Radiographic and Histological Assessment of Autogenous Onlay Block Versus Cortical Shell on Anterior Maxilla

NCT06450535 | Recruiting DMC

• 1 other identifier: CEBD_CU_2024_26_1
• Study Type: interventional
• Target: 16
• Locations: 1 country
• Sites: 1

Brief Summary

Two groups of patient with horizontally deficient anterior maxilla indicated for bone augmentation ,one will be subjected to autogenous onlay bone block from retromolar bone and the other to cortical shell from retromolar bone also.

Conditions

Alveolar Bone Loss

Keywords

Autogenous onlay bone block; Cortical shell technique

Outcome Measures

Primary Outcomes (1)

• radiographic analysis

  calculation of bone width gain using cone beam computed tomography

  4 month postoperative

Secondary Outcomes (1)

• histomorphometric analysis

  4 months postoperative

Study Arms (2)

Autogenous onlay block from retromolar bone

EXPERIMENTAL

In the first intervention, a bone block harvested from the donor site was fixed with osteosynthesis titanium screws to the recipient site as an onlay graft to achieve a horizontal enlargement of the alveolar ridge. ● Placement of the bone graft was always guided by an augmentation template

Procedure: Autogenous onlay bone block harvesting from retromolar bone in anterior maxilla

Cortical shell technique from retromolar bone

ACTIVE COMPARATOR

The harvested cortical plate was then split longitudinally in two parts using a microsaw, and thinned with the bone scraper to achieve a plate of 1 mm thickness. * The plate was fixed at a distance from the residual ridge with 2 screws. * Autogenous bone particles, collected with the bone scraper, were tightly packed into the gap between the plate and the recipient site.

Procedure: Autogenous cortical shell technique from retromolar bone in anterior maxilla

Interventions

Autogenous onlay bone block harvesting from retromolar bone in anterior maxilla PROCEDURE

Surgical protocol ( retromolar bone harvesting) After injecting local anesthesia a crestal incision is done, from a point on the occlusal surface along the external oblique ridge and extending anteriorly and inferiorly through the buccal mucosa, parallel to the gingival margin of the mandibular molars. The subperiosteal dissection extend to expose the ascending ramus and the retromolar region With the aid of surgical carbide burs, two proximal vertical cuts penetrating the cortex of the external oblique ridge. The depth of penetration of the posterior cut did not exceed 2.5 mm to avoid injury to the inferior alveolar nerve. By using microsaw , an inferior cut of 3.2 mm in depth joining the anterior and posterior vertical cuts was done. Small perforations of 3-4 mm in depth were performed on the superior aspect of the external oblique ridge using 1 mm drill bur. Finally, the block was sheared off using a chisel.

Also known as: Autogenous onlay block from retomolar bone

Autogenous onlay block from retromolar bone

Autogenous cortical shell technique from retromolar bone in anterior maxilla PROCEDURE

The harvested cortical plate was then split longitudinally in two parts using a microsaw, and thinned with the bone scraper to achieve a plate of 1 mm thickness. The plate was fixed at a distance from the residual ridge with 2 screws. Autogenous bone particles, collected with the bone scraper, were tightly packed into the gap between the plate and the recipient site.

Also known as: Cortical shell technique from retromolar bone

Cortical shell technique from retromolar bone

Eligibility Criteria

• Age: 20 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Patients in both sex with partial edentulism of the maxilla and requiring horizontal ridge augmentation
• The ages of the patients ranged from 20 to 60 years.
• The residual ridge width in these patients are less than 4.m
• Sufficient bone in intra-oral donor sites are available (external oblique ridge)
• Patients free from any systemic conditions and bone metabolism diseases that might interfere with the surgical intervention, soft tissue or hard tissue healing.
• The vertical level should be in a favourable esthetic appearance with normal inter-arch space
• The minimum number of missing teeth in the anterior maxilla alveolar ridge is one single extracted teeth

You may not qualify if:

• Subjected to irradiation in the head and neck area less than 1 year before implantation.
• Poor oral hygiene and motivation.
• Uncontrolled diabetes.
• Pregnant or nursing.
• Substance abuse.
• Psychiatric problems or unrealistic expectations.
• Severe bruxism or clenching.
• Immunosuppressed or immunocompromised.

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

faculty of oral and dental medicine ,Cairo university

Cairo, Giza Governorate, 12613, Egypt

RECRUITING

Related Links

• Breakage of internal maxillary distractor: considerable complication of maxillary distraction osteogenesis
• The outcome of intraoral onlay block bone grafts on alveolar ridge augmentations: A systematic review
• Lateral Ridge Augmentation Using Autogenous Block Grafts and Guided Bone Regeneration: A 10-Year Prospective Case Series Study
• Vertical Distraction Osteogenesis of Edentulous Ridges for Improvement of Oral Implant Positioning: A Clinical Report of Preliminary Results.
• Long-Term Results of Peri-implant Conditions in Periodontally Compromised Patients Following Lateral Bone Augmentation.
• Augmentation of the sinus floor with mandibular bone block and simultaneous implantation: a 6-year clinical investigation
• "Secure and effective stabilization of different sized autogenous bone grafts."
• Mechanisms of guided bone regeneration: a review
• Evolution of Barrier Membranes in Periodontal Regeneration-"Are the third Generation Membranes really here?
• Treatment concepts of horizontally deficient ridges-A retrospective study comparing narrow-diameter implants in pristine bone with standard-diameter implants in augmented bone.
• Bone healing and soft tissue contour changes following single-tooth extraction: a clinical and radiographic 12-month prospective study.
• The edentulous ridge expansion technique: a five-year study.

MeSH Terms

Conditions

Alveolar Bone Loss

Condition Hierarchy (Ancestors)

Bone Resorption; Bone Diseases; Musculoskeletal Diseases; Periodontal Atrophy; Periodontal Diseases; Mouth Diseases; Stomatognathic Diseases

Study Officials

• mohamed atef, PhD

  faculty of oral and dental medicine,cairo university

  STUDY DIRECTOR

Central Study Contacts

maria ibrahim nageeb, BSc

CONTACT

01002402712; maria.nageeb@dentistry.cu.edu.eg

maria ibrahim nageeb, BSc

CONTACT

01002402712; ibrahim9nageeb@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: This trial is considered a randomized single blind clinical trial due to the following: * The participants will be blinded to the technique that will be used during the surgical procedure. * The operator will not be blinded for both techniques during the surgical procedure as the two techniques are different. * The outcome assessor cannot be blinded. C) Data collection, management, and analysis:
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal investigator

Model Details: Randomzed cinical trial A trial will be caried out in hosptal of Oral and Maxllolacial surgery department- Faculy of Oral and Dental Medicine Cairo Univerity. Equal randomizaion: participants wih equal probabilites for intervenion Postive controlled :Both groups receiving treatment Parallel group study: Each group of patients receives a single treatment simutaneously

Study Record Dates

• First Submitted: May 9, 2024
• First Posted: June 10, 2024
• Study Start: July 1, 2024
• Primary Completion: December 1, 2025
• Study Completion: December 1, 2025
• Last Updated: June 10, 2024

Record last verified: 2024-06

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)