Primary Stability of Implant in Closed Sinus Lifting Cases Using Densah Bur Versus Osteotome

NCT ID: NCT03559777

Last Updated: 2018-06-18

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

14 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-07-01

Study Completion Date

2019-08-01

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

This study is aiming to evaluate primary stability of implant in closed sinus lifting cases by Densah bur in compared to Osteotome in partially edentulous patients hoping that densah bur can lift the sinus membrane and improve primary stability of implant.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

The osteotome technique is effective in certain cases, but the most sensitive aspect is the tapping force, which should be sufficient enough to infracture the sinus floor cortical bone but restrained enough to prevent the osteotome tip from traumatizing the Schneiderian membrane.

Several surgical techniques have been proposed to minimize the sinus membrane perforation rate by using a piezosurgical device, balloon, hydrostatic pressure.

The success of therapy in posterior maxilla is not only dependent on the success of the sinus elevation but also the primary stability of the implant that allow bone apposition on the implant surface without any micromovement for osseeointegration.

Later, densah burs are introduced as another treatment option for internal transalveolar approach of sinus floor elevation with improving primary stability of implant by osseodensification.

As treatment options of edentulous maxillary today may include dental implants, the practitioner must be familiar with various sinus lift surgical techniques in order to choose an ideal treatment option for the patient.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Sinus Pneumatization

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The patients will be randomly divided into 2 equal groups
Primary Study Purpose

OTHER

Blinding Strategy

SINGLE

Investigators
Each patient will be given a code by the researcher and the observers will be blind to which group this case belong.

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

closed sinus lifting by Osteotome

* Local anesthesia will be injected intra-orally
* A full thickness flap will be elevated
* A pilot drill will be used to start the osteotomy preparation, which should be ended 1mm short of sinus floor.
* The widening drills can be sequentially used to widen the osteotomy site to the same level
* An osteotome of diameter a little less than the planned implant body, will be inserted in the prepared osteotomy site and gently tapped to reach the same level.
* The osteotome will be tapped gently to fracture up the sinus floor.
* Xenograft will be added to the osteotomy as the grafting material.
* Once the desired height of sinus elevation will be gained and grafted, the implant fixture will be inserted.
* Smart peg will be placed on implant and Ostell will be used to record ISQ.
* Healing collar will be placed on implant.
* Suturing the flab around healing collar.

Group Type ACTIVE_COMPARATOR

closed sinus lifting by Osteotome

Intervention Type OTHER

* Local anesthesia will be injected intra-orally
* A full thickness flap will be elevated
* A pilot drill will be used to start the osteotomy preparation, which should be ended 1mm short of sinus floor.
* The widening drills can be sequentially used to widen the osteotomy site to the same level
* An osteotome of diameter a little less than the planned implant body, will be inserted in the prepared osteotomy site and gently tapped to reach the same level.
* The osteotome will be tapped gently to fracture up the sinus floor.
* Xenograft will be added to the osteotomy as the grafting material.
* Once the desired height of sinus elevation will be gained and grafted, the implant fixture will be inserted.
* Smart peg will be placed on implant and Ostell will be used to record ISQ.
* Healing collar will be placed on implant.
* Suturing the flab around healing collar.

closed sinus lifting by Densah bur

* Local anesthesia will be injected intra-orally
* A full thickness flap will be elevated
* A pilot drill will be used to start the osteotomy , which should be ended 1mm short of sinus floor.
* Change the drill motor to reverse- densifying Mode
* Begin with the densah bur (2.5mm) until 1 mm short of the sinus floor.
* Use the next wider Densah Bur (3.0) in densifying-mode until feeling the haptic feedback of the bur reaching the dense sinus floor, modulate pressure with a gentle pumping motion to advance past the sinus floor in 1 mm increments.
* densah burs (3.5mm) advance in the osteotomy.
* Xenograft will be added to the osteotomy .
* Once the desired height of sinus elevation will be gained and grafted, the implant fixture will be inserted.
* Smart peg will be placed on implant and Ostell will be used to record ISQ.
* Healing collar will be placed on implant.
* Suturing the flab around healing collar.

Group Type EXPERIMENTAL

closed sinus lifting by Densah bur

Intervention Type OTHER

* Local anesthesia will be injected intra-orally
* A full thickness flap will be elevated
* A pilot drill will be used to start the osteotomy , which should be ended 1mm short of sinus floor.
* Change the drill motor to reverse- densifying Mode
* with the densah bur (2.5mm) until 1 mm short of the sinus floor.
* Use the next wider Densah Bur (3.0) in densifying-mode until feeling the haptic feedback of the bur reaching the dense sinus floor, modulate pressure with a gentle pumping motion to advance past the sinus floor in 1 mm increments.
* densah burs (3.5mm) advance in the osteotomy.
* Xenograft will be added to the osteotomy .
* Once the desired height of sinus elevation will be gained and grafted, the implant fixture will be inserted.
* Smart peg will be placed on implant and Ostell will be used to record ISQ.
* Healing collar will be placed on implant.
* Suturing the flab around healing collar.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

closed sinus lifting by Osteotome

* Local anesthesia will be injected intra-orally
* A full thickness flap will be elevated
* A pilot drill will be used to start the osteotomy preparation, which should be ended 1mm short of sinus floor.
* The widening drills can be sequentially used to widen the osteotomy site to the same level
* An osteotome of diameter a little less than the planned implant body, will be inserted in the prepared osteotomy site and gently tapped to reach the same level.
* The osteotome will be tapped gently to fracture up the sinus floor.
* Xenograft will be added to the osteotomy as the grafting material.
* Once the desired height of sinus elevation will be gained and grafted, the implant fixture will be inserted.
* Smart peg will be placed on implant and Ostell will be used to record ISQ.
* Healing collar will be placed on implant.
* Suturing the flab around healing collar.

Intervention Type OTHER

closed sinus lifting by Densah bur

* Local anesthesia will be injected intra-orally
* A full thickness flap will be elevated
* A pilot drill will be used to start the osteotomy , which should be ended 1mm short of sinus floor.
* Change the drill motor to reverse- densifying Mode
* with the densah bur (2.5mm) until 1 mm short of the sinus floor.
* Use the next wider Densah Bur (3.0) in densifying-mode until feeling the haptic feedback of the bur reaching the dense sinus floor, modulate pressure with a gentle pumping motion to advance past the sinus floor in 1 mm increments.
* densah burs (3.5mm) advance in the osteotomy.
* Xenograft will be added to the osteotomy .
* Once the desired height of sinus elevation will be gained and grafted, the implant fixture will be inserted.
* Smart peg will be placed on implant and Ostell will be used to record ISQ.
* Healing collar will be placed on implant.
* Suturing the flab around healing collar.

Intervention Type OTHER

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Both males as well as females without any active periodontal disease.
* All patients were in a good health with no systemic diseases.
* All selected patients were non-smokers and non-alcoholics.
* Patient were free from T.M.J troubles, abnormal oral habits such as bruxism.
* The edentulous ridges were covered with optimal thickness of soft tissue.
* Remaining natural teeth had good.
* Periodontal tissue support and occlusion showed sufficient inter arch space.
* On the local level, patients with maxillary sinus diseases and unfavorable inter maxillary relationship were excluded.

Exclusion Criteria

* Patients with residual bone height less than 6mm.
* Patients with systemic disease that may affect bone quality.
* Patients with poor oral hygiene and active periodontal diseases.
* Patient with limited mouth opening.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Cairo University

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Taha amer taha

Principal Investigator(doctor)

Responsibility Role PRINCIPAL_INVESTIGATOR

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

taha amer, master

Role: CONTACT

+201095896951

ahmed fahmy, professor

Role: CONTACT

+201001029723

References

Explore related publications, articles, or registry entries linked to this study.

Zohrabian VM, Sonick M, Hwang D, Abrahams JJ. Dental Implants. Semin Ultrasound CT MR. 2015 Oct;36(5):415-26. doi: 10.1053/j.sult.2015.09.002. Epub 2015 Sep 12.

Reference Type BACKGROUND
PMID: 26589695 (View on PubMed)

Atwood DA. Reduction of residual ridges: a major oral disease entity. J Prosthet Dent. 1971 Sep;26(3):266-79. doi: 10.1016/0022-3913(71)90069-2. No abstract available.

Reference Type BACKGROUND
PMID: 4934947 (View on PubMed)

Tatum H Jr. Maxillary and sinus implant reconstructions. Dent Clin North Am. 1986 Apr;30(2):207-29.

Reference Type BACKGROUND
PMID: 3516738 (View on PubMed)

Valentini P, Abensur DJ. Maxillary sinus grafting with anorganic bovine bone: a clinical report of long-term results. Int J Oral Maxillofac Implants. 2003 Jul-Aug;18(4):556-60.

Reference Type BACKGROUND
PMID: 12939008 (View on PubMed)

Summers RB. A new concept in maxillary implant surgery: the osteotome technique. Compendium. 1994 Feb;15(2):152, 154-6, 158 passim; quiz 162.

Reference Type BACKGROUND
PMID: 8055503 (View on PubMed)

Pjetursson BE, Tan WC, Zwahlen M, Lang NP. A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. J Clin Periodontol. 2008 Sep;35(8 Suppl):216-40. doi: 10.1111/j.1600-051X.2008.01272.x.

Reference Type BACKGROUND
PMID: 18724852 (View on PubMed)

Chen L, Cha J. An 8-year retrospective study: 1,100 patients receiving 1,557 implants using the minimally invasive hydraulic sinus condensing technique. J Periodontol. 2005 Mar;76(3):482-91. doi: 10.1902/jop.2005.76.3.482.

Reference Type BACKGROUND
PMID: 15857085 (View on PubMed)

Pietrokovski J, Massler M. Alveolar ridge resorption following tooth extraction. J Prosthet Dent. 1967 Jan;17(1):21-7. doi: 10.1016/0022-3913(67)90046-7. No abstract available.

Reference Type BACKGROUND
PMID: 5224784 (View on PubMed)

Bartee BK. Extraction site reconstruction for alveolar ridge preservation. Part 1: rationale and materials selection. J Oral Implantol. 2001;27(4):187-93. doi: 10.1563/1548-1336(2001)0272.3.CO;2.

Reference Type BACKGROUND
PMID: 12500877 (View on PubMed)

Sharan A, Madjar D. Maxillary sinus pneumatization following extractions: a radiographic study. Int J Oral Maxillofac Implants. 2008 Jan-Feb;23(1):48-56.

Reference Type BACKGROUND
PMID: 18416412 (View on PubMed)

Chrcanovic BR, Albrektsson T, Wennerberg A. Reasons for failures of oral implants. J Oral Rehabil. 2014 Jun;41(6):443-76. doi: 10.1111/joor.12157. Epub 2014 Mar 11.

Reference Type BACKGROUND
PMID: 24612346 (View on PubMed)

Geckili O, Bilhan H, Geckili E, Cilingir A, Mumcu E, Bural C. Evaluation of possible prognostic factors for the success, survival, and failure of dental implants. Implant Dent. 2014 Feb;23(1):44-50. doi: 10.1097/ID.0b013e3182a5d430.

Reference Type BACKGROUND
PMID: 24113554 (View on PubMed)

Lundgren S, Cricchio G, Hallman M, Jungner M, Rasmusson L, Sennerby L. Sinus floor elevation procedures to enable implant placement and integration: techniques, biological aspects and clinical outcomes. Periodontol 2000. 2017 Feb;73(1):103-120. doi: 10.1111/prd.12165.

Reference Type BACKGROUND
PMID: 28000271 (View on PubMed)

Schwartz-Arad D, Herzberg R, Dolev E. The prevalence of surgical complications of the sinus graft procedure and their impact on implant survival. J Periodontol. 2004 Apr;75(4):511-6. doi: 10.1902/jop.2004.75.4.511.

Reference Type BACKGROUND
PMID: 15152813 (View on PubMed)

Tan WC, Lang NP, Zwahlen M, Pjetursson BE. A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. Part II: transalveolar technique. J Clin Periodontol. 2008 Sep;35(8 Suppl):241-54. doi: 10.1111/j.1600-051X.2008.01273.x.

Reference Type BACKGROUND
PMID: 18724853 (View on PubMed)

Di Girolamo M, Napolitano B, Arullani CA, Bruno E, Di Girolamo S. Paroxysmal positional vertigo as a complication of osteotome sinus floor elevation. Eur Arch Otorhinolaryngol. 2005 Aug;262(8):631-3. doi: 10.1007/s00405-004-0879-9. Epub 2005 Feb 27.

Reference Type BACKGROUND
PMID: 15735973 (View on PubMed)

Garbacea A, Lozada JL, Church CA, Al-Ardah AJ, Seiberling KA, Naylor WP, Chen JW. The incidence of maxillary sinus membrane perforation during endoscopically assessed crestal sinus floor elevation: a pilot study. J Oral Implantol. 2012 Aug;38(4):345-59. doi: 10.1563/AAID-JOI-D-12-00083.

Reference Type BACKGROUND
PMID: 22913307 (View on PubMed)

Nobrega AR, Norton A, Silva JA, Silva JP, Branco FM, Anitua E. Osteotome versus conventional drilling technique for implant site preparation: a comparative study in the rabbit. Int J Periodontics Restorative Dent. 2012 Jun;32(3):e109-15.

Reference Type BACKGROUND
PMID: 22408780 (View on PubMed)

Buchter A, Kleinheinz J, Wiesmann HP, Kersken J, Nienkemper M, Weyhrother Hv, Joos U, Meyer U. Biological and biomechanical evaluation of bone remodelling and implant stability after using an osteotome technique. Clin Oral Implants Res. 2005 Feb;16(1):1-8. doi: 10.1111/j.1600-0501.2004.01081.x.

Reference Type BACKGROUND
PMID: 15642025 (View on PubMed)

Stavropoulos A, Nyengaard JR, Lang NP, Karring T. Immediate loading of single SLA implants: drilling vs. osteotomes for the preparation of the implant site. Clin Oral Implants Res. 2008 Jan;19(1):55-65. doi: 10.1111/j.1600-0501.2007.01422.x. Epub 2007 Oct 22.

Reference Type BACKGROUND
PMID: 17956566 (View on PubMed)

Rosen PS, Summers R, Mellado JR, Salkin LM, Shanaman RH, Marks MH, Fugazzotto PA. The bone-added osteotome sinus floor elevation technique: multicenter retrospective report of consecutively treated patients. Int J Oral Maxillofac Implants. 1999 Nov-Dec;14(6):853-8.

Reference Type BACKGROUND
PMID: 10612923 (View on PubMed)

Meyer, E, and S Huwais, 'Osseodensification Is a Novel Implant Preparation Technique That Increases Implant Primary Stability by Compaction and Auto-Grafting Bone', American Academy of Periodontology, 2014

Reference Type BACKGROUND

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

closed sinus lifiting

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.