The Influence of Vertical Implant Position on the Marginal Bone Loss in Thick Versus Thin Phenotype.

NCT06177275 | Unknown

• 1 other identifier: NHR
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

Multiple clinical studies have established high survival rates and tremendous predictability of dental implant treatment (Schiegnitz and Al-Nawas 2018). However, a pleasant esthetic outcome is the patient's primary expectation regarding implants in the esthetic zone (Vermylen et al. 2003)and several esthetic factors have been evaluated to contribute to an esthetic appearance. Among these, the midfacial soft tissue level is considered to be one of the most important factors; Cosyn and co-workers reported that among factors including soft tissue phenotype, the midfacial recession was associated with the position of the implant (Cosyn et al. 2012). Therefore, subcrestal implant placement has been advocated as it has been associated with the reduction of crestal bone loss in cases with decreased soft tissue thickness. If the vertical soft tissues on the crest of the alveolar ridge are 2 mm or less at the time of implant placement, implants will undergo unavoidable bone resorption by establishing sufficient biologic protection. Another option was proposed by Linkevicius et al, who introduced the subcrestal implant placement as a method to accommodate the problem of thin soft tissues.(Linkevicius et al. 2020). Limiting the extent of peri-implant bone loss has been recognized for decades to be an important aspect of long-term implant success, and stable peri-implant bone conditions play an important role in maintaining esthetics (Laurell and Lundgren, 2011). The opinion expressed widely in the scientific literature has been that subcrestal implant placement leads to increased crestal bone resorption. However, clinical studies addressing the implant placement depth in relation to crestal bone have been rare. Data on subcrestal versus crestal placement have mostly come from animal studies. Even fewer data are available regarding the effects of crestal versus subcrestal positioning of platform-switched implants (Cochran et al., 2009). This study aims to compare the effect of different vertical implant position with immediate provisionalization on marginal bone loss thin and thick vertical tissue biotype.

Conditions

Dental Implant; Vertical Position; Esthetic Zone; Bounded Edentulous Area

Outcome Measures

Primary Outcomes (1)

• Crestal bone loss

  Interproximal bone loss will be measured using paralleling cone technique with standardized peri-apical x-ray and bone loss will be measured mesial and distal to the implant by measuring the vertical bone loss from the initial implant position at T3 immediately after implant position and T4 (6 months) and T5 (12 months), ,where interproximal bone loss will be defined as the distance from implant shoulder to the mesial and distal first visible bone-implant contact (fBIC) and (b) bone over the implant platform. One independent and calibrated examiner (A.P.) measured these radiological variables to the nearest 0.1 mm (Pico et al., 2019).

  1 year

Secondary Outcomes (6)

• Radiographic horizontal bucco-palatal bone changes

  1 year

• Radiographic vertical bone changes

  1 year

• Midfacial recession (MFR):

  easured at 6, and 12 months

• Esthetic evaluation

  1 year

• implant survival

  1 year

Study Arms (4)

Thin vertical soft tissue biotype, Placement of BLX implants 2 mm sub-crestal

EXPERIMENTAL

In Thin vertical soft tissue biotype, Placement of BLX implants 2 mm sub-crestal in single missing anterior or premolar teeth in the esthetic zone with immediate provisionalization via a straight emergence profile temporary crown on a temporary abutment.

Procedure: Placement of BLX implants 2 mm sub-crestal i

Thin vertical soft tissue biotype, Placement of BLX implants equicrestal

ACTIVE COMPARATOR

In Thin vertical soft tissue biotype, Placement of BLX implants equicrestal in single missing anterior or premolar teeth in the esthetic zone with immediate provisionalization via a straight emergence profile temporary crown on a temporary abutment.

Procedure: Placement of BLX implants equicrestal

Thick vertical soft tissue biotype, Placement of BLX implants 2 mm sub-crestal

EXPERIMENTAL

In Thick vertical soft tissue biotype, Placement of BLX implants 2 mm sub-crestal in single missing anterior or premolar teeth in the esthetic zone with immediate provisionalization via a straight emergence profile temporary crown on a temporary abutment.

Procedure: Placement of BLX implants 2 mm sub-crestal i

Thick vertical soft tissue biotype, Placement of BLX implants equicrestal

ACTIVE COMPARATOR

In Thick vertical soft tissue biotype, Placement of BLX implants equicrestal in single missing anterior or premolar teeth in the esthetic zone with immediate provisionalization via a straight emergence profile temporary crown on a temporary abutment.

Procedure: Placement of BLX implants equicrestal

Interventions

Placement of BLX implants 2 mm sub-crestal i PROCEDURE

Placement of BLX implants 2 mm sub-crestal in single missing anterior or premolar teeth in the esthetic zone with immediate provisionalization via a straight emergence profile temporary crown on a temporary abutment.

Thick vertical soft tissue biotype, Placement of BLX implants 2 mm sub-crestal; Thin vertical soft tissue biotype, Placement of BLX implants 2 mm sub-crestal

Placement of BLX implants equicrestal PROCEDURE

Placement of BLX implants equicrestal in single missing anterior or premolar teeth in the esthetic zone with immediate provisionalization via a straight emergence profile temporary crown on a temporary abutment.

Thick vertical soft tissue biotype, Placement of BLX implants equicrestal; Thin vertical soft tissue biotype, Placement of BLX implants equicrestal

Eligibility Criteria

• Age: 21 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients with single missing upper anterior or premolar teeth
• Patients with minimum buccolingual width of 6 mm and mesiodistal width of 6mm
• Patients with healthy systemic conditions.
• Patients older than 18 years.
• Good oral hygiene.
• Accepts one year follow-up period (cooperative patients).
• The patient provides informed consent.
• Adequate Inter-arch space for implant placement.
• Favorable occlusion (no traumatic occlusion).
• Absence of allergy to the prescribed medications.

You may not qualify if:

• Patients with inadequate bone volume and/ or quality
• Patients with local root remnants
• Patients with inadequate wound healing
• Patients with signs of acute infection related to the area of interest.
• Patients with habits that may jeopardize the implant longevity and affect the results of the study such as parafunctional habits (Lobbezoo et al., 2006).
• Heavy smokers patients (more than 10 cigarettes per day) (Lambert, Morris and Ochi, 2000).
• Metabolic diseases such as diabetes or hyperthyroidism as well as systemic medications such as chemotherapy or bisphosphonates
• Pregnant or nursing women.
• Uncooperative patients.

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

Faculty of Dentistry, Cairo University

Giza, 00000, Egypt

RECRUITING

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lecturer in the department of Oral Medicine & Periodontology

Study Record Dates

• First Submitted: December 11, 2023
• First Posted: December 20, 2023
• Study Start: December 1, 2023
• Primary Completion: December 30, 2024
• Study Completion: February 1, 2025
• Last Updated: December 20, 2023

Record last verified: 2023-12

Locations

EG (1)