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Purpose: The aim of this RCT was to evaluate and compare histomorphometric and immunohistochemical characteristics of peri-implant bone tissue after implant site preparation using piezoelectric tips versus conventional drills. Material and Methods: A split-mouth protocol was carried out on 6 patients with bilateral partial edentulism. A total of 12 alveolar ridges were randomized into two groups: 6 control sites (Group B) with conventional drills preparation (Drill-group) and 6 test sites (Group A) treated by piezoelectric implant inserts preparation (Piezo-group). At 28 days after surgery (T1), in both group, one study-fixtures with 0.5 mm of peri-implant bone tissue were explanted and processed for the histological, histomorphometrical and immunoistochemical analysis. For each sample Inflammatory infiltrates, necrotic bone (Zone 1), woven and newly formed bone (Zone 2), native bone (Zone 3), CD31 (cluster of differentiation 31) and SATB2 (special AT-rich sequence-binding protein necrotic bone undergoing remodeling) were evaluated.
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This was a pilot, parallel-group, doble-blinded, split-mouth, randomized clinical trial.
The study included six patients with bilateral partial edentulism, having in total 12 maxillary or mandibular edentulous alveolar ridges. All patients had been referred to the Unit of Oral and Maxillofacial Surgery, Alma Mater Studiorum, University of Bologna, Italy.
The alveolar ridges were randomized into two groups using a computer-generated method: Group A included six regions where implant sites were prepared by piezosurgery, and Group B six regions prepared by conventional drilling.
Surgical and prosthetic protocol In Group A, all implant sites were prepared with a piezoelectric device with IM1, IM2, IM2-3, or IM3 piezo-inserts according to the manufacturer's protocol (Piezosurgery, Mectron Medical Technology, Carasco, Italy). One or two implants were placed in each edentulous ridge along with an additional 3.3 x 8.5 mm implant, termed a "study fixture", in an adjacent area. In Group B, all implant sites were prepared with conventional drills according to the manufacturer's protocol (Premium, Sweden & Martina, Due Carrare, Padova, Italy); similarly to group A, one or two implants were placed in each edentulous ridge, and an additional 3.3 x 8.5 mm "study-fixture" was placed in the adjacent area.
After cover screw placement, a parallel periapical radiograph was taken and the flap was sutured with 4-0 Vicryl. After surgery, antibiotic therapy (1 g amoxicillin and clavulanic acid every 8 h for 4 days), analgesic therapy (nimesulid 200 mg/day for 2 days, continued if pain persisted), and antiseptic therapy (chlorhexidine 0.2% [w/v] three times daily), were prescribed.
All specimens were fully analyzed in terms of the percentages of necrotic bone area (NBA%) and newly-formed bone area (nFBA%), and the ratios of these values to total bone area (TBA). For each specimen, the authors identified three different areas proceeding from the surface of the fixture toward the border of the biopsy: zone 1, necrotic bone undergoing remodeling; zone 2, woven and newly formed bone; and zone 3, native bone. For each zone, we recorded:
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6 participants in 2 patient groups
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Data sourced from clinicaltrials.gov
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