The Application of a Biphasic Calcium Sulfate Graft Material in Sinus Floor Elevation

NCT ID: NCT06533397

Last Updated: 2024-11-29

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

RECRUITING

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-08-24

Study Completion Date

2031-09-30

Brief Summary

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Pneumatization of the maxillary sinus may lead to insufficient bone volume for dental implant placement in the edentulous posterior maxilla. Sinus floor elevation (SFE) surgery with the lateral window technique is a safe and predictable surgical intervention to restore bone height in the maxillary premolar and molar areas. According to the literature, several bone graft materials may be successfully applied for SFE surgery. There is a lack of evidence regarding the application of biphasic calcium sulfate (BCS) for SFE. The healing period following staged SFE is 2-9 months.

The aim of this study is:

* to evaluate the success of SFE surgery using BCS as graft material,
* to compare the microarchitecture of the augmented bone depending on the healing period,
* to evaluate the success of dental implants placed in the augmented bone and that of the prostheses delivered on the dental implants.

Detailed Description

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Conditions

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Alveolar Bone Loss Edentulism Nos

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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3-month healing period

Staged SFE is performed; following a 3-month-long healing period, bone core biopsy samples are harvested from the augmented bone, and dental implants are placed.

Group Type EXPERIMENTAL

Sinus floor elevation (SFE)

Intervention Type PROCEDURE

Patients rinse with 0.2% chlorhexidine solution for one minute before surgery. Under local anesthesia, a mucoperiosteal flap is raised from a midcrestal incision and two relieving incisions. Lateral window osteotomies are carried out using diamond burs. The Schneiderian membrane is carefully elevated and the synthetic bone graft material (Bond Apatite, Augma Biomaterials, Cesarea, Israel) (2-3 cm3) is packed in the defect with light force. The buccal flap is then mobilized to allow tension-free primary closure. The margins are stabilized with single interrupted sutures. Antibiotics (1 g amoxicillin-clavulanate twice a day for 5 days, or in case of side effects or known allergy to penicillin, 300 mg clindamycin 4 times a day for 4 days), anti-inflammatory drugs (50 mg diclofenac 3 times a day for 3 days), and chlorhexidine mouthwash (twice a day for 21 days from the first day after surgery) are prescribed. Suture removal takes place after 10 days.

preoperative cone beam computed tomography (CBCT)

Intervention Type DIAGNOSTIC_TEST

A CBCT scan is performed before SFE surgery to evaluate the anatomy and pathologies of the maxillary sinus.

postoperative CBCT

Intervention Type DIAGNOSTIC_TEST

A CBCT scan is performed following the 3- or 6-month-long healing period after SFE to evaluate the anatomy and healing of the augmented bone and the maxillary sinus.

bone core biopsy

Intervention Type DIAGNOSTIC_TEST

At the time of dental implant placement, the first step of the implant bed preparation is performed using a trephine drill to harvest a bone core biopsy sample from the augmented bone. The biopsy sample is harvested from the implant bed, this way the patient is spared of excess surgical burden as this bone would be removed even if no biopsy sample was harvested during dental implant placement. The bone core biopsy samples are subjected to histomorphometric and microCT analysis.

dental implant placement

Intervention Type PROCEDURE

Following the 3- or 6-month-long healing period following SFE, dental implants are placed non-submerged in the augmented bone under local anesthesia.

fixed dental prosthesis (FDP) fabrication

Intervention Type PROCEDURE

3 months after dental implant placement, fixed dental prostheses are delivered on the dental implants.

bone grafting

Intervention Type DEVICE

A synthetic bone graft material (Bond Apatite, Augma Biomaterials, Cesarea, Israel) is used during SFE.

6-month healing period

Staged SFE is performed; following a 6-month-long healing period, bone core biopsy samples are harvested from the augmented bone, and dental implants are placed.

Group Type EXPERIMENTAL

Sinus floor elevation (SFE)

Intervention Type PROCEDURE

Patients rinse with 0.2% chlorhexidine solution for one minute before surgery. Under local anesthesia, a mucoperiosteal flap is raised from a midcrestal incision and two relieving incisions. Lateral window osteotomies are carried out using diamond burs. The Schneiderian membrane is carefully elevated and the synthetic bone graft material (Bond Apatite, Augma Biomaterials, Cesarea, Israel) (2-3 cm3) is packed in the defect with light force. The buccal flap is then mobilized to allow tension-free primary closure. The margins are stabilized with single interrupted sutures. Antibiotics (1 g amoxicillin-clavulanate twice a day for 5 days, or in case of side effects or known allergy to penicillin, 300 mg clindamycin 4 times a day for 4 days), anti-inflammatory drugs (50 mg diclofenac 3 times a day for 3 days), and chlorhexidine mouthwash (twice a day for 21 days from the first day after surgery) are prescribed. Suture removal takes place after 10 days.

preoperative cone beam computed tomography (CBCT)

Intervention Type DIAGNOSTIC_TEST

A CBCT scan is performed before SFE surgery to evaluate the anatomy and pathologies of the maxillary sinus.

postoperative CBCT

Intervention Type DIAGNOSTIC_TEST

A CBCT scan is performed following the 3- or 6-month-long healing period after SFE to evaluate the anatomy and healing of the augmented bone and the maxillary sinus.

bone core biopsy

Intervention Type DIAGNOSTIC_TEST

At the time of dental implant placement, the first step of the implant bed preparation is performed using a trephine drill to harvest a bone core biopsy sample from the augmented bone. The biopsy sample is harvested from the implant bed, this way the patient is spared of excess surgical burden as this bone would be removed even if no biopsy sample was harvested during dental implant placement. The bone core biopsy samples are subjected to histomorphometric and microCT analysis.

dental implant placement

Intervention Type PROCEDURE

Following the 3- or 6-month-long healing period following SFE, dental implants are placed non-submerged in the augmented bone under local anesthesia.

fixed dental prosthesis (FDP) fabrication

Intervention Type PROCEDURE

3 months after dental implant placement, fixed dental prostheses are delivered on the dental implants.

bone grafting

Intervention Type DEVICE

A synthetic bone graft material (Bond Apatite, Augma Biomaterials, Cesarea, Israel) is used during SFE.

Interventions

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Sinus floor elevation (SFE)

Patients rinse with 0.2% chlorhexidine solution for one minute before surgery. Under local anesthesia, a mucoperiosteal flap is raised from a midcrestal incision and two relieving incisions. Lateral window osteotomies are carried out using diamond burs. The Schneiderian membrane is carefully elevated and the synthetic bone graft material (Bond Apatite, Augma Biomaterials, Cesarea, Israel) (2-3 cm3) is packed in the defect with light force. The buccal flap is then mobilized to allow tension-free primary closure. The margins are stabilized with single interrupted sutures. Antibiotics (1 g amoxicillin-clavulanate twice a day for 5 days, or in case of side effects or known allergy to penicillin, 300 mg clindamycin 4 times a day for 4 days), anti-inflammatory drugs (50 mg diclofenac 3 times a day for 3 days), and chlorhexidine mouthwash (twice a day for 21 days from the first day after surgery) are prescribed. Suture removal takes place after 10 days.

Intervention Type PROCEDURE

preoperative cone beam computed tomography (CBCT)

A CBCT scan is performed before SFE surgery to evaluate the anatomy and pathologies of the maxillary sinus.

Intervention Type DIAGNOSTIC_TEST

postoperative CBCT

A CBCT scan is performed following the 3- or 6-month-long healing period after SFE to evaluate the anatomy and healing of the augmented bone and the maxillary sinus.

Intervention Type DIAGNOSTIC_TEST

bone core biopsy

At the time of dental implant placement, the first step of the implant bed preparation is performed using a trephine drill to harvest a bone core biopsy sample from the augmented bone. The biopsy sample is harvested from the implant bed, this way the patient is spared of excess surgical burden as this bone would be removed even if no biopsy sample was harvested during dental implant placement. The bone core biopsy samples are subjected to histomorphometric and microCT analysis.

Intervention Type DIAGNOSTIC_TEST

dental implant placement

Following the 3- or 6-month-long healing period following SFE, dental implants are placed non-submerged in the augmented bone under local anesthesia.

Intervention Type PROCEDURE

fixed dental prosthesis (FDP) fabrication

3 months after dental implant placement, fixed dental prostheses are delivered on the dental implants.

Intervention Type PROCEDURE

bone grafting

A synthetic bone graft material (Bond Apatite, Augma Biomaterials, Cesarea, Israel) is used during SFE.

Intervention Type DEVICE

Other Intervention Names

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sinus lift surgery maxillary sinus augmentation

Eligibility Criteria

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Inclusion Criteria

* Patients over the age of 18 years,
* Patients who need dental implant-borne prostheses,
* Patients with insufficient bone height in the posterior maxilla due to sinus pneumatization.

Exclusion Criteria

.• Patients who had major systemic diseases as classified by the American Society of Anesthesiologists (ASA grades III-IV),

* psychiatric contraindications,
* patients on medication interfering with bone metabolism, including steroid therapy and antiresorptive medication,
* radiation to the head or neck region within the previous five years,
* localized periapical disease, odontogenic and nonodontogenic cysts, and maxillary sinusitis,
* evidence of uncontrolled periodontal disease,
* Alcohol Use Disorder defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5),
* recreational drug abuse,
* heavy smoking (\>10 cigarettes/day),
* diseases of the oral mucosa, including blisters and ulcers, i.e.: red and white lesions, pigmented lesions, benign tumors of the oral cavity, and oral cancer. Leukoplakia, Erythroplakia, Precancerous lesions, Oral squamous cell carcinoma and malign tumors of the soft and hard tissues, Oral candidiasis, Oral lichen planus, Psoriasis, Pemphigus, and Pemphigoid.
* pregnancy or nursing,
* poor oral hygiene
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Semmelweis University

OTHER

Sponsor Role lead

Responsible Party

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Marton Kivovics

associate professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Márton Kivovics, DMD,MSD,PHD

Role: PRINCIPAL_INVESTIGATOR

Department of Public Dental Health, Semmelweis University

Locations

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Semmelweis University Department of Public Dental Health

Budapest, Budapest, Hungary

Site Status RECRUITING

Countries

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Hungary

Central Contacts

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Márton Kivovics, DMD,MSD,PHD

Role: CONTACT

003614591500 ext. 60732

Dorottya Pénzes, DMD,MSD,PHD

Role: CONTACT

003614591500 ext. 60759

Facility Contacts

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Márton Kivovics, DMD MSc PhD

Role: primary

003614591500 ext. 60732

Other Identifiers

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SEDCD44

Identifier Type: -

Identifier Source: org_study_id