Evaluation of Vertical Height in Anterior Maxillary Sandwich Osteotomy: Simultaneous Versus Delayed Implant Placement

NCT ID: NCT04022538

Last Updated: 2019-07-17

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

Clinical Phase

NA

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-07-31

Study Completion Date

2020-08-31

Brief Summary

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Vertical bone height has always presented challenge for the clinicians especially in the anterior aesthetic zone. Therefore, this trial will attempt to compare whether better vertical bone height and implant placement technique can be achieved using simultaneous implant placement with the sandwich osteotomy, which is a time saving procedure performed in a single stage surgery; when compared to using fixation plates to support the segment followed by delayed implant placement.

Detailed Description

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Fixation plates are usually used to support the segmentalized bone segment during vertical bone augmentation using sandwich osteotomy and inlay bone grafting; to minimize movement of the bone segment and allow for new bone formation. Therefore, the aim of this study is to evaluate vertical bone height achieved at the anterior maxilla in vertical segmental sandwich osteotomy with simultaneous implant placement versus the same technique using fixation plates.

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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Alveolar Bone Resorption

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

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.

Group Type EXPERIMENTAL

Anterior maxillary vertical segmental sandwich osteotomy with simultaneous implant placement

Intervention Type PROCEDURE

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.

Group Type ACTIVE_COMPARATOR

Anterior maxillary vertical segmental sandwich osteotomy using micro-plates fixation

Intervention Type PROCEDURE

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.

Intervention Type PROCEDURE

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.

Intervention Type PROCEDURE

Other Intervention Names

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Inlay alveolar bone grafting with simultaneous implant placement

Eligibility Criteria

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Inclusion Criteria

* Age range from 20-55 years. No sex predilection.
* 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

* • Intra-bony lesions (e.g. cysts) or infections (e.g. abscess) that may retard the osteotomy healing.
* Previous grafting procedures in the edentulous area.
* Deficient horizontal dimensions of the alveolar ridge i.e. width is less than 5 mm.
Minimum Eligible Age

20 Years

Maximum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Cairo University

OTHER

Sponsor Role lead

Responsible Party

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Mohammed Ahmed Ali Abdulkhaleq Al-dubai

Master Candidate of Oral & Maxillofacial Surgery, Faculty of Oral & Dental Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

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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Evidence-based Dentistry Committe at OMFS dept.

Role: CONTACT

+201001932020

References

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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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