Comparison of Envelope Coronally Advanced Flap and Modified Tunnel Technique in Soft Tissue Dehiscence Around Implants

NCT ID: NCT03498911

Last Updated: 2022-05-09

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

COMPLETED

Clinical Phase

NA

Total Enrollment

28 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-07-10

Study Completion Date

2022-04-11

Brief Summary

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The purpose of this study is to assess the influence of two different flap designs (envelope Coronally Advanced Flap (eCAF) and Modified Tunnel Technique (MTT)) with the addition of a connective tissue graft (CTG) in treating soft tissue dehiscences at implant sites

Detailed Description

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The primary aim is to compare the test and control groups in terms of:

1. mean mid-facial recession coverage (mRC) measured as a percentage
2. the keratinized tissue (KT) gain measured in mm
3. the keratinized tissue thickness (KTT) gain measured in mm.

The secondary aims are to compare the two groups in terms of:

1. Esthetic score, using numeric values from 0 to 10
2. patient-reported esthetics, using numeric values from 1 to 5
3. patient-reported post-operative pain, based on Visual Analog Scale (VAS) scale, measured as numbers from 0 to 10.

Conditions

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Dental Implants

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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envelope Coronally Advanced Flap (eCAF)

A mucogingival surgery where an envelope flap is coronally advanced and sutured to cover the mucosal recession

Group Type ACTIVE_COMPARATOR

Mucogingival surgery

Intervention Type PROCEDURE

The gingiva around the mucosal recession at implant site will be coronally positioned by releasing the underlying mucosa

Modified Tunnel Technique (MTT)

A mucogingival surgery where the gingiva is released without reflecting a flap (as described for tunnel techniques) and then coronally advanced and sutured to cover the mucosal recession

Group Type EXPERIMENTAL

Mucogingival surgery

Intervention Type PROCEDURE

The gingiva around the mucosal recession at implant site will be coronally positioned by releasing the underlying mucosa

Interventions

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Mucogingival surgery

The gingiva around the mucosal recession at implant site will be coronally positioned by releasing the underlying mucosa

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 18 years
* Periodontally and systemically healthy
* Full-mouth plaque score and full-mouth bleeding score ≤ 20% (measured at four sites per tooth)
* Correct implant 3-dimensional position or buccal position ≤ 1 mm
* Buccal soft tissue dehiscence ≤ 4 mm
* Only osseointegrated implants
* The patient must be able to perform good oral hygiene

Exclusion Criteria

* Contraindications for periodontal surgery
* Patients pregnant or attempting to get pregnant
* Malpositioned implant
* Soft tissue dehiscence (STD) \> 4 mm
* Multiple adjacent implants with STD
* Existing of peri-implantitis
* Severe bone loss (≥4mm)
* Moderate-severe interproximal bone loss (implant fixture level to the alveolar bone \> 3 mm)
* Moderate-severe papilla height loss (Nordland and Tarnow implant papillae index \>1)
* Previous mucogingival surgery around the implant within the past six months or implant placement at the surgical site less than six months prior
* Smoking more than 10 cigarettes a day
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Delta Dental Foundation

OTHER

Sponsor Role collaborator

University of Michigan

OTHER

Sponsor Role lead

Responsible Party

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Hom-Lay Wang, DDS, MSD, Ph D

Collegiate Professor of Periodontics and Professor of Dentistry

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Hom-Lay Wang, DDS MSD PhD

Role: PRINCIPAL_INVESTIGATOR

University of Michigan

Locations

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University of Michigan School of Dentistry

Ann Arbor, Michigan, United States

Site Status

Countries

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United States

References

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Zucchelli G, Mazzotti C, Mounssif I, Mele M, Stefanini M, Montebugnoli L. A novel surgical-prosthetic approach for soft tissue dehiscence coverage around single implant. Clin Oral Implants Res. 2013 Sep;24(9):957-62. doi: 10.1111/clr.12003. Epub 2012 Aug 27.

Reference Type RESULT
PMID: 22924841 (View on PubMed)

Sculean A, Chappuis V, Cosgarea R. Coverage of mucosal recessions at dental implants. Periodontol 2000. 2017 Feb;73(1):134-140. doi: 10.1111/prd.12178.

Reference Type RESULT
PMID: 28000282 (View on PubMed)

Schwarz F, Mihatovic I, Shirakata Y, Becker J, Bosshardt D, Sculean A. Treatment of soft tissue recessions at titanium implants using a resorbable collagen matrix: a pilot study. Clin Oral Implants Res. 2014 Jan;25(1):110-5. doi: 10.1111/clr.12042. Epub 2012 Oct 31.

Reference Type RESULT
PMID: 23113567 (View on PubMed)

Roccuzzo M, Gaudioso L, Bunino M, Dalmasso P. Surgical treatment of buccal soft tissue recessions around single implants: 1-year results from a prospective pilot study. Clin Oral Implants Res. 2014 Jun;25(6):641-6. doi: 10.1111/clr.12149. Epub 2013 Apr 15.

Reference Type RESULT
PMID: 23582029 (View on PubMed)

Morelli T, Neiva R, Nevins ML, McGuire MK, Scheyer ET, Oh TJ, Braun TM, Nor JE, Bates D, Giannobile WV. Angiogenic biomarkers and healing of living cellular constructs. J Dent Res. 2011 Apr;90(4):456-62. doi: 10.1177/0022034510389334. Epub 2011 Jan 19.

Reference Type RESULT
PMID: 21248359 (View on PubMed)

Burkhardt R, Joss A, Lang NP. Soft tissue dehiscence coverage around endosseous implants: a prospective cohort study. Clin Oral Implants Res. 2008 May;19(5):451-7. doi: 10.1111/j.1600-0501.2007.01497.x. Epub 2008 Mar 26.

Reference Type RESULT
PMID: 18371102 (View on PubMed)

Bassetti RG, Stahli A, Bassetti MA, Sculean A. Soft tissue augmentation around osseointegrated and uncovered dental implants: a systematic review. Clin Oral Investig. 2017 Jan;21(1):53-70. doi: 10.1007/s00784-016-2007-9. Epub 2016 Nov 21.

Reference Type RESULT
PMID: 27873018 (View on PubMed)

Anderson LE, Inglehart MR, El-Kholy K, Eber R, Wang HL. Implant associated soft tissue defects in the anterior maxilla: a randomized control trial comparing subepithelial connective tissue graft and acellular dermal matrix allograft. Implant Dent. 2014 Aug;23(4):416-25. doi: 10.1097/ID.0000000000000122.

Reference Type RESULT
PMID: 25033346 (View on PubMed)

Tavelli L, Majzoub J, Kauffmann F, Rodriguez MV, Mancini L, Chan HL, Kripfgans OD, Giannobile WV, Wang HL, Barootchi S. Coronally advanced flap versus tunnel technique for the treatment of peri-implant soft tissue dehiscences with the connective tissue graft: A randomized, controlled clinical trial. J Clin Periodontol. 2023 Jul;50(7):980-995. doi: 10.1111/jcpe.13806. Epub 2023 Apr 4.

Reference Type DERIVED
PMID: 36935199 (View on PubMed)

Other Identifiers

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HUM00140205

Identifier Type: -

Identifier Source: org_study_id

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