Dental Implant in Compromised Adjacent SocketsVSTNCT07063836
Management of Multiple Adjacent Extraction Sockets
A study testing VST and contour augmentation and early implant placement in people with Dental Implant in Compromised Adjacent Sockets, run by British University In Egypt at 1 site in Egypt.
Trial summary
While early implant placement with guided bone regeneration (GBR) offers advantages, the desire for reduced treatment time and fewer surgical steps continues to drive the exploration of alternative approaches. In this context, the recent introduction of vestibular socket therapy (VST) presents an intriguing option. Read more about this study
- Who is it for?
- Ages 18 to 70 yearsHealthy volunteers can take part
- Conditions the study is for
- Dental Implant in Compromised Adjacent Sockets
- What is being tested?
- VST and contour augmentation and early 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 siteEgypt
- Study dates
- 14 Jul 2025to Mar 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 to 70 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- patients with two adjacent hopeless maxillary teeth or remaining roots in the esthetic region missing coronal tooth structure, type II socket (deficient labial plate of bone and intact overlying soft tissues), adequate palatal bone, ≥ 3 mm apical bone to engage the immediately placed implants, thereby achieving optimum primary stability (a minimum of 30 Ncm insertion torque) following teeth extraction.
- acceptable compliance and oral hygiene.
Who cannot join
- medically compromised patients. (Systemic diseases). general contraindication for implant placement. (Untreated periodontitis, severe bruxism , immunosuppression , uncontrolled diabetes , smokers , patients under radiation therapy, patients on bisphosphonate medications).
- -
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Egypt1 site, 1 recruiting
- Recruiting
The British university in Egypt
Cairo
Eman Khalil, professor, +201005002986, Eman.khalil@bue.edu.eg
Al-Hassan Diab, PHD, +201003642191, alhassan.diab@bue.edu.eg
About this study
Official title: Management of Compromised Adjacent Extraction Sockets Via Vestibular Socket Therapy Versus Early Contour Augmentation a Randomized Controlled Clinical Trial
While early implant placement with guided bone regeneration (GBR) offers advantages, the desire for reduced treatment time and fewer surgical steps continues to drive the exploration of alternative approaches. In this context, the recent introduction of vestibular socket therapy (VST) presents an intriguing option. VST utilizes a minimally invasive tunnel access technique through the vestibular area to perform socket augmentation for immediate implant placement in compromised extraction sockets .
Read the detailed description
The concept of immediate implant placement has been around for a while. Professor Wilfried Schulte conducted the first study on this technique in 1978, Extensive studies conducted over the past 40 years have demonstrated that immediate implant placement is a safe and effective method for restoring teeth that are badly destructed.
While immediate implant placement has been shown as a viable option, new studies using advanced imaging techniques (cone beam CT scans) reveal limitations in the front upper jaw (anterior maxilla).
Thin Bone Walls: These scans show that a thick bone wall, ideal for implant stability, is uncommon in this area. Only about 5% of patients have a thick wall (>1mm) in the central incisor region.
Facial Bone Defects: Another recent study found that over half (52%) of implant sites in the central incisor area have a missing facial bone wall (defect).
These findings highlight the main concerns with immediate implants in the front upper jaw:
Bone Instability: Thin bone and missing facial bone can lead to an unstable implant, especially in the thin tissue layer at the front of the jaw (labial plate).
Soft Tissue instability: An unstable implant can cause the gum tissue to recede, compromising the cosmetic outcome in this highly visible area.
researchers like Buser et al. propose a treatment option that offers documented long-term predictability for achieving good aesthetic outcomes. This approach involves:
Early Implant Placement (Type 2): The implant is placed shortly after tooth extraction.
Flap Surgery: This surgical technique allows for better access to the bone for grafting.
Guided Bone Regeneration: Bone grafting material is used to stimulate new bone growth in the missing facial bone area.
Submerged Healing: The implant is left covered by gum tissue for a period of healing before attaching the final restoration.
This alternative approach addresses the challenges of immediate implant placement in cases with missing facial bone walls in the front upper jaw, while offering a predictable and aesthetically pleasing long-term solution.
A recent studies compared an alternative approach to the contour augmentation technique. The technique is the novel vestibular socket therapy proposed by ELaskary et al.
The findings suggest VST may be a viable option for these situations, offering comparable bone formation and improved soft tissue stability while streamlining the treatment process with fewer surgical interventions.
The study found that VST offered several advantages:
More stable gum tissue Similar bone growth compared to contour augmentation Faster treatment time Fewer surgeries Overall, VST appears to be a promising alternative to contour augmentation for implant placement.
- Being tested
- VST, contour augmentation and early implant placement
- Keywords
- dental implant, compromised socket, bone augmentation
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
VSTProcedure or surgery
atraumatic extraction to the hopeless teeth will be performed using periotomes followed by conventional forceps under local anesthesia.A small incision (1 cm) is made on (vestibular area) near the base of the extracted teeth, extending slightly towards neighboring teeth.Using special instruments from the VST kit, the gum tissue is carefully dissected to expose the underlying bone and an immediate implant is placed using a surgical guide. the augmentation is done using A mixture of bone chips harvested from the surgical site (autogenous bone) and a bone-grafting material (deproteinized bovine bone mineral) is used to fill any gaps and support the implant, especially in the labial bone wall (labial plate).
A special 0.6 mm thick membrane is inserted through the access incision. the vestibular incision is then sutured and the provisional is inserted.
contour augmentation and early implant placementProcedure or surgery
Teeth extraction : minimally invasive adjacent teeth extraction under anesthesia using periotome and forceps.
the empty sockets will be filled with a special collagen material (BioPlug) to aid healing for 4 to 8 weeks.
flap elevation : a full-thickness flap will be carefully raised using a crestal incision extended one tooth mesial and distal to the extraction location, then connected with two vertical incisions extended through the sulcus forming a trapezoid flap.
Implants Insertion: The two implant is then placed into the prepared sockets using surgical guide.
Bone Grafting: Any bone deficiencies are addressed by grafting. This involves placing a layer of (autogenous bone) directly on the two implants' surface, followed by a layer of a bone-grafting material (Demineralized Bone Matrix).
Membrane Placement: A double-layered collagen membrane is used to cover the grafted area.
Flap Closure: The previously lifted flap is repositioned and sutured back in place.
| Study group | Role | What they receive |
|---|---|---|
| vestibular socket therapy | Experimental | A small incision (1 cm) is made on (vestibular area) near the base of the extracted teeth, extending slightly towards neighboring teeth. This creates a pouch for accessing the socket and surrounding bone.An immediate implant is inserted using a guide and covered with a cortical membrane Receives: Procedure: VST |
| Contour augmentation and early implant placement | Active comparator | early implant placement after socket healing for four weeks using bioplug along with contour augmentation using bone and membrane Receives: Procedure: contour augmentation and early implant placement |
What is being measured
The primary outcome is the main question the study is designed to answer.
soft tissue stability
it will be measured digitally using the intraoral scanner. A preoperative scanning, immediate postoperative, 3 months postoperative and 6 months postoperative scanning will be done.
Measured: 6 months after final restoration
Secondary outcomes (1)
buccal plate of bone regeneration
measuring the thickness of the labial plate of bone. It will be measured preoperatively, immediate postoperative to measure the amount of the augmented bone, 3 months postoperatively and 6 months post operative. Tool to be used: cone beam computed tomography (cbct)
Measured: 6 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Jul 2025
- Study start14 Jul 2025
- Primary completionJan 2026 (estimated)
- Study completionMar 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Dental Implant in Compromised Adjacent SocketsStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 32 participants (estimated)
Sponsor and investigators
- Lead sponsor
- British University In Egypt
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Mohamed Yousef, B.D.S, Principal investigator, British University In Egypt
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07063836
- Sponsor's protocol ID
- 25-026
- Acronym
- VST
- Status last verified
- Jul 2025
- First submitted
- 3 Jul 2025
- Last updated
- 7 Aug 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 7 Aug 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Management of Compromised Adjacent Extraction Sockets Via Vestibular Socket Therapy Versus Early Contour Augmentation a Randomized Controlled Clinical Trial
- ClinicalTrials.gov ID
- NCT07063836
- Acronym / sponsor ID
- VST / 25-026
- Keywords
- dental implant, compromised socket, bone augmentation
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 32 participants (estimated)
- Lead sponsor
- British University In EgyptUniversity, hospital or other
- Study start
- 14 Jul 2025 (actual)
- Primary completion
- Jan 2026 (estimated)
- Study completion
- Mar 2026 (estimated)
- First posted
- 14 Jul 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
While early implant placement with guided bone regeneration (GBR) offers advantages, the desire for reduced treatment time and fewer surgical steps continues to drive the exploration of alternative approaches. In this context, the recent introduction of vestibular socket therapy (VST) presents an intriguing option. VST utilizes a minimally invasive tunnel access technique through the vestibular area to perform socket augmentation for immediate implant placement in compromised extraction sockets .
Detailed description
The concept of immediate implant placement has been around for a while. Professor Wilfried Schulte conducted the first study on this technique in 1978, Extensive studies conducted over the past 40 years have demonstrated that immediate implant placement is a safe and effective method for restoring teeth that are badly destructed.
While immediate implant placement has been shown as a viable option, new studies using advanced imaging techniques (cone beam CT scans) reveal limitations in the front upper jaw (anterior maxilla).
Thin Bone Walls: These scans show that a thick bone wall, ideal for implant stability, is uncommon in this area. Only about 5% of patients have a thick wall (>1mm) in the central incisor region.
Facial Bone Defects: Another recent study found that over half (52%) of implant sites in the central incisor area have a missing facial bone wall (defect).
These findings highlight the main concerns with immediate implants in the front upper jaw:
Bone Instability: Thin bone and missing facial bone can lead to an unstable implant, especially in the thin tissue layer at the front of the jaw (labial plate).
Soft Tissue instability: An unstable implant can cause the gum tissue to recede, compromising the cosmetic outcome in this highly visible area.
researchers like Buser et al. propose a treatment option that offers documented long-term predictability for achieving good aesthetic outcomes. This approach involves:
Early Implant Placement (Type 2): The implant is placed shortly after tooth extraction.
Flap Surgery: This surgical technique allows for better access to the bone for grafting.
Guided Bone Regeneration: Bone grafting material is used to stimulate new bone growth in the missing facial bone area.
Submerged Healing: The implant is left covered by gum tissue for a period of healing before attaching the final restoration.
This alternative approach addresses the challenges of immediate implant placement in cases with missing facial bone walls in the front upper jaw, while offering a predictable and aesthetically pleasing long-term solution.
A recent studies compared an alternative approach to the contour augmentation technique. The technique is the novel vestibular socket therapy proposed by ELaskary et al.
The findings suggest VST may be a viable option for these situations, offering comparable bone formation and improved soft tissue stability while streamlining the treatment process with fewer surgical interventions.
The study found that VST offered several advantages:
More stable gum tissue Similar bone growth compared to contour augmentation Faster treatment time Fewer surgeries Overall, VST appears to be a promising alternative to contour augmentation for implant placement.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| vestibular socket therapy | Experimental | Procedure: VSTA small incision (1 cm) is made on (vestibular area) near the base of the extracted teeth, extending slightly towards neighboring teeth. This creates a pouch for accessing the socket and surrounding bone.An immediate implant is inserted using a guide and covered with a cortical membrane |
| Contour augmentation and early implant placement | Active comparator | Procedure: contour augmentation and early implant placementearly implant placement after socket healing for four weeks using bioplug along with contour augmentation using bone and membrane |
Who may qualify
- Ages
- 18 to 70 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- patients with two adjacent hopeless maxillary teeth or remaining roots in the esthetic region missing coronal tooth structure, type II socket (deficient labial plate of bone and intact overlying soft tissues), adequate palatal bone, ≥ 3 mm apical bone to engage the immediately placed implants, thereby achieving optimum primary stability (a minimum of 30 Ncm insertion torque) following teeth extraction.
- acceptable compliance and oral hygiene.
Key exclusion criteria (2 listed)
- medically compromised patients. (Systemic diseases). general contraindication for implant placement. (Untreated periodontitis, severe bruxism , immunosuppression , uncontrolled diabetes , smokers , patients under radiation therapy, patients on bisphosphonate medications).
- -
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| VSTatraumatic extraction to the hopeless teeth will be performed using periotomes followed by conventional forceps under local anesthesia.A small incision (1 cm) is made on (vestibular area) near the base of the extracted teeth, extending slightly towards neighboring teeth.Using special instruments from the VST kit, the gum tissue is carefully dissected to expose the underlying bone and an immediate implant is placed using a surgical guide. the augmentation is done using A mixture of bone chips harvested from the surgical site (autogenous bone) and a bone-grafting material (deproteinized bovine bone mineral) is used to fill any gaps and support the implant, especially in the labial bone wall (labial plate). A special 0.6 mm thick membrane is inserted through the access incision. the vestibular incision is then sutured and the provisional is inserted. | Procedure or surgery | vestibular socket therapy |
| contour augmentation and early implant placementTeeth extraction : minimally invasive adjacent teeth extraction under anesthesia using periotome and forceps. the empty sockets will be filled with a special collagen material (BioPlug) to aid healing for 4 to 8 weeks. flap elevation : a full-thickness flap will be carefully raised using a crestal incision extended one tooth mesial and distal to the extraction location, then connected with two vertical incisions extended through the sulcus forming a trapezoid flap. Implants Insertion: The two implant is then placed into the prepared sockets using surgical guide. Bone Grafting: Any bone deficiencies are addressed by grafting. This involves placing a layer of (autogenous bone) directly on the two implants' surface, followed by a layer of a bone-grafting material (Demineralized Bone Matrix). Membrane Placement: A double-layered collagen membrane is used to cover the grafted area. Flap Closure: The previously lifted flap is repositioned and sutured back in place. | Procedure or surgery | Contour augmentation and early implant placement |
Primary outcome
soft tissue stability
Time frame: 6 months after final restoration
it will be measured digitally using the intraoral scanner. A preoperative scanning, immediate postoperative, 3 months postoperative and 6 months postoperative scanning will be done.
1 secondary outcome
buccal plate of bone regeneration
Time frame: 6 months
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 7 Aug 2025.
- Individual participant dataSharing planned: No
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Mohamed Yousef, B.D.S principal investigator
British University In Egypt
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing VST and contour augmentation and early implant placement in people with Dental Implant in Compromised Adjacent Sockets, run by British University In Egypt 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 2 inclusion and 2 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: looking for participants now, as of the sponsor's last update on 7 Aug 2025. 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Mohamed G yousef, B.D.S (00201224289601, pgmohamed9214@bue.edu.eg), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
soft tissue stability (time frame: 6 months after final restoration). 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 7 Aug 2025.