Soft Tissue Response and IL-1β Levels Around CAD/CAM-Milled vs 3D-Printed PMMA Healing Abutments

NCT ID: NCT07287722

Last Updated: 2025-12-17

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

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

22 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-11-23

Study Completion Date

2025-12-23

Brief Summary

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This study looked at how the gums and tissues around dental implants heal when using two different types of temporary healing caps made of PMMA (a common dental material). These healing caps help shape the gums before placing the final crown.

There are two ways to make these caps:

1. CAD/CAM-milled (carved from a solid block)
2. 3D-printed (built layer by layer using resin) The goal was to find out which type leads to healthier gum tissue. What the Researchers Did

* 22 dental implants in 22 patients were included.
* Each implant received one healing cap-either milled or 3D-printed.
* Patients were checked after 1 week, 2 weeks, and 4 weeks.
* The team measured:

* Gum inflammation
* Bleeding around the implant
* Plaque buildup
* Pocket depth around the implant
* Levels of an inflammatory marker called Interleukin-1β (IL-1β) in the gum fluid (higher levels mean more inflammation).
* Surface smoothness and material quality of each type of healing cap. What the Study Found
* Gum inflammation and bleeding were higher with 3D-printed caps, especially at week 4.
* IL-1β levels were much higher around 3D-printed caps-showing more inflammation.
* Both types had some increase in plaque and probing depth over time, but there was no major difference between groups.
* The milled caps had smoother surfaces and better material quality, which may have helped reduce irritation and inflammation.
* 3D-printed caps were rougher and had lower polymerization (more leftover monomers), which may trigger soft-tissue irritation.

What This Means

* CAD/CAM-milled PMMA healing caps appear to be safer and healthier for gum healing around dental implants.
* They may help reduce early inflammation, support better tissue health, and more predictably shape the gums during healing.

Why This Matters for Patients

* Using a smoother, better-finished healing cap may lower the risk of early gum inflammation.
* Healthier soft tissue around an implant leads to better long-term implant stability.
* This information can help dentists choose the best healing cap for optimal healing.

Study Timeframe

• The follow-up was 4 weeks, so results focus on early healing. More research is needed to know long-term differences.

Detailed Description

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Conditions

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Peri-implant Soft Tissue Healing

Keywords

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Dental implants Healing abutments PMMA CAD/CAM milled abutments 3D-printed abutments Peri-implant soft tissue Peri-implant inflammation Interleukin-1 beta (IL-1β) Peri-implant crevicular fluid Surface roughness Degree of conversion Biocompatibility Digital dentistry Soft tissue healing

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants are randomly assigned in a 1:1 ratio to one of two parallel groups. Each participant receives only one type of healing abutment either a CAD/CAM-milled PMMA abutment or a 3D-printed PMMA abutment at the time of second-stage implant surgery and remains in that assigned group throughout the 4-week follow-up period. No crossover occurs between groups.
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

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CAD/CAM-Milled PMMA Healing Abutment

Participants receive a customized PMMA healing abutment manufactured using CAD/CAM milling from a pre-polymerized PMMA block. The abutment is attached to the implant at second-stage surgery to guide soft-tissue healing.

Group Type EXPERIMENTAL

CAD/CAM-Milled PMMA Healing Abutment

Intervention Type DEVICE

A customized healing abutment fabricated by subtractive CAD/CAM milling from a pre-polymerized PMMA block. Milling produces a highly polished, low-porosity surface with a high degree of polymerization. The abutment is connected to a Ti-base and placed at second-stage surgery to shape peri-implant soft tissues.

3D-Printed PMMA Healing Abutment

Participants receive a customized PMMA healing abutment manufactured using 3D printing from a light-cured PMMA resin, followed by post-processing and UV curing. The abutment is attached to the implant at second-stage surgery.

Group Type EXPERIMENTAL

3D-Printed PMMA Healing Abutment

Intervention Type DEVICE

A customized healing abutment produced by additive manufacturing (3D printing) using a light-cured PMMA resin. The abutment is printed layer-by-layer, washed in isopropyl alcohol, UV-cured, finished, and polished. This manufacturing technique results in a different surface texture and polymerization level compared to milled PMMA. The abutment is attached to a Ti-base and placed at second-stage surgery.

Interventions

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CAD/CAM-Milled PMMA Healing Abutment

A customized healing abutment fabricated by subtractive CAD/CAM milling from a pre-polymerized PMMA block. Milling produces a highly polished, low-porosity surface with a high degree of polymerization. The abutment is connected to a Ti-base and placed at second-stage surgery to shape peri-implant soft tissues.

Intervention Type DEVICE

3D-Printed PMMA Healing Abutment

A customized healing abutment produced by additive manufacturing (3D printing) using a light-cured PMMA resin. The abutment is printed layer-by-layer, washed in isopropyl alcohol, UV-cured, finished, and polished. This manufacturing technique results in a different surface texture and polymerization level compared to milled PMMA. The abutment is attached to a Ti-base and placed at second-stage surgery.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Adults aged 25 to 65 years
* Presence of one osseointegrated dental implant placed at least 8 weeks prior to second-stage surgery
* Adequate zone of attached keratinized gingiva (\> 1 mm) around the implant site
* Good general health and able to provide informed consent
* Willing and able to attend all follow-up visits (1, 2, and 4 weeks)

Exclusion Criteria

* Smoking more than 20 cigarettes per day
* Presence of systemic diseases that may affect healing (e.g., autoimmune conditions, uncontrolled diabetes, immunosuppressive disorders)
* Oral inflammatory conditions or active oral infections
* History of head and neck radiation therapy or chemotherapy
* Use of corticosteroids or antibiotics within the last 3 months
* Parafunctional habits (e.g., bruxism)
* Pregnant or breastfeeding individuals
* Implants with insufficient attached gingiva or poor oral hygiene maintenance
Minimum Eligible Age

25 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Ali Hassan Eid Toto

OTHER

Sponsor Role lead

Responsible Party

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Ali Hassan Eid Toto

MSC Candidate in periodontology department Alexandria university

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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Faculty of Dentistry, Alexandria University

Alexandria, , Egypt

Site Status

Countries

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Egypt

Other Identifiers

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AlexandriaUali

Identifier Type: -

Identifier Source: org_study_id