Comparison Between Modified Periosteal Inhibition (MPI) and Flapless Immediate Implant Placement

Mansoura University

Status: Not yet enrolling

Conditions: Thin Buccal Bone Plate; Non-restorable Posterior Teeth; Buccal Bone Fenestraion

Treatments: Procedure: Immediate implant placement in conjunction with modified periosteal inhibition technique using collagen sponge in the gap distance; Procedure: Immediate implant placement in conjunction with modified periosteal inhibition technique using cortico-cancellous bone allograft in the gap distance; Procedure: Immediate implant placement via flapless approach

Study type: Interventional

Funder types: Other

Identifiers

NCT07238738

MPI with immediate implant

Details and patient eligibility

About

To clinically and radiographically assess the impact of the modified periosteal inhibition (MPI) technique, applied during immediate post-extraction implant placement, on alveolar bone dimensional changes, in comparison to the conventional flapless immediate implant approach.

Full description

To assess the impact of the modified periosteal inhibition (MPI) technique, applied during immediate post-extraction implant placement in comparison to the conventional flapless immediate implant approach on radiographically by assessing marginal bone level measurements and bucco-lingual alveolar width. Clinically, pain levels, wound healing index, primary, secondary implant stability measured by resonance frequency analysis (RFA), peri-implant probing depth, and pink esthetic score (PES) will be assessed.

Enrollment: 30 estimated patients

Sex: All

Ages: 20 to 50 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patient's age ranges between 20 and 50 years including both genders.
• General good health (American Society of Anesthesiologists I-II).
• Presence of one hopeless non-restorable tooth requiring extraction at the posterior region.
• Adequate amount of palatal bone and basal bone (≥ 3 mm) to engage the immediately placed implants.
• Adequate keratinized soft tissue.
• Thick gingival phenotype (˃ 1.5 mm).
• Thin buccal bone plate or presence of fenestration.
• Favorable pattern of occlusion.
• Patient who is able to understand and sign a written consent.

Exclusion criteria

• Pregnancy or lactating females.
• Untreated periodontitis.
• Acute dentoalveolar infection.
• Complete absence of buccal bone plate.
• Osteometabolic disease.
• Chemotherapy or radiation therapy history of the neck-head area within the past 12 months.
• Heavy smokers (>20 cigarettes/per day) according to WHO.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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30 participants in 3 patient groups

Flapless immediate implant placement with cortico-cancellous bone allograft in the gap distance

Experimental group

Description:

Participants receive immediately inserted implant via flapless approach with the grafting of cortico-cancellous bone allograft in the gap distance between dental implant and surrounding native alveolar bone followed by insertion of customized healing abutment.

Treatment:

Procedure: Immediate implant placement via flapless approach

Immediate implant placement with MPI technique using collagen sponge in gap distance

Experimental group

Description:

Participants receive immediately inserted implant in conjunction with modified periosteal inhibition technique (MPI) after flap reflection from the buccal side and fixation of a 0.5 mm-thick cortical lamina glued to the buccal cortex with cyanoacrylate material. Collagen sponge will be filled in the gap distance followed by insertion of customized healing abutment.

Treatment:

Procedure: Immediate implant placement in conjunction with modified periosteal inhibition technique using collagen sponge in the gap distance

Immediate implant with MPI technique using cortico-cancellous bone allograft in gap distance

Experimental group

Description:

Participants receive immediately inserted implant in conjunction with MPI technique as described in group 2, however, cortico-cancellous bone allograft will be placed in the gap distance instead of collagen sponge and followed by insertion of customized healing abutment.

Treatment:

Procedure: Immediate implant placement in conjunction with modified periosteal inhibition technique using cortico-cancellous bone allograft in the gap distance