Regenerative Surgical Treatment of Peri-implant Defects

NCT ID: NCT04440241

Last Updated: 2021-09-29

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

44 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-04-01

Study Completion Date

2022-12-01

Brief Summary

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Does submerged healing of implants improve clinical and radiologic outcomes for the treatment of peri-implantitis? A number of recent systematic reviews have shown that the prevalence of periimplantitisin the population is high.

Nevertheless, there appears to be no consensus on treatment standards for the management of peri-implant diseases. Also, the significant variation in the empirical use of the available therapeutic modalities seems to result in moderately effective treatment outcomes. Animal and human case series-studies have shown improved outcomes when using a submerged healing approach. However, there seems to be no randomized controlled clinical studies comparing submerged/non-submerged healing efficacy for the treatment of peri-implantitis. Since current modalities for the treatment of peri-implantitis seem to result inmoderately effective outcomes, there is an urgency to investigate treatment strategies that will result in improved patient's benefits in terms of health.

Detailed Description

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The present study will be double-blinded randomized controlled clinical trial. Patients requiring surgical treatment of peri-implantitis after non-surgical therapy will beassigned to either:

Test group: submerged healing or Control group: non-submerged healing treatment of peri-implantitis using guided bone regeneration with a bone substitute and a resorbable membrane.

The primary aim of this study is to evaluate whether submerged healing of implants willsignificantly improve the changes in marginal bone levels measured on X-rays 12months post-treatment compared to a non-submerged healing approach for the treatment of peri-implantitis.

Secondary aims include changes in clinical attachment levels, changes in probing pocket depth, recession, keratinized tissue, occurrence of bleeding on probing, suppuration on probing (PUS), marginal gingival recession (REC), full mouth plaque score (FMPS), full mouth bleeding score (FMBS), type of peri-implant bone defect, frequency and type of complications and implant loss.

Conditions

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Implant Site Pocket Infection

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Test group: submerged healing Control group: non-submerged healing treatment of peri-implantitis using guided bone regeneration with a bone substitute and a resorbable membrane.
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Investigators Outcome Assessors

Study Groups

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Test group

submerged healing treatment of peri-implantitis using guided bone regeneration with a bone substitute and a resorbable membrane.

Group Type EXPERIMENTAL

regenerative treatment periimplantitis

Intervention Type PROCEDURE

Full thickness buccal and lingual flaps will be performed. After debridement of the defect using hand and ultrasonic instruments and implant surface decontamination using titanium brushes (TiBrush®) and saline Regenerative treatment will be performed only in the intrabony component of type 1 peri-implant defects. Guided bone regeneration using a bone substitute (Bio-oss®) and a resorbable membrane (bio-gide®) will be performed in the intrabony and dehiscenses areas of the defect.

The surgeon will be blinded to the assignment of treatment until it is time to close the flaps.

Control group

non submerged healing treatment of peri-implantitis using guided bone regeneration with a bone substitute and a resorbable membrane.

Group Type EXPERIMENTAL

regenerative treatment periimplantitis

Intervention Type PROCEDURE

Full thickness buccal and lingual flaps will be performed. After debridement of the defect using hand and ultrasonic instruments and implant surface decontamination using titanium brushes (TiBrush®) and saline Regenerative treatment will be performed only in the intrabony component of type 1 peri-implant defects. Guided bone regeneration using a bone substitute (Bio-oss®) and a resorbable membrane (bio-gide®) will be performed in the intrabony and dehiscenses areas of the defect.

The surgeon will be blinded to the assignment of treatment until it is time to close the flaps.

Interventions

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regenerative treatment periimplantitis

Full thickness buccal and lingual flaps will be performed. After debridement of the defect using hand and ultrasonic instruments and implant surface decontamination using titanium brushes (TiBrush®) and saline Regenerative treatment will be performed only in the intrabony component of type 1 peri-implant defects. Guided bone regeneration using a bone substitute (Bio-oss®) and a resorbable membrane (bio-gide®) will be performed in the intrabony and dehiscenses areas of the defect.

The surgeon will be blinded to the assignment of treatment until it is time to close the flaps.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age ≥18 years.
* Systemically healthy patients.
* Presence of at least 1 implant diagnosed with peri-implantitis (peri-implant probing pocket depth ≥6 mm in at least 1 aspect of the implant with bleeding and/or suppuration on probing and radiographically documented marginal bone loss ≥3mm) according to Renvert et al. (2018), after non-surgical therapy of periimplantitis, and a 4mm deep intrabony component.
* Absence of mobility of the implants.
* Individual implant-supported crown or partial fixed implant supported restoration (removable prosthesis will be excluded).
* Patient's smoking ≤ 10 cigarettes/day.

Exclusion Criteria

* Non-removable prostheses
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Osteology Foundation

OTHER

Sponsor Role collaborator

University of Santiago de Compostela

OTHER

Sponsor Role lead

Responsible Party

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Juan Blanco Carrión

Principal investigator - Juan Blanco Carrión

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Santiago Mareque

Role: STUDY_DIRECTOR

University of Santiago de Compostela

Locations

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Master Periodoncia. Facultad odontología

Santiago de Compostela, A Coruña, Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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Santiago Mareque

Role: CONTACT

616 975 256‬

Juan Blanco

Role: CONTACT

616 975 256‬

Facility Contacts

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Santiago Mareque

Role: primary

Carlota Blanco

Role: backup

References

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Schwarz F, Herten M, Sager M, Bieling K, Sculean A, Becker J. Comparison of naturally occurring and ligature-induced peri-implantitis bone defects in humans and dogs. Clin Oral Implants Res. 2007 Apr;18(2):161-70. doi: 10.1111/j.1600-0501.2006.01320.x.

Reference Type RESULT
PMID: 17348880 (View on PubMed)

Schwarz F, Sahm N, Schwarz K, Becker J. Impact of defect configuration on the clinical outcome following surgical regenerative therapy of peri-implantitis. J Clin Periodontol. 2010 May;37(5):449-55. doi: 10.1111/j.1600-051X.2010.01540.x. Epub 2010 Mar 24.

Reference Type RESULT
PMID: 20374416 (View on PubMed)

Roccuzzo M, Bonino F, Bonino L, Dalmasso P. Surgical therapy of peri-implantitis lesions by means of a bovine-derived xenograft: comparative results of a prospective study on two different implant surfaces. J Clin Periodontol. 2011 Aug;38(8):738-45. doi: 10.1111/j.1600-051X.2011.01742.x. Epub 2011 Jun 2.

Reference Type RESULT
PMID: 21635278 (View on PubMed)

Other Identifiers

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REGT_CT_19

Identifier Type: -

Identifier Source: org_study_id

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