Comparison of the Use of Natural and Synthetic Bone Substitutes in Dental Implants

NCT ID: NCT05938114

Last Updated: 2023-11-30

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

34 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-01-31

Study Completion Date

2024-07-31

Brief Summary

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The goal of this clinical trial is to compare the effectiveness of a natural and synthetic bone substitute in preserving the alveolar ridge (bone) of a single- rooted tooth after an extraction.

The main question it aims to answer:

Is there a difference between natural (Bio-Oss®) and synthetic (Bonalive®) bone substitutes in preserving the alveolar ridge dimensions based on changes in the width of the alveolar ridge (expressed in millimetres) from augmentation (baseline) to 24-week follow-up (post augmentation)?

Participants will have a tooth extraction and a bone substitute will be inserted into their socket immediately after. Participants will be divided into two equal groups and those in group A will receive Bio-Oss® while those in group B will receive Bonalive®. In both groups measurements of the alveolar bone will be taken when the bone substitute is inserted and 24 weeks after the insertion of the bone substitute. These measurements will be used to compare the effectiveness of Bio-Oss® and Bonalive in preserving the alveolar bone of a tooth after an extraction.

Detailed Description

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It is a pilot single-blind two-arm parallel randomised control trial that aims to assess the differences between two bone substitutes, natural versus synthetic. The study will mimic the routine practice, and patients will be randomly allocated to receive either natural (control) or synthetic (intervention) bone substitutes. The patient follow-up period will be 24 weeks from the baseline data collection point.

The University of Central Lancashire will lead the study in collaboration with Imperial College London and dental clinics in Midlands, Southeast and Northwest England. We will recruit 34 patients who require tooth extractions and divide them into two equal groups. Patients in group A will receive Bio-Oss® , while those in group B will receive Bonalive® For both groups, the bone substitute will be inserted immediately after an extraction, and the socket will be sealed with a membrane sutured in place. Patients in both groups will be reviewed after 2 weeks to remove the suture. Patients will have another review at 24 weeks, during which the researcher will take a scan or mould, a photograph, and a small biopsy sample of the area where the bone substitute was placed. Measurements obtained at the 24-week follow-up will be used to evaluate the effectiveness and differences between natural and synthetic bone substitutes in preserving the bone supporting a tooth after an extraction.

The results of this pilot study will inform the design and implementation of a full-scale randomised controlled trial to investigate the effectiveness of bioactive glass-derived bone compared with bovine-derived bone in preserving the alveolar bone of a tooth after an extraction

Conditions

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Alveolar Ridge Augmentation

Keywords

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Ridge Preservation Bone Substitutes Alveolar Bone

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

SINGLE

Participants

Study Groups

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Group A (Bonalive®)

The test bone substitute is Bonalive®, bioactive glass S53P4, which contains SiO2, Na2O, CaO, and P2O5 (granule size 0.5-0.8mm). Bonalive® is osteoconductive, meaning that it has the ability of promoting bone growth across the granules and the grafting area and slowly replace it with new bone over time. Bonalive® is osteostimulative and has antibacterial properties

Group Type EXPERIMENTAL

Bonalive

Intervention Type OTHER

Bonalive® is a bioactive glass synthetic bone substitute material that has been shown to have a low substitution rate and antibacterial properties. It has been used successfully in the orthopaedics, craniofacial and ear nose and throat (ENT) specialities for the treatment of osteomyelitis, sinusitis and bony cyst cavities. There have also been a few maxillofacial surgery case reports on its usage in the jaws.

Group B ( Bio-Oss®)

The comparator is Bio-Oss®, deproteinized bovine bone granules (granule size 0.25- 1mm). Bio-Oss® is osteoconductive, which means it acts as a scaffold only for new bone to grow.

Group Type ACTIVE_COMPARATOR

Bio-Oss®

Intervention Type OTHER

Bio-Oss® is a bovine xenogeneic bone graft substitute that is widely used in regenerative dentistry. Bio-Oss® is very similar to human bone in its structure and chemical make-up. The material's porosity allows for vascularisation and new bone formation.

Interventions

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Bonalive

Bonalive® is a bioactive glass synthetic bone substitute material that has been shown to have a low substitution rate and antibacterial properties. It has been used successfully in the orthopaedics, craniofacial and ear nose and throat (ENT) specialities for the treatment of osteomyelitis, sinusitis and bony cyst cavities. There have also been a few maxillofacial surgery case reports on its usage in the jaws.

Intervention Type OTHER

Bio-Oss®

Bio-Oss® is a bovine xenogeneic bone graft substitute that is widely used in regenerative dentistry. Bio-Oss® is very similar to human bone in its structure and chemical make-up. The material's porosity allows for vascularisation and new bone formation.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Adult patients (age \>18) in need of extraction of a single-rooted tooth attending the clinics selected for the study
* Single units in a dentate patient
* Non-surgical extraction - no flap raised, and no bone removed Intact socket walls post-extraction
* Bleeding sockets
* Stable periodontal health

Exclusion Criteria

* Multiple adjacent extractions
* Presence of active periodontal disease
* Socket walls not intact - \>50% bone loss in any of the four walls
* Sclerotic sockets post-extraction - the socket does not fill up with blood post-extraction
* Denture wearer - the extraction socket site under the load of a denture
* Patients on medication that can affect bone healing e.g., bisphosphonates (oral or intravenous), selective serotonin reuptake inhibitors (SSRI), methotrexate, proton pump inhibitors (PPI)
* Uncontrolled diabetes Smokers Immunosuppressed Patients
* Patients with a history of myocardial Infarction in the last year ASA Class \> II patients
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Imperial College London

OTHER

Sponsor Role collaborator

University of Central Lancashire

OTHER

Sponsor Role lead

Responsible Party

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Fadi Barrak

Course Lead and Senior Lecturer, University of Central Lancashire, School of Dentistry

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ihtesham Rehman, PhD

Role: STUDY_CHAIR

University of Central Lancashire

Locations

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University of Central Lanchashire

Preston, Lancashire, United Kingdom

Site Status

Devonshire House Dental Practice

Cambridge, , United Kingdom

Site Status

St Faith's Dental Clinic,

East Grinstead, , United Kingdom

Site Status

Halesowen Dental

Halesowen, , United Kingdom

Site Status

Imperical College,London

London, , United Kingdom

Site Status

UCLan community Dentists

Preston, , United Kingdom

Site Status

Countries

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United Kingdom

Central Contacts

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FADI BARRAK, MBBS; BDS

Role: CONTACT

Phone: +441772201201

Email: [email protected]

Aderonke Ajiboye, BDS

Role: CONTACT

Phone: 07846272779

Email: [email protected]

Facility Contacts

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Ihtesham Rehman, PhD MSc BSc

Role: primary

FADI BARRAK, MBBS BDS

Role: backup

Wail Girgis

Role: primary

Gerry Van Deventer

Role: primary

Manoj Bhatia

Role: primary

JULIAN JONES, PhD MEng

Role: primary

Siwei Li, PhD MSc MEng

Role: backup

Fadi Barrak, MBBS; BDS

Role: primary

References

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Solakoglu O, Gotz W, Heydecke G, Schwarzenbach H. Histological and immunohistochemical comparison of two different allogeneic bone grafting materials for alveolar ridge reconstruction: A prospective randomized trial in humans. Clin Implant Dent Relat Res. 2019 Oct;21(5):1002-1016. doi: 10.1111/cid.12824. Epub 2019 Aug 19.

Reference Type BACKGROUND
PMID: 31424173 (View on PubMed)

Rignon-Bret C, Hadida A, Aidan A, Nguyen TH, Pasquet G, Fron-Chabouis H, Wulfman C. Efficacy of bone substitute material in preserving volume when placing a maxillary immediate complete denture: study protocol for the PANORAMIX randomized controlled trial. Trials. 2016 May 20;17(1):255. doi: 10.1186/s13063-016-1380-7.

Reference Type BACKGROUND
PMID: 27206923 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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IRAS ID: 316275

Identifier Type: OTHER

Identifier Source: secondary_id

HEALTH 01032

Identifier Type: -

Identifier Source: org_study_id