Treatment of Peri-implantitis With or Without Simultaneous Soft Tissue Augmentation

NCT ID: NCT04323540

Last Updated: 2020-03-26

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

32 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-09-01

Study Completion Date

2023-12-01

Brief Summary

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The study will aim to compare two modalities in the reconstructive treatment of peri-implantitis defects. More specifically, the control group will be a reconstructive approach (xenograft bone graft granules and collagen membrane, BioOss and BioGide, Geistlich, Wolhusen). The test group will be the same with the exception of an autologous sub-epithelial connective tissue palatal graft, sutured beneath the flap, which will be used in addition to grafting materials.

Outcomes will include CAL, PD, MR, defect resolution, PI, BoP, SUPP, patient-reported outcome measures including an aesthetic self-evaluation.

Detailed Description

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The study will aim to compare two modalities in the reconstructive treatment of peri-implantitis defects.

More specifically, the control group will be a "pure" reconstructive approach (xenograft bone graft granules and reservable collagen membrane, BioOss and BioGide, Geistlich, Wolhusen). This is in accordance with gold standard practices of reconstructive therapy of peri-implant defects.

The test group will be treated with the same approach and materials, with the exception of an autologous sub-epithelial connective tissue palatal graft, sutured beneath the flap, which will be used in addition to the grafting materials. The graft will be harvested from the homolateral palate (molar region).

Outcomes will include CAL, clinical attachment level (primary outcome), PD or probing depth, MR or mucosal recession, defect resolution (composite outcome made up of simultaneous absence of PD\>5 mm, BOP/SUP and bone level changes \>0.5 mm, PI, BoP or bleeding upon probing, suppuration SUP on probing, SUP on palpation, patient-reported outcome measures including an aesthetic self-evaluation.

The measures will be recorded at baseline, 6-, 12-, 18- and 24 months. Radiographic bone levels will be compared with 2 week image at 12 and 24 months

Conditions

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Peri-Implantitis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Xenograft+collagen membrane

Reconstructive approach (Xenograft+collegen membrane)

Group Type ACTIVE_COMPARATOR

Peri-implantitis reconstructive surgery

Intervention Type PROCEDURE

For both arms (excluding the already included information): defect debridement, removal of debris using titanium curettes, titanium brushes on the implant surface, irrigation with saline, application of sterile cotton pellets with saline solution. Grafting with (experimental) xenograft and soft tissue, or xenograft alone (control). Suture.

Specific to control group (active comparator): the peri-implant defect will be filled with xenograft, and a collagen membrane will be fitted and trimmed to the defect area.

Specific to test/experimental group: same as above (for control). In addition a soft tissue graft will be harvested from the palate and sutured to the buccal flap. The entire flap will then be sutured to the lingual flap.

Xenograft+collagen membrane+autologous soft tissue graft

Reconstructive approach (Xenograft+collegen membrane) plus soft tissue graft (autologous, harvested as FGG)

Group Type EXPERIMENTAL

Peri-implantitis reconstructive surgery

Intervention Type PROCEDURE

For both arms (excluding the already included information): defect debridement, removal of debris using titanium curettes, titanium brushes on the implant surface, irrigation with saline, application of sterile cotton pellets with saline solution. Grafting with (experimental) xenograft and soft tissue, or xenograft alone (control). Suture.

Specific to control group (active comparator): the peri-implant defect will be filled with xenograft, and a collagen membrane will be fitted and trimmed to the defect area.

Specific to test/experimental group: same as above (for control). In addition a soft tissue graft will be harvested from the palate and sutured to the buccal flap. The entire flap will then be sutured to the lingual flap.

Interventions

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Peri-implantitis reconstructive surgery

For both arms (excluding the already included information): defect debridement, removal of debris using titanium curettes, titanium brushes on the implant surface, irrigation with saline, application of sterile cotton pellets with saline solution. Grafting with (experimental) xenograft and soft tissue, or xenograft alone (control). Suture.

Specific to control group (active comparator): the peri-implant defect will be filled with xenograft, and a collagen membrane will be fitted and trimmed to the defect area.

Specific to test/experimental group: same as above (for control). In addition a soft tissue graft will be harvested from the palate and sutured to the buccal flap. The entire flap will then be sutured to the lingual flap.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* · Be able and willing to provide consent and sign the informed consent form.

* Be able and willing to comply with study procedures and follow-up appointments required by the study protocol.
* Age\>18 years
* Presence of at least one implant affected with peri-implantitis, defined as the following con-dition: at least one site presenting peri-implant probing depth (PPD) \>6 mm and simultane-ous presence of profuse BoP/SUP and a radiographically documented change in bone level greater than initial bone remodeling. In the likely event that a baseline radiographic image is absent, the bone level will be compared to where it would likely have been at the time of implant insertion and a difference of \>3 mm from that level will be considered.
* Implants in function (i.e. loaded) for at least 1 year.
* Screw- and cement-retained suprastructures for both fixed and removable prostheses.

Exclusion Criteria

* Compromised systemic health which contraindicates the study procedures.
* Pregnant or nursing women.
* Cigarette smoking\>5 per day
* Systemic conditions compromising healing (i.e. diabetes mellitus). Patients with diabe-tes mellitus types I or II will be asked to provide information regarding their most re-cent HbA1c values. Only patients with HbA1c\<7% will be enrolled.
* Patients taking medications known to interfere with gingival or bone metabolism.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Belgrade

OTHER

Sponsor Role collaborator

George Eastman Dental Hospital, Italy

OTHER

Sponsor Role lead

Responsible Party

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Lucrezia Paternò Holtzman

Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Luca Cordaro, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

G. Eastman Dental Hospital Rome, Italy

Central Contacts

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Lucrezia Paternò Holtzman, DMD

Role: CONTACT

+39.06.3241406

Iva Milinkovic, DMD, PhD

Role: CONTACT

Other Identifiers

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18117

Identifier Type: -

Identifier Source: org_study_id

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