NCT04449302

Brief Summary

The original implant treatment protocol recommended that the implant should be placed in a fully healed site and covered with mucosa after placement to ensure osseointegration. The reason was to protect the implant site from bacterial contamination and to avoid loading of the implant. After that, a second stage surgical procedure had to be performed to expose the implant to connect the abutment. However, it was shown that a one stage or non-submerged (NS) approach can lead to successful and predictable outcomes. Customized healing abutments can be used in the non-submerged protocol, protecting and containing the bone substitute during healing, preserving the alveolar contour, preventing food impaction, and eliminating the need for a second stage surgery and. By means of this technique, critical and subcritical contours can be projected speeding up the peri-implant soft tissue conditioning phase in order to achieve final natural-like restorations. This randomized controlled trial will compare the clinical and radiographic hard and soft tissue changes using chairside customized healing abutment versus submerged healing following immediate implant placement in mandibular molars through measuring the horizontal ridge changes by CBCT , the crestal bone loss by a standardized digital x-ray and the soft tissue changes by the pink esthetic score (PES).

Trial Health

35
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
22

participants targeted

Target at below P25 for not_applicable

Timeline
Completed

Started Sep 2020

Typical duration for not_applicable

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

June 19, 2020

Completed
7 days until next milestone

First Posted

Study publicly available on registry

June 26, 2020

Completed
2 months until next milestone

Study Start

First participant enrolled

September 1, 2020

Completed
2.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2023

Completed
4 months until next milestone

Study Completion

Last participant's last visit for all outcomes

October 1, 2023

Completed
Last Updated

June 26, 2020

Status Verified

June 1, 2020

Enrollment Period

2.7 years

First QC Date

June 19, 2020

Last Update Submit

June 23, 2020

Conditions

Keywords

immediate dental implantscustomized healing abutmentsubmerged healingpapilla index

Outcome Measures

Primary Outcomes (1)

  • Papilla Index

    JEMT Index (mm.)

    1 year follow up

Secondary Outcomes (4)

  • Hard tissue horizontal ridge changes (bucco lingual)

    1 year follow up

  • Crestal bone loss

    1 year follow up

  • Soft tissue profile

    1 year follow up

  • Satisfaction index

    1 year follow up

Study Arms (2)

Immediate molar implant with customized healing abutment

EXPERIMENTAL

Patients will receive an immediate mandibular molar implant with customized healing abutment

Procedure: Immediate molar implant with customized healing abutment

Immediate molar implant with submerged healing

ACTIVE COMPARATOR

Patients will receive an immediate mandibular molar implant with submerged healing

Procedure: Immediate molar implant with customized healing abutment

Interventions

Patients will receive an immediate implant with customized healing abutment 1. Atraumatic extraction without flap elevation using periotomes and elevators then sectioning of the roots will be performed to preserve the interseptal bone. 2. The drilling will be performed starting from the pilot drill in the interseptal bone to the twisting drills according to the manufacturer's instructions to the selected implant size. The implant is to be placed immediately then the insertion torque will be measured using a torque wrench. In order to place the customized healing abutment, the insertion torque should be more than 25 ncm. 3. The gap distance will be filled by xenograft, a plastic abutment will be screwed in place then a flowable composie resin will be applied around into small amounts and cured to take the soft tissue contour then finishing and polishing of the customized healing abutment will be done.

Immediate molar implant with customized healing abutmentImmediate molar implant with submerged healing

Eligibility Criteria

Age20 Years - 70 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patients age between 20 and 70 years old.
  • Patients with non-restorable mandibular molars
  • Medically free.
  • Integrity of the extraction socket wall
  • Patients who are able to sign an informed consent form.
  • Cooperative, motivated and hygiene conscious Patients.
  • Patients who are able to come for the follow up appointments.

You may not qualify if:

  • Patients with compromised general health conditions that would impair bone healing including: Past or present history of bone irradiation Patients taking bisphosphonates
  • Teeth with acute periapical pathosis
  • Heavy Smokers
  • Parafunctional habits
  • Pregnant females
  • Drug abusers
  • Uncontrolled diabetes

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (1)

  • Perez A, Caiazzo A, Valente NA, Toti P, Alfonsi F, Barone A. Standard vs customized healing abutments with simultaneous bone grafting for tissue changes around immediate implants. 1-year outcomes from a randomized clinical trial. Clin Implant Dent Relat Res. 2020 Feb;22(1):42-53. doi: 10.1111/cid.12871. Epub 2019 Dec 3.

    PMID: 31797548BACKGROUND

Study Officials

  • Omnia Aboul Dahab, Phd

    Cairo University

    STUDY CHAIR
  • Hani El-Nahas, Phd

    Cairo University

    STUDY CHAIR
  • Omnia K. Tawfik, Phd

    Cairo University

    STUDY CHAIR

Central Study Contacts

Mohamed N. Ibrahem, Msc

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Masking Details
single blinded
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: it is randomized clinical trial
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Teaching assistant

Study Record Dates

First Submitted

June 19, 2020

First Posted

June 26, 2020

Study Start

September 1, 2020

Primary Completion

June 1, 2023

Study Completion

October 1, 2023

Last Updated

June 26, 2020

Record last verified: 2020-06