Management of the Fresh Extraction Socket in the Aesthetic Area

NCT ID: NCT04367766

Last Updated: 2023-12-12

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

RECRUITING

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-09-27

Study Completion Date

2026-08-31

Brief Summary

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After atraumatic tooth extraction and the assessment of the feasibility of immediate implant placement, patients will be randomly assigned to one of three treatment concepts:

1. Immediate Implant Placement and Immediate Provisionalization
2. Alveolar Ridge Preservation. After 4 months of healing an implant will be placed with simultaneous GBR and/or Soft Tissue Augmentation procedures, if needed.
3. Spontaneous Healing of the socket. After 4 months of healing, an implant will be placedwith simultaneous GBR and/or Soft Tissue Augmentation procedures, if needed.

In all groups, four months after implant placement, a prosthesis will be delivered. From this experimental period onward, patients will be scheduled for maintenance. Clinical, radiographic and volumetric assessment will be performed by clinicians not involved in the surgery and blind with respect to treatment assignment at 1, 3 and 5 years post loading.

Detailed Description

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The overall objective of this study will be to compare the three treatment modalities after tooth extraction (immediate implant placement, alveolar ridge preservation, spontaneous healing) in terms of:

* patient-related (morbidity) outcomes during surgical procedure and the first 2 weeks after the surgical procedure
* cost-effectiveness ratio (treatment time, number of surgeries, number of appointments and overall appointments time, need for bone and soft tissue augmentation, overall costs) at the time of prosthesis delivery
* volumetric bone and soft tissue changes of the site before treatment (prior to tooth extraction), 4 months after tooth extraction, 1, 3 and 5 years after final prosthesis.
* clinical, radiographic, aesthetic and patient-related (satisfaction) outcomes at the time of prosthesis delivery and 1, 3 and 5 years after final prosthesis.
* Implant Success and Survival at 1, 3 and 5 years after final prosthesis.

Conditions

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Tooth Extraction Status Nos Dental Implant Bone Augmentation Soft Tissue Augmentation

Keywords

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Immediate implant placement alveolar ridge preservation delayed implant placement PROMs implant health volumetric analysis tissue augmentation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Immediate Implant Placement

prosthetically driven immediate implant placement (TLC implant, Straumann) with bone substitute (BioOss Collagen, Geistlich) filling the gap between the buccal socket wall and the implant surface and a collagen matrix (Fibrogide, Geistlich) positioning at the vestibular aspect to increase soft tissue volume, with immediate (non occlusal loading) prosthetic provisionalization.

Group Type ACTIVE_COMPARATOR

Prosthetically driven implant placement

Intervention Type PROCEDURE

Insertion of an osseointegrated implant into the bone of anterior maxilla/mandible, following the right prosthetic plan

Alveolar Ridge Preservation (ARP) + Delayed Implant Placement:

ARP performed with bone substitute (BioOss Collagen, Geistlich) and a collagen matrix placed to seal the socket entrance (Mucograft Seal, Geistlich). After 4 months of healing a prosthetically driven implant (TLC implant, Straumann) will be placed with adjunctive GBR procedure with bone substitute (BioOss Collagen, Geistlich) and a collagen membrane (BioGide, Geistlich) if buccal bone will be \< 2 mm and soft tissue augmentation with a collagen matrix (Fibrogide, Geistlich) if soft tissue thickness will be \< 2mm

Group Type ACTIVE_COMPARATOR

Prosthetically driven implant placement

Intervention Type PROCEDURE

Insertion of an osseointegrated implant into the bone of anterior maxilla/mandible, following the right prosthetic plan

Spontaneous Healing + Delayed Implant Placement

extraction socket will be left to heal spontaneously. After 4 months of healing a prosthetically driven implant (TLC implant, Straumann) will be placed with adjunctive GBR procedure with bone substitute (BioOss Collagen, Geistlich) and a collagen membrane (BioGide, Geistlich) if buccal bone will be \< 2 mm, and soft tissue augmentation with a collagen matrix (Fibrogide, Geistlich) if soft tissue thickness will be \< 2mm .

Group Type ACTIVE_COMPARATOR

Prosthetically driven implant placement

Intervention Type PROCEDURE

Insertion of an osseointegrated implant into the bone of anterior maxilla/mandible, following the right prosthetic plan

Interventions

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Prosthetically driven implant placement

Insertion of an osseointegrated implant into the bone of anterior maxilla/mandible, following the right prosthetic plan

Intervention Type PROCEDURE

Other Intervention Names

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Prosthetically driven implant installation

Eligibility Criteria

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Inclusion Criteria

* single tooth extraction in the anterior region of the dentition (including premolars) to be extracted
* smoking no more than 10 cigarettes/day,
* periodontal health (BoP \< 10%) and good plaque control (\< 20%)
* absence of symptomatic periapical radiolucencies, acute abscesses at the site of extraction,
* extraction sites with less than 30% loss of one or more walls
* adequate quantity and quality of native bone to achieve primary stability

Exclusion Criteria

* growing patients
* patients with autoimmune disease, uncontrolled diabetes or immunocompromised
* history of head and neck radiation for cancer treatment,
* pregnancy
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Centro Specialistico Odontoiatrico, Rome

NETWORK

Sponsor Role lead

Responsible Party

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Marco Clementini

Research Fellow

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Marco Clementini, DDS, PhD

Role: PRINCIPAL_INVESTIGATOR

Centro Specialistico Odontoiatrico, Rome

Locations

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Centro Specialistico Odontoiatrico (CSO)

Roma, , Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Marco Clementini, DDS, PhD

Role: CONTACT

Phone: 00393388378866

Email: [email protected]

Facility Contacts

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Marco Clementini, DDS, PhD

Role: primary

References

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Tonetti MS, Jung RE, Avila-Ortiz G, Blanco J, Cosyn J, Fickl S, Figuero E, Goldstein M, Graziani F, Madianos P, Molina A, Nart J, Salvi GE, Sanz-Martin I, Thoma D, Van Assche N, Vignoletti F. Management of the extraction socket and timing of implant placement: Consensus report and clinical recommendations of group 3 of the XV European Workshop in Periodontology. J Clin Periodontol. 2019 Jun;46 Suppl 21:183-194. doi: 10.1111/jcpe.13131.

Reference Type BACKGROUND
PMID: 31215112 (View on PubMed)

Clementini M, Agostinelli A, Castelluzzo W, Cugnata F, Vignoletti F, De Sanctis M. The effect of immediate implant placement on alveolar ridge preservation compared to spontaneous healing after tooth extraction: Radiographic results of a randomized controlled clinical trial. J Clin Periodontol. 2019 Jul;46(7):776-786. doi: 10.1111/jcpe.13125. Epub 2019 May 31.

Reference Type BACKGROUND
PMID: 31050359 (View on PubMed)

Other Identifiers

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IIP/ARP/SH

Identifier Type: -

Identifier Source: org_study_id