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Missing ToothNCT07095881

Peri-implant Soft Tissue Response to Direct Zirconia-Based Composite Customized Healing Abutment

A study testing Zirconia-based composite customized healing abutment and Conventional composite customized healing abutment. in people with Missing Tooth, run by Ain Shams University at 1 site in Egypt.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of this clinical trial is to learn if using zirconia-based composite customized healing abutment can have a favorable effect on peri implant soft tissue that may be related to the superior biological properties of zirconium nano particles regarding increased biocompatibility and decreased inflammatory… Read more about this study

Who is it for?
Ages 20 to 50 years
Conditions the study is for
Missing Tooth
What is being tested?
Zirconia-based composite customized healing abutment and Conventional composite customized healing abutment.
Could I receive a placebo?
No, everyone receives an active treatment
How many people
22 participants
Where
1 siteEgypt
Study dates
6 Jan 2025to Dec 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 20 to 50 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Patients should be systematically free from any disease as according to Cornell Medical Index-Health Questionnaire (Pendleton et al., 2004).
  • Both genders.
  • Age from 20-50 years.
  • Missing tooth to be restored with standard implant, with no need for additional bone and soft tissue augmentation procedures (Beretta et al., 2019).
  • Implants primary stability ISQ ≥ 70 unites using the Osstell Mentor (Baltayan et al., 2016).
  • Sound Mesial and distal neighboring teeth.
Show all 9Show fewer
  • At least 6 natural teeth remaining in the same arch .
  • Mouth opening ≥ 30mm.
  • Thick phenotype.

Who cannot join

  • Poor oral hygiene condition.
  • Pregnant and lactating females.
  • Smokers.
  • Vulnerable groups (Prisoners and handicaps).

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Ahmed A El Sayed, MSc Perio contact

+201127999187

ahmed.abdelmoteleb.std@dent.asu.edu.eg

Egypt1 site, 1 recruiting
  • Faculty of Dentistry Ain Shams University

    Cairo, Abaseya, 7154411

    Dean of the faculty, +20222639083, administrator@asfd.asu.edu.eg

    Ahmed A El Sayed, MSc Perio

    Recruiting

Other trials in Egypt

About this study

Official title: Peri-implant Soft Tissue Response to Direct Zirconia-Based Composite Customized Healing Abutment: A Randomized Controlled Clinical Study With Biochemical Analysis

The goal of this clinical trial is to learn if using zirconia-based composite customized healing abutment can have a favorable effect on peri implant soft tissue that may be related to the superior biological properties of zirconium nano particles regarding increased biocompatibility and decreased inflammatory response Patients that are eligible for implant placement

The main question it aims to answer is:

Read more

Does zirconia-based composite customized healing abutment have a significantly different effect on peri-implant soft tissue compared to conventional composite customized healing abutment in terms of biological properties or biocompatibility or inflammatory response? Researchers will compare between direct zirconia-based composite customized healing abutments vs conventional composite customized healing abutments placed simultaneously with delayed dental implant placement.

Participants will be undergo the following procedures :

  1. Presurgical procedures:
  2. Detailed clinical examination, full history, and radiographic examination (CBCT) will be performed initially to aid in patients' selection.
  3. After enrollment, all participants will sign the informed consent.
  4. All participants will be subjected to periodontal phase I treatment including periodontal supra- and sub-gingival debridement and oral hygiene instructions.
  5. Surgical procedures:
  6. After local anesthesia administration, flap is raised, osteotomy site preparation, and implant will be placed.
  7. Check the ISQ to exceed or equal 70 unit.
  8. A customized Light-cured Direct Zirconia-Based Composite or A customized Light-cured Direct Convential Composite Healing Abutment will be placed.

Then all participants should follow up at the following times : Baseline, 1,2 and 3 months after implantation.

Read the detailed description

Light-cured direct zirconia-based composite has many potential uses in dentistry, because of mechanical and biological reasons maintaining the health of peri-implant soft tissues during healing.

Direct zirconia-based composite customized healing abutments have superior properties such as biocompatibility, chemical stability, antibacterial and mechanical properties.

Aim of the study: This study will be carried out to compare zirconia-based composite customized healing abutments vs conventional composite customized healing abutment placed simultaneously with delayed dental implant placement.

Materials and Methods: This will be done by clinical evaluation of peri-implant soft tissue changes. Moreover, peri-implant sulcus fluid (PISF) will be measured for the level of Interleukin-1 beta (IL-1β) in the gingival crevicular fluid.

PICOTS Elements:

Patient/Problem:Patients that are eligible for implant placement within inclusion criteria.

Intervention: Zirconia-based composite customized healing abutment. Comparator: Conventional composite customized healing abutment.

Outcome:

Primary outcome : Clinical evaluation of peri-implant soft tissue changes via pink esthetic score and papilla index.

Secondary outcome : Biochemical assessment of IL-1β level in the gingival crevicular fluid using Periopaper strip .

Time: Baseline, 1,2 and 3 months after implantation. Biochemical assessment : after 2 months of implantation. Setting: Faculty of Dentistry, Ain Shams University. Clinical Relevance: The result will affect the gold standard in choosing the customized healing abutment material for implant patients, regarding which one offers better peri-implant soft tissue results, healing stimulation, and less inflammatory response.

Conditions
Missing Tooth
Being tested
Zirconia-based composite customized healing abutment, Conventional composite customized healing abutment.
Keywords
Implant, dental implant, Delayed implant, Healing abutment, Customized healing abutment, Zirconia-based composite customized healing abutment, Conventional composite customized healing abutment, Biochemical Analysis, Pink esthetic Score, Papilla index, PISF samples, IL-1β
Medical subject headings
Anodontia

What participants receive

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

  • Zirconia-based composite customized healing abutmentOther

    using Zirconia-based composite in customized healing abutment fabrication

  • Conventional composite customized healing abutment.Other

    using conventional composite in customized healing abutment fabrication

Study groups in NCT07095881
Study groupRoleWhat they receive
Zirconia-based composite customized healing abutmentActive comparatorParticipants in this arm will receive a customized healing abutment made of Zirconia-based composite material fabricated chairside. The abutment will be designed to mimic the emergence profile of the final prosthesis, aiming to optimize soft tissue shaping and healing. The abutment is placed immediately after implant placement and will remain in place for 3 months.
Receives: Other: Zirconia-based composite customized healing abutment
Conventional composite customized healing abutmentActive comparatorParticipants in this arm will receive a customized healing abutment made of conventional composite material fabricated chairside. The abutment will be designed to mimic the emergence profile of the final prosthesis, aiming to optimize soft tissue shaping and healing. The abutment is placed immediately after implant placement and will remain in place for 3 months.
Receives: Other: Conventional composite customized healing abutment.

What is being measured

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

  1. Pink Esthetic Score

    The Pink Esthetic Score is used to evaluate the soft tissue esthetics around single-tooth implants.

    It includes 7 parameters: mesial and distal papilla, tissue contours, gingival level, alveolar process, and both the color and texture of the soft tissue. Each is scored from 0 to 2, with higher scores reflecting more natural esthetics. For the papillae, a score of 0 indicates the papilla is missing, 1 is incomplete, and 2 is complete. Tissue contours are rated as unnatural (0), virtually natural (1), or natural (2). Gingival level is assessed based on vertical discrepancy with adjacent teeth: more than 2 mm scores 0, 1-2 mm scores 1, and less than 1 mm scores 2. The alveolar process is scored as clearly resorbed (0), slightly resorbed (1), or showing no difference (2). Finally, both soft tissue color and texture are evaluated against the neighboring tissue: a clear difference (0), a slight difference (1),no difference (2). The maximum PES is 14, represents ideal soft tissue esthetics.

    Measured: Baseline, 1,2 and 3 months after implantation.

  2. Papilla index

    The Papilla Index is a clinical tool used to evaluate the degree of interdental papilla fill in the proximal space around implants.

    It is scored on a scale from 0 to 4. A score of 0 indicates that no papilla is present. A score of 1 means less than half of the papilla height is visible. A score of 2 is assigned when half or more of the papilla height is present, though not completely filling the space.

    A score of 3 denotes a papilla that fully occupies the entire proximal space, representing the ideal scenario.

    A score of 4 indicates a hyperplastic papilla, where the tissue extends beyond the normal contours.

    Measured: baseline, 1,2 and 3 months

Secondary outcomes (1)
  1. Biochemical assessment of IL-1β level in the gingival crevicular fluid

    Biochemical assessment of IL-1β level in the gingival crevicular fluid using Periopaper strip.

    Measured: After 2 months of implant placement

Timeline

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

  1. First posted31 Jul 2025
  2. Study start6 Jan 2025
  3. Primary completionJun 2026 (estimated)
  4. Study completionDec 2026 (estimated)

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
Randomized, controlled, parallel design, two arms clinical trial
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
22 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07095881
Sponsor's protocol ID
FDASU-REC 1437
Status last verified
Jul 2025
First submitted
16 Jul 2025
Last updated
31 Jul 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes

Publications

  • Pendleton N, Clague JE, Horan MA, Rabbitt PM, Jones M, Coward R, Lowe C, McInnes L. Concordance of Cornell medical index self-reports to structured clinical assessment for the identification of physical health status. Arch Gerontol Geriatr. 2004 May-Jun;38(3):261-9. doi: 10.1016/j.archger.2003.10.005.

    PubMed 15066312
  • Lashkarizadeh N, Foroudisefat M, Abyari S, Mohammadi M, Lashkarizadeh L. Is It Safe to Reuse Healing Abutments? An Experimental Study on IL-1beta and TNF-alpha Cytokine Levels in Peri-Implant Crevicular Fluid. J Prosthodont. 2022 Jun;31(5):399-404. doi: 10.1111/jopr.13474. Epub 2022 Feb 19.

    PubMed 34962679
  • Kunrath MF, Gupta S, Lorusso F, Scarano A, Noumbissi S. Oral Tissue Interactions and Cellular Response to Zirconia Implant-Prosthetic Components: A Critical Review. Materials (Basel). 2021 May 25;14(11):2825. doi: 10.3390/ma14112825.

    PubMed 34070589
  • Khatri M, Bansal M, Puri K, Mehrotra S, Kumar A, Rehan M. Evaluation of the correlation between interleukin 1beta levels in peri-implant crevicular fluid as an adjunctive diagnostic marker with clinical and radiographic parameters for assessing the peri-implant health status. Natl J Maxillofac Surg. 2022 Sep-Dec;13(3):421-429. doi: 10.4103/njms.njms_337_21. Epub 2022 Dec 10.

    PubMed 36683945
  • Chokaree P, Poovarodom P, Chaijareenont P, Yavirach A, Rungsiyakull P. Biomaterials and Clinical Applications of Customized Healing Abutment-A Narrative Review. J Funct Biomater. 2022 Dec 10;13(4):291. doi: 10.3390/jfb13040291.

    PubMed 36547551
  • Beretta M, Poli PP, Pieriboni S, Tansella S, Manfredini M, Cicciu M, Maiorana C. Peri-Implant Soft Tissue Conditioning by Means of Customized Healing Abutment: A Randomized Controlled Clinical Trial. Materials (Basel). 2019 Sep 19;12(18):3041. doi: 10.3390/ma12183041.

    PubMed 31546800
  • Bannunah AM. Biomedical Applications of Zirconia-Based Nanomaterials: Challenges and Future Perspectives. Molecules. 2023 Jul 15;28(14):5428. doi: 10.3390/molecules28145428.

    PubMed 37513299
  • Baltayan S, Pi-Anfruns J, Aghaloo T, Moy PK. The Predictive Value of Resonance Frequency Analysis Measurements in the Surgical Placement and Loading of Endosseous Implants. J Oral Maxillofac Surg. 2016 Jun;74(6):1145-52. doi: 10.1016/j.joms.2016.01.048. Epub 2016 Feb 1.

    PubMed 26917203
  • Almadani, T. M., Amer, A.-F. M., Abdallah, H. M., & El Sayed, I. S. Clinical and radiographic evaluation of peri-implant tissue changes associated with use of standard versus customized healing abutments. Al-Azhar Journal of Dental Science (2023), 26(2), 229-239.

  • Ramenzoni LL, Fluckiger LB, Attin T, Schmidlin PR. Effect of Titanium and Zirconium Oxide Microparticles on Pro-Inflammatory Response in Human Macrophages under Induced Sterile Inflammation: An In Vitro Study. Materials (Basel). 2021 Jul 27;14(15):4166. doi: 10.3390/ma14154166.

    PubMed 34361359

Questions about this trial

What is this clinical trial studying?

A study testing Zirconia-based composite customized healing abutment and Conventional composite customized healing abutment. in people with Missing Tooth, run by Ain Shams 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 9 inclusion and 4 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 31 Jul 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 Ahmed A El Sayed, MSc Perio (+201127999187, ahmed.abdelmoteleb.std@dent.asu.edu.eg), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pink Esthetic Score (time frame: Baseline, 1,2 and 3 months after implantation.). The study lists 2 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 NCT07095881, which also lists 10 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 31 Jul 2025.

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