Narrow Implants Vs Standard Implants With Simultaneous GBR

Universitat Internacional de Catalunya26 enrolled

Overview

NDI represent an advisable treatment option when the mesio-distal space is compromised. In a recent retrospective study with a follow-up of 8 years in which they wanted to evaluate the long-term survival, complications, peri-implant conditions, marginal bone loss, and patient satisfaction of fixed dental prostheses supported by NDI in the posterior area. They observe a survival rate of 97% and absence of prosthetic complications after the study period time. More recently, Souza et al. performed a prospective randomized split mouth study with 3 years follow-up with the aim of comparing marginal bone level, implant survival and success rates and prosthesis success rates of NDI and SDI placed in the posterior area of the mandible to support single prosthesis. They observed an implant survival rate of 100% for both groups at 1 and 3 years. The prosthesis success rate at 1 and 3 years was of 95.4% and 100%, respectively. NDI present a high survival rate on the evaluated studies. Therefore, the aim of the first study is to compare the patient related outcomes, implants and prostheses success and survival rates of pure titanium NDI versus SDI with simultaneous bone regeneration in narrow alveolar ridges at posterior areas of the maxilla and the mandible.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Narrow Implant Dental Implant

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: Patients: * 18 years old * Healthy periodontal status (absence of generalized probing pocket depth (PPD) \<4mm) * Oral hygiene levels (FMPS \<20 and FMBS \<20) Site: * Ridge width of \>5mm and \<6.5mm and minimum bone height of 10mm prior evaluation on a CBCT scan * Presence of antagonistic natural tooth or fixed prosthetic restoration * Presence of adjacent teeth * One maxillary or mandibular premolars * Minimum of 3mm of keratinized tissue over the bone crest (20) * Bone regeneration within the limits of the prosthetic restoration. Implants: * Unitary prosthesis * Screwed retained restorations Exclusion Criteria: Patients * Presence of active chronic or aggressive periodontal disease * Presence of systemic disease which contraindicate surgery (patients with an ASA ≥ 3) * Drugs or medications which may alter the results (chronic intake of analgesic medication) * Smokers (\>10cig/day) * Pregnant women * History of head and neck radiotherapy. Site * Anterior area (from 1.3 to 2.3 and from 3.3 to 4.3) and molar area * Previous guided bone regeneration * Location where there is not sufficient restorative space (mesio-distally \<8mm for every restoration unit and \<5mm from the bone crest to the antagonist) * Implant dehiscence of more than 2/3 of the implant. Implant * Implants which cannot be restored with a screwed restoration * Implants which doesn't reach a manual implant stability * implants which after placement doesn't reach a favourable position according to the restoration.

Outcomes

Primary Outcomes

Marginal bone level difference

To assess the MBL, each radiograph must register the most coronal aspect of the bone crest (BC) at mesial and distal to the implant, the position of the implant shoulder (IS) and the first bone to implant contact (FBiC). The marginal bone crest level (MBL) will be measured by calculating the distance between BC and IS. MBL will be considered negative when position of BC is coronal to IS, positive when position BC is apical to IS.

Time frame: The changes in MBL will be registered at 8 weeks, 6 months, 12 months, and 3 years.

Secondary Outcomes

Patient related outcomes

\- Level of discomfort - at 1-, 2- and 12-weeks post-surgery (VAS scale): 0 - 4 (being 0 no discomfort and 4 very severe discomfort)

Time frame: At 1, 2 and 12 weeks

Patient Related Outcomes

Willingness of undergoing same surgical procedure - at 1-, 2- and 12-weeks post-surgery (VAS scale): 0 - 4 (being 0 will never undergo this surgery again and 4 no problem to repeat this surgery)

Time frame: At 1, 2 and 12 weeks

Patient Related Outcomes

\- Level of pain perceived - during first 7 days after surgery (VAS scale): 0-100 (being 0 no pain and 100 intolerable pain)

Time frame: At 7 days

Patient Related Outcomes

Medication required: Number of ibuprofen tablets taken between the 2nd and the 7th day.

Time frame: At 7 days

Implant survival criteria:

Defined as the implant being still in function

Time frame: 12 months

Implant success criteria:

Defined as absence of: * Persistent pain, foreign body sensation, and/or dysesthesia * Recurrent peri-implant infection with suppuration * Implant mobility * Continuous radiolucency around the implant * Clinical probing depth (CPD) ≥5 mm associated with bleeding/suppuration on probing (BoP/SoP).

Time frame: 12 months

Prosthesis success criteria

* Absence of prosthesis (crown or abutment) mobility * Number of maintenance visits * Crown screw loosening * Abutment screw loosening * Implant fracture * Crown screw fracture * Abutment screw fracture * Crown chipping.

Time frame: 12 months

Resonance frequency analysis

Resonance frequency analysis using Penguin ® will be measured immediately after implant placement, when taking implant impressions

Time frame: Implant surgery and after 12 months

Level of keratinized tissue surrounding the implants

Level of keratinized tissue will be measured from the gingival margin of the restored implant to the mucogingival line using a periodontal millimetre probe.

Time frame: 12 months

Peri-implant mucosal thickness using a millimetre probe

Time frame: 12 months

Presence of post-surgical complications

Defined as absence of: * Infection/suppuration * Wound dehiscence * Implant failure * Post-op oedema

Time frame: At 1, 2 and 12 weeks

Presence of peri-implant health

Defined as: * Peri-implant probing depth (6 points). * Bleeding on probing (presence or absence). * Suppuration on probing (presence or absence). * Plaque index (presence or absence).

Time frame: At 12 weeks, 6 and 12 months

Presence of prosthetic complications

Defined as: * Number of maintenance visits * Crown screw loosening ("Yes" or "No") * Abutment screw loosening ("Yes" or "No") * Implant fracture ("Yes" or "No") * Crown screw fracture ("Yes" or "No") * Abutment screw fracture ("Yes" or "No") * Framework fracture ("Yes" or "No") * Crown ceramic chipping ("Yes" or "No")

Time frame: At 6 and 12 months

Narrow Implants Vs Standard Implants With Simultaneous GBR

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts