Soft Tissue Esthetic With Autogenous Dentin Chips and Immediate Implantation Versus Conventional Immediate Implantation With Xenograft in Thin Buccal Bone

Cairo University (CU)

Status: Completed

Conditions: Crestal Bone Loss

Treatments: Procedure: immediate implant with dentine chips; Procedure: conventional immediate implant

Study type: Interventional

Funder types: Other

Identifiers

NCT03544580

CEBD-CU-2018-05-01

Details and patient eligibility

About

After tooth extraction, host bone resorption and atrophy of alveolar ridge may be observed. Bone resorption occurs specially in incisors and premolar area of jaw in region of thin buccal bone that may lead to change in contour. Total clinical bone loss height approximately 2-5 mm at first 6 months may be observed in vertical dimension , after 12 months alveolar ridge may lose up to 50 % of its width.

Full description

Recently augmentation with bone grafting became one of the most common techniques surgically ; progressive bone resorption may be prevented by using augmentation procedures with use of graft materials. The gold standard in regenerative procedures is autogenous bone graft because of osteoinduction , osteoconduction and osteointergration properties required in regeneration. In autogenous bone graft there is need for a second surgical site , donor site morbidity and limited availability will lead to challenge for alternative bio-materials.

Extracted healthy non functional teeth from human are considered to be a dental waste all over the world. High proportion of extracted sockets are left untreated for physiological healing. Inadequate or failure of bone healing in sockets has been seen due to absence of bone graft material. Stem cells, matrix , trace metal ions and growth factors are rich in human tooth. Bone and dentin tissue structure are different but ratio of components is similar (mineral 70% , collagen 20% and body fluid 10% by weight). Dentin after demineralization is mainly composed of type 1 collagen 95% and non collagenous proteins as growth factors.

Enrollment: 16 patients

Sex: All

Ages: 20 to 50 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Patient related :

  • Patient who only need to restore this single tooth.
  • Good oral hygiene
  • Systemically healthy (free from any systemic diseases)

Site related :

• Hopeless tooth (nonrestorable, badly broken, endodontically treated) indicated for extraction and immediate implant placement
• Esthetic area with thin buccal bone
• Having periapical bone more than 3mm for primary stability

Exclusion criteria

• Patient related :

  • Smokers
  • Pregnant woman

Site related

• Teeth that have to be extracted due to advanced periodontal bone loss
• Trauma in aesthetic area
• Periapical infection.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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16 participants in 2 patient groups

immediate implant with dentin chips

Experimental group

Description:

using the tooth structure presented in socket either as remaining root or as unrestorable tooth structure remove all periodontal ligaments \& scraping all enamel \& cementum using a stone also to cut it into slices then putting it in acid to demineralize the dentine ; then using a bone mill to transform dentine into small particles or chips to be used in jumping gap between implant \& thin buccal bone

Treatment:

Procedure: immediate implant with dentine chips

immediate implant with xenograft

Active Comparator group

Description:

after surgical removal of entire badly decayed tooth we immediately put implant and in jumping gap we use xenograft

Treatment:

Procedure: conventional immediate implant