Freeze-dried Bone Allograft vs Autologous Bone Blocks in the Lateral Augmentation of the Jaws

NCT ID: NCT07104370

Last Updated: 2025-10-03

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

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-09-29

Study Completion Date

2033-09-01

Brief Summary

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After tooth loss, the alveolar ridge undergoes various modeling and remodeling processes, resulting in overall bone resorption. In case of extensive alveolar atrophy, bone volume must be restored before or during implant placement to achieve successful dental rehabilitation and maximize implant survival and success rates. One possible method for reconstructing severe bone resorption is block bone augmentation.

Due to its biological properties, autologous bone is considered the "gold standard" among bone graft materials, as it possesses osteoinductive, osteoconductive, and osteogenic properties.

The advantages of using allografts over autologous bone grafts include reduced postoperative morbidity, decreased surgical time, and the absence of anatomical limitations regarding the amount of bone that can be harvested. The disadvantage of allografts is the loss of viable osteogenic cells and osteoinductive factors during processing.

The aim of the study is:

* to compare the success of the bone augmentation surgery depending on whether freeze-dried bone allograft blocks or autologous bone blocks are used,
* compare the microarchitecture of the augmented bone depending on the bone graft material applied,
* 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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Edentulous Alveolar Ridge Edentulous Alveolar Ridge Atrophy

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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Freeze-dried allograft bone block

A freeze-dried bone allograft block is used for the lateral augmentation of the atrophied jaw.

Group Type EXPERIMENTAL

Bone augmentation using freeze-dried allograft block

Intervention Type PROCEDURE

* Under local anesthesia, a crestal and mesial releasing incision is made, followed by preparation of a full-thickness mucoperiosteal flap.
* In the test group, a freeze-dried allograft bone block is prepared to the required size using rotary instruments.
* The block is fixed to the recipient site with two screws.
* The flap is mobilized, and the wound is closed tension-free with mattress and simple interrupted sutures.
* Sutures are removed two weeks postoperatively.
* All patients receive therapeutic-dose antibiotics: amoxicillin and clavulanic acid 2x1 for one week. In case of amoxicillin allergy, clindamycin 4x1 for seven days is administered. Non-steroid anti-inflammatory treatment with diclofenac 3x1 is also provided.
* Patients do not wear temporary prostheses during the healing period.

preoperative cone beam computed tomography (CBCT)

Intervention Type DIAGNOSTIC_TEST

• Preoperatively, a CBCT scan is performed to assess inflammatory and other pathological changes and anatomical variations in the dentomaxillofacial region.

post-operative cone beam computed tomography (CBCT)

Intervention Type DIAGNOSTIC_TEST

Postoperatively, a CBCT scan is performed to assess bone quantity and quality before implantation.

Dental implant placement

Intervention Type PROCEDURE

Following the 3-month-long healing period following bone augmentation, dental implants are placed non-submerged in the augmented bone under local anaesthesia.

Bone core biopsy

Intervention Type DIAGNOSTIC_TEST

At the time of dental implant placement, a rotary instrument is used to harvest a bone core biopsy sample from the augmented bone. The bone core biopsy samples are subjected to histomorphometric and microCT analysis.

Fixed dental prosthesis (FDP) fabrication

Intervention Type PROCEDURE

After 3 months of dental implant placement, fixed dental prosthesis are delivered on the dental implants.

Bone grafting

Intervention Type DEVICE

Freeze-dried bone allograft block

Autogenous bone block

An autogenous bone block harvested from the retromolar area of the mandible is used for the lateral augmentation of the atrophied jaw.

Group Type ACTIVE_COMPARATOR

Bone augmentation using an autologous bone block

Intervention Type PROCEDURE

* Under local anesthesia, a crestal and mesial releasing incision is made, followed by preparation of a full-thickness mucoperiosteal flap.
* In the control group, an autologous bone block graft is harvested from the retromolar donor area using rotary instruments and piezoelectric surgery.
* The block is fixed to the recipient site with two screws.
* The flap is mobilized, and the wound is closed tension-free with mattress and simple interrupted sutures.
* Sutures are removed two weeks postoperatively.
* All patients receive therapeutic-dose antibiotics: amoxicillin and clavulanic acid 2x1 for one week. In the case of an amoxicillin allergy, clindamycin 4x1 for seven days is administered. Non-steroid anti-inflammatory treatment with diclofenac 3x1 is also provided.
* Patients do not wear temporary prostheses during the healing period.

preoperative cone beam computed tomography (CBCT)

Intervention Type DIAGNOSTIC_TEST

• Preoperatively, a CBCT scan is performed to assess inflammatory and other pathological changes and anatomical variations in the dentomaxillofacial region.

post-operative cone beam computed tomography (CBCT)

Intervention Type DIAGNOSTIC_TEST

Postoperatively, a CBCT scan is performed to assess bone quantity and quality before implantation.

Dental implant placement

Intervention Type PROCEDURE

Following the 3-month-long healing period following bone augmentation, dental implants are placed non-submerged in the augmented bone under local anaesthesia.

Bone core biopsy

Intervention Type DIAGNOSTIC_TEST

At the time of dental implant placement, a rotary instrument is used to harvest a bone core biopsy sample from the augmented bone. The bone core biopsy samples are subjected to histomorphometric and microCT analysis.

Fixed dental prosthesis (FDP) fabrication

Intervention Type PROCEDURE

After 3 months of dental implant placement, fixed dental prosthesis are delivered on the dental implants.

Interventions

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Bone augmentation using an autologous bone block

* Under local anesthesia, a crestal and mesial releasing incision is made, followed by preparation of a full-thickness mucoperiosteal flap.
* In the control group, an autologous bone block graft is harvested from the retromolar donor area using rotary instruments and piezoelectric surgery.
* The block is fixed to the recipient site with two screws.
* The flap is mobilized, and the wound is closed tension-free with mattress and simple interrupted sutures.
* Sutures are removed two weeks postoperatively.
* All patients receive therapeutic-dose antibiotics: amoxicillin and clavulanic acid 2x1 for one week. In the case of an amoxicillin allergy, clindamycin 4x1 for seven days is administered. Non-steroid anti-inflammatory treatment with diclofenac 3x1 is also provided.
* Patients do not wear temporary prostheses during the healing period.

Intervention Type PROCEDURE

Bone augmentation using freeze-dried allograft block

* Under local anesthesia, a crestal and mesial releasing incision is made, followed by preparation of a full-thickness mucoperiosteal flap.
* In the test group, a freeze-dried allograft bone block is prepared to the required size using rotary instruments.
* The block is fixed to the recipient site with two screws.
* The flap is mobilized, and the wound is closed tension-free with mattress and simple interrupted sutures.
* Sutures are removed two weeks postoperatively.
* All patients receive therapeutic-dose antibiotics: amoxicillin and clavulanic acid 2x1 for one week. In case of amoxicillin allergy, clindamycin 4x1 for seven days is administered. Non-steroid anti-inflammatory treatment with diclofenac 3x1 is also provided.
* Patients do not wear temporary prostheses during the healing period.

Intervention Type PROCEDURE

preoperative cone beam computed tomography (CBCT)

• Preoperatively, a CBCT scan is performed to assess inflammatory and other pathological changes and anatomical variations in the dentomaxillofacial region.

Intervention Type DIAGNOSTIC_TEST

post-operative cone beam computed tomography (CBCT)

Postoperatively, a CBCT scan is performed to assess bone quantity and quality before implantation.

Intervention Type DIAGNOSTIC_TEST

Dental implant placement

Following the 3-month-long healing period following bone augmentation, dental implants are placed non-submerged in the augmented bone under local anaesthesia.

Intervention Type PROCEDURE

Bone core biopsy

At the time of dental implant placement, a rotary instrument is used to harvest a bone core biopsy sample from the augmented bone. The bone core biopsy samples are subjected to histomorphometric and microCT analysis.

Intervention Type DIAGNOSTIC_TEST

Fixed dental prosthesis (FDP) fabrication

After 3 months of dental implant placement, fixed dental prosthesis are delivered on the dental implants.

Intervention Type PROCEDURE

Bone grafting

Freeze-dried bone allograft block

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* over 18 years old
* require lateral augmentation for implant rehabilitation

Exclusion Criteria

* Smoking
* Pregnancy
* Poor oral hygiene
* Failure to attend follow-up visits
* Therapeutic-dose irradiation to the head and neck region
* Local bone tumors, cysts, or inflammatory processes
* Decompensated systemic diseases contraindicate surgery
* Use of medications affecting bone metabolism (steroids, antiresorptive medications such as bisphosphonates, RANKL inhibitor antibodies, VEGF antagonists)
* Psychiatric disorders contraindicate implant rehabilitation
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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Dr. Szerencse Csilla

Dentist, oral surgeon

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Csilla Szerencse, DMD, MDS

Role: PRINCIPAL_INVESTIGATOR

Department of Public Dental Health Semmelweis University

Locations

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Semmelweis University Department of Public Dental Health

Budapest, Hungary, Hungary

Site Status RECRUITING

Countries

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Hungary

Central Contacts

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Csilla Szerencse, DMD, MDS

Role: CONTACT

003614591500 ext. 55890

Márton Kivovics, DMD, MDS, PHD

Role: CONTACT

003614591500 ext. 55890

Facility Contacts

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Csilla dr. Szerencse

Role: primary

0614591500 ext. 55890

Other Identifiers

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SEDCD45

Identifier Type: -

Identifier Source: org_study_id

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