Osseointegrated Dental Implants in Kidney Transplanted Patients

NCT ID: NCT02513602

Last Updated: 2016-11-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

26 participants

Study Classification

OBSERVATIONAL

Study Start Date

2014-05-31

Study Completion Date

2022-08-31

Brief Summary

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The evaluation of the bone, using several techniques and on several aspects will be the purpose to study the possible impact of the kidney transplant (and, extensively, the pre-transplant dialysis, the organ replacement and the immunosuppressive therapy) could have on the bone metabolism and on the density of the bone where the implants are placed. The assessment on the bone density only in a retrospectively selected population that underwent the same surgical procedure will help the comparison of the data to get a satisfactory conclusion. The evaluation of other clinical and instrumental parameters in the test group makes the kidney-transplant patients bone quality clear, and will consequently demonstrate if implants are a feasible therapy for these patients.

Detailed Description

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The primary purpose of this study is the evaluation of the effects of the kidney transplant on the periimplant bone density by the comparison with the density of healthy patients. The secondary purpose is obtaining clinical, histological and radiographic data to evaluate the effect of systemic conditions and its rebound on the insertion of fixtures.

Evaluation criteria

1. Control group: evaluation of the periimplant bone density (1 mm) next to the implant virtually planned using the CT editing software on the cone beam CT acquired in a retrospective sample of patients already treated with the insertion of a fixture in the molar or premolar edentulous site
2. Test group: periodontal evaluation with plaque index, bleeding on probing index and probing 1 month before operation.
3. Test group: evaluation of periimplant bone density (1 mm) in the fixture virtual-projected zone (the implant will be inserted there) with the CT acquisition and editing software.
4. Test group: evaluation of the implant stability after their insertion (primary stability) using the Resonance Frequence Analysis. ISQ (Implant Stability Quotient) value is expressed in 4 numbers (mesial, distal, buccal, lingual), average values of three measures acquired in each side.
5. Test group: evaluation of the implant stability immediately after the insertion calculating the insertional torque value (ITV) with an implant motor.
6. Test group: evaluation of the periimplant bone using an endoral periapical radiograph with Rinn device immediately after the operation.
7. Test group: histomorphological examination of the bone core sample made by a trephine resulted from the implant site preparation

Conditions

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Tooth Loss Disorder Related to Renal Transplantation

Keywords

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implantology kidney renal disease edentulism tooth loss

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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TEST group (kidney transplanted)

Kidney transplanted patients, passed through dialysis phase presenting a mandibular edentulism. It will be scheduled one or two dental implants to be inserted in mandible.

This group will be subjected to a dental implant insertion procedure.

Dental implant insertion

Intervention Type PROCEDURE

Dental implant insertion will be carry out in the mandible of the patients enrolled, through a surgical template in order to repeat the same position of the simulating implant insertion. After a trephine bur passage, the final two or three twist-drills will be used to realize the implant socket. After implant positioning, a cover screw will be tightened and the mucosa sutured above.

CONTROL group (healthy patients)

Healthy patients, with an inserted mandibular implant, retrospectively enrolled with a preoperative cbct scan.

No interventions assigned to this group

Interventions

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Dental implant insertion

Dental implant insertion will be carry out in the mandible of the patients enrolled, through a surgical template in order to repeat the same position of the simulating implant insertion. After a trephine bur passage, the final two or three twist-drills will be used to realize the implant socket. After implant positioning, a cover screw will be tightened and the mucosa sutured above.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Diagnosis: single or partial mandibular molar-premolar edentulism that requires up to 2 fixtures
* Good systemic compensation of the kidney transplant (≤ ASA American Society of Anesthesiologists score 3) with at least 1 year of previous hemodialysis or peritoneal dialysis and in actual immunosuppressive therapy
* Be older than 18 years
* The patient must be able to understand the meaning of the study and accept to undergo periodical follow-up controls.
* The patient must be able to understand and practice all the oral hygiene procedures demanded by the experimenter
* Signature of the informed consent form

and for control

* Diagnosis: single or partial mandibular molar-premolar edentulism that requires up to 2 fixtures
* Having a pre-operatory cone beam CT available
* Age older than 18 years
* Signature of the authorization to use and process personal details at the acceptance of every sort of treatment in the Company Hospital of Trieste.

Exclusion Criteria

* Post extraction implant (before 3 months from the extraction)
* Be less than 18 years old
* Smoking more than 10 cigarettes/day
* Plaque index more than 25
* Bleeding on probe index more than 25
* Clear allergy or intolerance against the products used in the study
* Patients that require reconstructive bone surgery before the fixtures placement (gbr and bone grafting)

and for control group

* Patients that require reconstructive bone surgery before the fixtures placement (gbr and bone grafting)
* Pathologies and pharmacological therapies that interfere with bone (for instance osteoporosis, osteomalacia, malnutrition, Paget's disease, corticosteroid therapy, bisphosphonate therapy, head and neck radiotherapy)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Trieste

OTHER

Sponsor Role lead

Responsible Party

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prof. Roberto Di Lenarda

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Roberto Di Lenarda, DDS, MSc

Role: STUDY_DIRECTOR

University of Trieste Medical School, Department of Odontology and Stomatology

Locations

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University Hospital Company, "Ospadale Maggiore"

Trieste, TS, Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Federico Berton, DDS

Role: CONTACT

Phone: 0403992254

Email: [email protected]

Facility Contacts

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Federico Berton, DDS

Role: primary

Gaetano Castronovo, MS, Msc

Role: backup

References

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Arisan V, Karabuda ZC, Avsever H, Ozdemir T. Conventional multi-slice computed tomography (CT) and cone-beam CT (CBCT) for computer-assisted implant placement. Part I: relationship of radiographic gray density and implant stability. Clin Implant Dent Relat Res. 2013 Dec;15(6):893-906. doi: 10.1111/j.1708-8208.2011.00436.x. Epub 2012 Jan 17.

Reference Type BACKGROUND
PMID: 22251553 (View on PubMed)

Cassetta M, Stefanelli LV, Di Carlo S, Pompa G, Barbato E. The accuracy of CBCT in measuring jaws bone density. Eur Rev Med Pharmacol Sci. 2012 Oct;16(10):1425-9.

Reference Type BACKGROUND
PMID: 23104660 (View on PubMed)

Zou H, Zhao X, Sun N, Zhang S, Sato T, Yu H, Chen Q, Weber HP, Dard M, Yuan Q, Lanske B. Effect of chronic kidney disease on the healing of titanium implants. Bone. 2013 Oct;56(2):410-5. doi: 10.1016/j.bone.2013.07.014. Epub 2013 Jul 19.

Reference Type BACKGROUND
PMID: 23876979 (View on PubMed)

Other Identifiers

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ITR

Identifier Type: -

Identifier Source: org_study_id