Bone Resorption Clinical Trial
Official title:
Influence of Soft Tissue Thickness and Insertion Depth of Platform Switched Implants on Crestal Bone Level Alteration
This is a two-year prospective randomized clinical study to to evaluate whether the gingival thickness and insertion depth of dental implants have any influence on marginal bone levels changes around platform switched implants.
Patient selection: Patients at the Department of Oral Implantology, Peking University School
and Hospital of stomatology, Bei Jing, China, who seek for implant restoration for two
continous posterior teeth are potentially recruited. Inclusion criteria are generally
healthy (ASA score I), non-smoking, periodontally healthy, and sufficient bone volume to
place an implant without augmentation procedure. Patients were excluded in cases of medical
and/or psychiatric contraindications, local infection, pregnancy or lactating, poor oral
hygiene, tissue deficiency, or not willing to participate in this study.
Randomization: The two implant sites of each subject are randomly assigned to two different
group with a predefined randomization tables. In order to reduce the chance of unfavorable
splits between groups in terms of key prognostic factors,the randomization process will take
into account the following variables: patient's gender, age, presence of adjacent teeth,
distal extension sites and site location in the dental arch. Assignment will perform using a
sealed envelope.
Surgical protocol: Before the surgical procedure, prophylactic antibiotics of 1g amoxicillin
will prescribed to the patient 1 h before surgery, and continued with 2 g/day for 6 days.
After crestal incision, full thickness buccal flap was raised, whereas lingual part was not
elevated. Thickness of soft tissues was measured with 1.0-mm marked periodontal probe on the
top of bone crest in the center of the two future implant sites. This ensured direct
visibility of mucosal thickness during measurement. After measurements, full-thickness
lingual flap is raised and subsequent implant osteotomy is finished, Two dental implants
(Dentsply Implants Manufacturing GmbH, Mannheim, Germany) with diameter of 3.5 mm are ready
to torch into the bone cavities. In one site (group 1), the platform of implants are placed
at the crestal level (flush to the alveolar ridge) . In the other site (group 2), the
implants are placed 1mm below the alveolar ridge. narrow healing abutment are connected to
all the implants. The flap are repositioned and closed with interrupted single sutures.
Implants are allowed for a un-submerged healing. 3 month after healing, the implant level
impressions are taken, splinted restorations of two neighbouring posterior teeth are
delivered 2 weeks later.
Radiographic and Clinical Examination: All the patients are required for recall visit at 3,
6,12 months and 2 years post surgery. A digital peri-apical radiograph was taken at the 1
year and 2year follow-up examination for bone level evaluation using a film holder to aim
the x-ray beam perpendicular to the implant threads, and the implant length is used as
calibration for the measurement. Using a image analysis software (ImageJ, version 1.47, NIH,
Bethesda, MD, USA), the investigators are able to have an accurate assessment of the crest
of bone and to analyze the bone changes over period of time. Bone loss was defined as a
positive value and bone gain as a negative one. Mean values, standard deviations, and
maximum and minimum values were calculated. Furthermore, periodontal parameters [bleeding on
probing (BOP), probing pocket depth (PPD), modified plaque index on adjacent teeth and
implants] were assessed.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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