Evaluation of Vertical Height in Anterior Maxillary Sandwich Osteotomy: Simultaneous Versus Delayed Implant Placement
NCT ID: NCT04022538
Last Updated: 2019-07-17
Study Results
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Basic Information
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UNKNOWN
NA
20 participants
INTERVENTIONAL
2019-07-31
2020-08-31
Brief Summary
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Detailed Description
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Description of Sandwich Osteotomy procedure to be done:
* A full thickness pyramidal flap with buccal paracrestal incision and two vertical releasing incisions slightly divergent to each other will be made. Then the mucoperiosteal flap will be reflected exposing the whole buccal cortical plate without reflection of the palatal mucosa.
* The palatal mucosa will not be reflected to avoid disturbance of blood supply to the mobilized segment for proper healing.
* With a Tungsten carbide disc - 1 mm in thickness and 10 mm in diameter - the alveolar bone will be segmented using a horizontal cut 3 to 5 mm apical to the crest of the ridge, and two lateral vertically oblique cuts 1-2 mm away from adjacent teeth roots slightly converging toward the alveolar crest or almost parallel to each other; thus creating a trapezoid-shaped bone segment pedicled on the attached palatal tissues.
* The horizontal and the two vertical cuts will then be revised using a set of graduated ridge splitting (fine chisels) osteotomes of sequential width and a light weight mallet to ensure that the surgical cuts are down to spongy bone.
* The segment will then be mobilized crestally, pedicled on the non-reflected palatal tissue.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
SINGLE
Study Groups
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Sandwich osteotomy with simultaneous implant placement
This group will undergo Sandwich osteotomy procedure and segment will be fixed using the dental implants placed simultaneously during the same surgical procedure. The remaining gap will be filled using xenograft.
Anterior maxillary vertical segmental sandwich osteotomy with simultaneous implant placement
Following the Sandwich Osteotomy procedure described in the study description, the following steps will be done:
* The first implant osteotomy will be prepared and placed while a chisel is placed between the down fractured segment and the basal bone, and then the second implant will be installed.
* The gap between the transported segment and the basal bone will be filled with xenograft particulate bone substitute.
* Finally, periosteal scoring will be done to allow tension-free interrupted closure using 3-0 vicryl suturing material.
Sandwich osteotomy using micro-plates fixation
This group will undergo Sandwich osteotomy procedure and segment will be fixed using micro-plates and screws, and the gap will be filled using xenograft.
Anterior maxillary vertical segmental sandwich osteotomy using micro-plates fixation
Following the Sandwich Osteotomy procedure described in the study description, the following steps will be done:
* The created gap between the transported segment and the basal bone will be filled with xenograft particulate bone substitute.
* The mobilized segment is to be fixed to the basal bone using micro-plates and micro-screws.
* Finally, periosteal scoring will be done to allow tension-free interrupted closure using 3-0 vicryl suturing material.
Interventions
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Anterior maxillary vertical segmental sandwich osteotomy with simultaneous implant placement
Following the Sandwich Osteotomy procedure described in the study description, the following steps will be done:
* The first implant osteotomy will be prepared and placed while a chisel is placed between the down fractured segment and the basal bone, and then the second implant will be installed.
* The gap between the transported segment and the basal bone will be filled with xenograft particulate bone substitute.
* Finally, periosteal scoring will be done to allow tension-free interrupted closure using 3-0 vicryl suturing material.
Anterior maxillary vertical segmental sandwich osteotomy using micro-plates fixation
Following the Sandwich Osteotomy procedure described in the study description, the following steps will be done:
* The created gap between the transported segment and the basal bone will be filled with xenograft particulate bone substitute.
* The mobilized segment is to be fixed to the basal bone using micro-plates and micro-screws.
* Finally, periosteal scoring will be done to allow tension-free interrupted closure using 3-0 vicryl suturing material.
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* Patients free from any systemic conditions and bone metabolism diseases that might interfere with the surgical intervention, soft tissue or hard tissue healing.
* Edentulous anterior maxilla with vertically deficient alveolar ridge that is less than 10 mm measured from the crest of the alveolar ridge to the nasal floor.
* Normal vertical dimension with increased inter-arch space.
* The minimum number of missing teeth in the anterior maxillary alveolar ridge is two adjacent anterior teeth.
Exclusion Criteria
* Previous grafting procedures in the edentulous area.
* Deficient horizontal dimensions of the alveolar ridge i.e. width is less than 5 mm.
20 Years
55 Years
ALL
Yes
Sponsors
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Cairo University
OTHER
Responsible Party
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Mohammed Ahmed Ali Abdulkhaleq Al-dubai
Master Candidate of Oral & Maxillofacial Surgery, Faculty of Oral & Dental Medicine
Principal Investigators
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Mohammed Aldubai
Role: PRINCIPAL_INVESTIGATOR
Master's Degree Candidate at Faculty of Dentistry, Cairo University
Central Contacts
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References
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Bashutski JD, Wang HL. Common implant esthetic complications. Implant Dent. 2007 Dec;16(4):340-8. doi: 10.1097/ID.0b013e318159ca05.
Carlsson GE, Bergman B, Hedegard B. Changes in contour of the maxillary alveolar process under immediate dentures. A longitudinal clinical and x-ray cephalometric study covering 5 years. Acta Odontol Scand. 1967 Jun;25(1):45-75. doi: 10.3109/00016356709072522. No abstract available.
El Hadidy MS, Mounir M, Abou-Elfetouh A, Barakat A. Assessment of vertical ridge augmentation and labial prominence using buccal versus palatal approaches for maxillary segmental sandwich osteotomy (inlay technique): A randomized clinical trial. Clin Implant Dent Relat Res. 2018 Oct;20(5):722-728. doi: 10.1111/cid.12653. Epub 2018 Jul 18.
Esposito M, Grusovin MG, Kwan S, Worthington HV, Coulthard P. Interventions for replacing missing teeth: bone augmentation techniques for dental implant treatment. Cochrane Database Syst Rev. 2008 Jul 16;(3):CD003607. doi: 10.1002/14651858.CD003607.pub3.
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Keestra JA, Barry O, Jong Ld, Wahl G. Long-term effects of vertical bone augmentation: a systematic review. J Appl Oral Sci. 2016 Jan-Feb;24(1):3-17. doi: 10.1590/1678-775720150357.
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Lim G, Lin GH, Monje A, Chan HL, Wang HL. Wound Healing Complications Following Guided Bone Regeneration for Ridge Augmentation: A Systematic Review and Meta-Analysis. Int J Oral Maxillofac Implants. 2018 January/February;33(1):41-50. doi: 10.11607/jomi.5581. Epub 2017 Sep 22.
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Milinkovic I, Cordaro L. Are there specific indications for the different alveolar bone augmentation procedures for implant placement? A systematic review. Int J Oral Maxillofac Surg. 2014 May;43(5):606-25. doi: 10.1016/j.ijom.2013.12.004. Epub 2014 Jan 19.
Mounir M, Mounir S, Abou-Elfetouh A, Shaker MA. Assessment of vertical ridge augmentation in anterior aesthetic zone using onlay xenografts with titanium mesh versus the inlay bone grafting technique: A randomized clinical trial. Int J Oral Maxillofac Surg. 2017 Nov;46(11):1458-1465. doi: 10.1016/j.ijom.2017.04.021. Epub 2017 May 16.
Nkenke E, Neukam FW. Autogenous bone harvesting and grafting in advanced jaw resorption: morbidity, resorption and implant survival. Eur J Oral Implantol. 2014 Summer;7 Suppl 2:S203-17.
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Schropp L, Wenzel A, Kostopoulos L, Karring T. Bone healing and soft tissue contour changes following single-tooth extraction: a clinical and radiographic 12-month prospective study. Int J Periodontics Restorative Dent. 2003 Aug;23(4):313-23.
Tolstunov L. Classification of the alveolar ridge width: implant-driven treatment considerations for the horizontally deficient alveolar ridges. J Oral Implantol. 2014 Jul;40 Spec No:365-70. doi: 10.1563/aaid-joi-D-14-00023. Epub 2014 Feb 27.
Rutkowski JL. Vertical Alveolar Ridge Augmentation in Implant Dentistry: A Surgical Manual and Horizontal Alveolar Ridge Augmentation in Implant Dentistry: A Surgical Manual. Tolstunov L, ed. Hoboken, NJ: John Wiley & Sons, Inc. Hoboken, New Jersey. J Oral Implantol. 2016 Dec;42(6):518. doi: 10.1563/aaid-joi-D-Review.4206. No abstract available.
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Other Identifiers
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CEBD-CU-2019-05-27
Identifier Type: -
Identifier Source: org_study_id
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