield. An osteotomy will be then sequentially prepared and internal conical connection implant was inserted palatal to the shield with the implant 2 mm below the facial crest.

Study groups in NCT06478511
Study groupRoleWhat they receive
Classic immediate implantActive comparatorInclude 11 implants (Nucleoss T6®) , maximum two per patient, will be placed immediately after atraumatic extraction.
Receives: Procedure: Classic Immediate implant
Immediate implant combined with subepithelial connective tissue graftActive comparatorInclude 11 implants, maximum two per patient will be placed immediately after atraumatic extraction and subepithelial connective tissue graft will be harvested and placed.
Receives: Procedure: Immediate implant combined with subepithelial connective tissue graft
Immediate implant using socket shield techniqueActive comparatorinclude 11 implants, maximum two per patient will be placed immediately using Socket Shield Technique.
Receives: Procedure: Immediate dental implant placement using socket shield technique

What is being measured

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

  1. Clinical success of socket shield technique in immediate implant placement

    Implant placement using socket shield technique, including: shortened treatment time and minimizes alveolar bone loss.

    Measured: 6 months

  2. Clinical success of socket shield technique in immediate implant placement

    Implant placement using socket shield technique, including: shortened treatment time and minimizes alveolar bone loss.

    Measured: 12 months

  3. Clinical success of SECT graft in immediate implant placement

    Implant placement with SECT graft, including: shortened treatment time and minimizes alveolar bone loss.

    Measured: 6 months

  4. Clinical success of SECT graft in immediate implant placement

    Implant placement with SECT graft, including: shortened treatment time and minimizes alveolar bone loss.

    Measured: 12 months

Timeline

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

  1. First posted27 Jun 2024
  2. Study start5 Dec 2020
  3. Primary completion10 Sep 2023
  4. Study completion20 Apr 2024

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
Patients participating in this study will sign an informed consent demonstrating the purpose of this study, treatment procedure, probable risks and benefits from this treatment procedure. Patients will be randomly allocated to one of three groups: 1. Group 1 (control group): Will include 11 implants (Nucleoss T6®) , maximum two per patient, will be placed immediately after atraumatic extraction. 2. Group 2 : Will include 11 implants, maximum two per patient will be placed immediately after atraumatic extraction and subepithelial connective tissue graft will be harvested and placed. 3. Group 3: Will include 11 implants, maximum two per patient will be placed immediately using Socket Shield Technique. All osteotomy sites will receive Biogap® bone graft if there are gap between implant and labial bone/ buccal shield ≥ 2mm. All the selected patients will receive full mouth scaling, preoperative periapical x-ray and cone beam computed tomography.
Masking
Single blind
Who is masked
Participant
Enrolment
33 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06478511
Sponsor's protocol ID
SECT / SST immediate implant
Status last verified
Jun 2024
First submitted
24 Jun 2024
Last updated
27 Jun 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Sun C, Zhao J, Liu Z, Tan L, Huang Y, Zhao L, Tao H. Comparing conventional flap-less immediate implantation and socket-shield technique for esthetic and clinical outcomes: A randomized clinical study. Clin Oral Implants Res. 2020 Feb;31(2):181-191. doi: 10.1111/clr.13554. Epub 2019 Dec 13.

    PubMed 31680339
  • Zhang Z, Dong Y, Yang J, Xu R, Deng F. Effect of socket-shield technique on alveolar ridge soft and hard tissue in dogs. J Clin Periodontol. 2019 Feb;46(2):256-263. doi: 10.1111/jcpe.13073.

    PubMed 30661247

Questions about this trial

What is this clinical trial studying?

A study testing Classic Immediate implant, Immediate implant combined with subepithelial connective tissue graft and Immediate dental implant placement using socket shield technique in people with Immediate Implants, run by Mansoura University at 1 site in Egypt.

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 7 inclusion and 7 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 27 Jun 2024. 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 Egypt. 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?

Clinical success of socket shield technique in immediate implant placement (time frame: 6 months). The study lists 4 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 NCT06478511, which also lists 2 linked publications.

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 27 Jun 2024.

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