This randomized controlled clinical trial aimed to evaluate the clinical, radiographic, and histological outcomes of immediate implant loading in extraction sockets preserved using autogenous mineralized dentin graft (AMDG), beta-tricalcium phosphate (β-TCP), or no grafting. Twenty-two patients requiring extraction of maxillary premolars were enrolled, contributing a total of 27 extraction sites. Sites were randomly allocated into three groups: AMDG, β-TCP, or ungrafted control. Following socket preservation, dental implants were placed after a 6-month healing period and immediately loaded within 48 hours. Alveolar ridge dimensional changes were assessed using cone-beam computed tomography (CBCT) between implant placement and 2 years post-loading. Implant stability, peri-implant soft tissue health, and probing depths were evaluated at loading and during follow-up visits. Histological evaluation of regenerated bone was performed at the time of implant placement. The study sought to determine whether AMDG provides comparable or superior outcomes to β-TCP and ungrafted sockets in supporting immediate implant loading.
Immediate implant loading requires adequate primary stability and sufficient bone volume and quality. Ridge preservation techniques are therefore critical in maintaining post-extraction socket dimensions. Autogenous dentin grafts have recently gained attention due to their osteoconductive properties, biocompatibility, and cost-effectiveness. This study compares AMDG with a commonly used synthetic graft material (β-TCP) and ungrafted sockets to assess their influence on ridge preservation, implant stability, peri-implant tissue health, and bone quality under immediate loading conditions.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
22
Extraction sockets were preserved using AMDG prepared from the patient's own extracted tooth. Implants were placed 6 months post-grafting and immediately loaded within 48 hours.
Extraction sockets were preserved using synthetic β-TCP bone graft. Implants were placed 6 months post-grafting and immediately loaded within 48 hours.
Extraction sockets were left ungrafted and allowed to heal naturally. Implants were placed 6 months post-extraction and immediately loaded within 48 hours.
Faculty of Dentistry, Mansoura University
Al Mansurah, Egypt
Alveolar Ridge Width Change
Dimensional changes in alveolar ridge width were assessed using CBCT at the center, mesial, and distal sections of each implant site. Measurements were compared between the grafted (AMDG and β-TCP) and control groups over the follow-up period.Unit of Measure: Millimeters (mm)
Time frame: From 6 months post-extraction (implant placement) to 2 years post-loading
Implant Stability Quotient (ISQ)
Implant stability was assessed using resonance frequency analysis to record ISQ values at each follow-up visit for all groups.Unit of Measure: ISQ units(0-100)
Time frame: At implant loading, 3 months, and 6 months post-loading
Modified Sulcus Bleeding Index (mSBI)
Peri-implant soft tissue inflammation was evaluated using the mSBI at each follow-up visit for all groups. Unit of Measure: Index score (0-5 scale)
Time frame: At implant loading, 3 months, and 6 months post-loading
Probing Pocket Depth (PPD)
Probing depth around each implant was measured using a periodontal probe to assess peri-implant tissue health across all groups.Unit of Measure: Millimeters (mm)
Time frame: At implant loading, 3 months, and 6 months post-loading
Histological Bone Quality
Histological analysis of bone biopsies obtained from grafted and control sites was performed to evaluate bone maturity, remodeling, and osseointegration. Unit of Measure: Qualitative histological score.
Time frame: 6 months post-grafting (at implant placement)
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