Prosthetic Modality and MBL

NCT ID: NCT07156110

Last Updated: 2025-09-04

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

2025-09-01

Study Completion Date

2026-12-31

Brief Summary

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The present study will test the effect of different prosthetic modalities on conical and internal hex connection implants, assessing the radiographic MBL changes after one year.

Consecutive patients fulfilling inclusion/exclusion criteria will enter the study. Once the implant is inserted, patients will be divided into three groups according to the time if their inclusion in the study.

Study groups (20 patients per group):

1. Group 1: Placing Lance Conical implant with a healing abutment. Three months later, after an impression, a screw-retained restoration will be seated using a Ti-Base abutment.
2. Group 2: Placing Lance+ (Internal Hex connection) implant with a healing abutment. Three months later, after an impression, a screw-retained restoration will be seated using a Ti-Base abutment.
3. Group 3: Placing Lance Conical implant together with Connect Abutment (tightened to 30 Ncm) with a Connect healing cap ("one time one abutment"). Screw retained restoration after 3 months.

Consecutive inclusion of patients - 1st- group 1, 2nd - group 2, 3rd - group 3 and vice versa.

Primary outcome variable: bone level changes 12 months post-loading

Detailed Description

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Actually, the histologic composition of the soft tissue around the prosthetic district was Indirectly clarified firstly in animal studies focused on biologic width re- establishment, now renamed supracrestal tissue attachment, which described the epithelial and connective components and the key role in the implant longitudinal maintenance they have (1). In fact, it was shown that the soft tissue morphogenesis in humans may occur in 8-12 weeks (2) This histologic structure is represented by a dense connective tissue with few fibroblasts and edondotelial cells isolated by a junctional epithelium indirectly connected to the abutment in the most coronal portion by a thin layer of proteoglycans and psudopodia (3).

Traditionally the Interaction between living cells and a biocompatible foreign material is mediated by some biological factors and could be associated with a mathematical equation Apparently, this is based on few variables generically represented by soft tissue patterns and biomaterial features (4). In fact, according to the basic science, the host tissue (intended both histologically and epigenetically), the biocompatible foreign material and the antagonist.

The tissue variable should be intended not only as its clinical appearance (thin vs thick), but overall as its INDIVIDUAL regenerative and inflammatory capability (which of course involves also the histologic aspect) (5) Changing our prospecting and focusing on the prosthetic variable, this should be intended not only as it is in its macro/micro and nano structure, but also as it is used in the prosthetic work flow In fact, the proximity of the prosthetic components to the connective tissues (mostly evident in case platform switching configuration) could allow the clinician during the healing period to actively influence soft tissue morphogenesis In fact, 2 weeks after reopening, traditional prosthetic work flow provides for healing abutment disconnection and impression taking (just at the peak of the first phases of wound healing) and two weeks there after new disconnections are required for try ins and definitive prosthetic delivery, just when the maturation healing phase peak occurs(6-7).

These continuous dis-reconnections may lead to soft tissue healing disruption with a long junctional epithelium till the IAJ.

Not to mention the fact that continuous disconnections create a link for the contamination of the connection and the exposure of soft tissues to abutment not always contaminated The only approach able to prevent this "physiological reaction" and allow a complete healing is to adopt a protocol aimed, after an intraoperative impression, to definitively screw the final abutment at the time of second surgery and allow soft tissue to heal undisturbed (so called "one-abutment/one-time) (8) Another factor affecting soft tissue/abutment interaction is the abutment macro design A recent systematic review our group recently produced, suggested that narrower abutments fail to show any difference in terms of soft tissue health (and this is reasonable) and esthetics (9).

On the other hand, the metanalysis highlighted significant differences in terms of MBL in favor of narrower abutments just because this configuration allows for more room for soft tissues supracrestal attachment, probably changing their fiber arrangement from parallel to the long axis to ring-shaped circular with a stronger connective seal Another factor related to the "abutment variable" that dramatically may affect soft tissue/abutment interaction, and therefore interacting with the underlaid bone, is its micro design.

In fact, the importance of the material should be shifted from the bulk to the external surface and its biochemophysical and topographic properties, including cleanliness.

In fact, decontamination of the abutment surface is a prerequisite for cell. Aim The present study will test the effect of different prosthetic modalities on conical and internal hex connection implants, assessing the radiographic MBL changes after one year.

Materials and Methods Study design The study was designed as a prospective, controlled clinical trial with a parallel design. Approval from the Ethics Committee will be obtained before the study commences. Selected patients were informed about the purpose of the study, and if they agreed to participate, they were recruited to participate in the clinical trial once they had signed the informed consent form.

Subject population Subjects in need of an implant-supported restoration will be screened for the following study criteria Consecutive patients fulfilling inclusion/exclusion criteria will enter the study. Once the implant is inserted, patients will be divided into three groups according to the time if their inclusion in the study.

Study groups (20 patients per group):

1. Group 1: Placing Lance Conical implant with a healing abutment. Three months later, after an impression, a screw-retained restoration will be seated using a Ti-Base abutment.
2. Group 2: Placing Lance+ (Internal Hex connection) implant with a healing abutment. Three months later, after an impression, a screw-retained restoration will be seated using a Ti-Base abutment.
3. Group 3: Placing Lance Conical implant together with Connect Abutment (tightened to 30 Ncm) with a Connect healing cap ("one time one abutment"). Screw retained restoration after 3 months.

Consecutive inclusion of patients - 1st- group 1, 2nd - group 2, 3rd - group 3 and vice versa.

Information to collect:

Inclusion day: Demographic data, medical condition Day of surgery: implant site, insertion torque, parallel X-ray. Suture removal - adverse effects. 3 months (impression) - parallel X-ray. Adverse effects. Loading day - parallel X-ray. Adverse effects. 6 months post-loading - parallel X-ray. Adverse effects. 12 months post-loading - parallel X-ray. Adverse effects, pocket depth, BOP.

Clinical photos and videos will be appreciated for future presentations.

Primary outcome variable: bone level changes 12 months post-loading Surgical and prosthetic protocol According to the manufacturer's instructions, using the Lance surgical kit, with tools for Conical connection and internal hex implants (fig 1 and 2).

Prosthetic parts will be inserted according to the manufacturer's instructions using the specific tools and a torque-controlled rachet.

Conditions

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Bone Loss

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Arm 1

Placing Lance+ (Internal Hex connection) implant with a healing abutment. Three months later, after an impression, a screw-retained restoration will be seated using a Ti-Base abutment.

Group Type ACTIVE_COMPARATOR

Traditional prosthetic procedure

Intervention Type PROCEDURE

Three months later, after an impression, haling abutment will be removed and a screw-retained restoration will be seated using a Ti-Base abutment.

Arm 2

Placing Lance Conical implant with a healing abutment. Three months later, after an impression, a screw-retained restoration will be seated using a Ti-Base abutment.

Group Type EXPERIMENTAL

Traditional prosthetic procedure

Intervention Type PROCEDURE

Three months later, after an impression, haling abutment will be removed and a screw-retained restoration will be seated using a Ti-Base abutment.

Arm 3

Placing Lance Conical implant together with Connect Abutment (tightened to 30 Ncm) with a Connect healing cap ("one time one abutment"). Screw retained restoration after 3 months.

Group Type EXPERIMENTAL

one abutment-one time

Intervention Type PROCEDURE

Three months later, after an impression, a screw-retained restoration will be seated directly on the connect healing

Interventions

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Traditional prosthetic procedure

Three months later, after an impression, haling abutment will be removed and a screw-retained restoration will be seated using a Ti-Base abutment.

Intervention Type PROCEDURE

one abutment-one time

Three months later, after an impression, a screw-retained restoration will be seated directly on the connect healing

Intervention Type PROCEDURE

Eligibility Criteria

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Exclusion Criteria

1. Any bone augmentation performed on the implant site with a healing period of less than 3 months.
2. Local inflammation (including untreated periodontitis).
3. Mucosa disease such as erosive lichen planus
4. History of local irradiation therapy.
5. Presence of osseous lesions
6. History of implant failure
7. Postextraction sites with less than 6 weeks of healing
8. Sever bruxism or cjenching habits
9. Persistent intraoral infection.
10. Bone type 4.


1. Lack of primary stability less than 35 Ncm.
2. Need for augmentation procedures during implant surgery.
3. Inability to place the implant according to the prosthetic requirements.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Alessio Triestino

UNKNOWN

Sponsor Role collaborator

Studio Odontoiatrico Associato Dr. P. Cicchese e L. Canullo

OTHER

Sponsor Role lead

Responsible Party

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Luigi Canullo

professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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luigi Canullo, prof

Role: PRINCIPAL_INVESTIGATOR

Studi Odontoiatrici Canullo

Locations

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Studi Odontoiatrici Luigi Canullo

Roma, RM, Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Luigi Canullo, prof

Role: CONTACT

3476201976 ext. +39

Luigi Canullo

Role: CONTACT

Facility Contacts

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Luigi Canullo, Professor

Role: primary

3476201976

Other Identifiers

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L1

Identifier Type: -

Identifier Source: org_study_id

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