Dental Implants Clinical Trial
Official title:
Evaluation of Dental Implant Treatment With and Without Flap for Clinical, Radiographic and Patient Comfort
The aim of this clinical study is to compare two different approaches during dental implant
applications. One group of patients in the study received flapless approach which is
performed without surgical reflection of soft tissues (gums) during implant surgery. In the
control group of the study, patients received conventional flap approach in which flap
reflections performed on soft tissues (gums) of the patients.
After the surgery patients were monitored for marginal bone loss around implants and
discomfort after the surgery for 3 months. And received data statistically analyzed to
compare the different surgical procedures.
Filling the Case Report Form for each registered patient and signed by the responsible
investigator or an authorized representative of the study staff. This also applies to records
for patients who could not complete the study (even if a case report form was prepared, even
during screening prior to randomization). If a patient withdraws from the study, the reason
for this is recorded in the Case report form. If a patient withdraws from the study because
of a limiting adverse event, all necessary efforts will be made to clearly document the
result.
All forms must be filled with a typewriter or an indelible ink pen and must be readable.
Errors can be crossed out, but errors cannot be deleted; the correction is entered and the
change is initialed and dated by the investigator or his authorized representative. The
researcher should ensure the accuracy, completeness and legibility of the data reported to
the sponsor in the case report forms and all required reports and that it was processed on
time.
The researcher is responsible for the accuracy of the data transferred on the forms and will
sign these forms in the sense of showing their compatibility with the recorded data.
As a result of the power analysis made with G * Power3.1 (Franz Faul, UniversitätKiel,
Germany) software program, it has been determined that the sampling number consisting of 20
people with 0.8 effect size and α = 0.05 significance level generates more than 80% power. it
was deemed appropriate to include a total of 24 people in the study. Karim M. Ahmed A, Salah
Abd Elfatah B, Mohamed Abd El-Mageed Katamish's ''Crestal bone loss of standard implant
versus platform switch implant design using minimal invasive technique'' article is used as a
reference for marginal bone loss data calculation.
Patients with sufficient amount of bone were included in the study after bone sounding and x
rays were evaluated after local anesthesia before surgery. By an unbiased researcher, the
patients were recruited to the groups using the envelope method; control group (with flap
raised) or test group (without flap raised) were assigned.
A total of 24 patients complying with these criteria were included in the study and a total
of 37 implants were applied to the patients.
Implant applications of the patients in the control group were performed by lifting the flap.
The implants of the patients included in the test group were applied without lifting the
flap.
For each implant in the study marginal bone loss were evaluated; Digital bite-wing x-rays
taken with a standard technique were used.Bite-wing x-rays taken were standardized with bite
blocks on the film holder prepared individually for each patient. From each implant site; two
x-rays were taken first immediately after implant surgery and the second three months later,
just before the uncovering session of the implants. Digital bite-wing x-rays were transferred
to RadiAnt Dicom Viewer program and measurements were made on them. Implant diameter values
which is known in the images are accepted as reference.The diameter in the image was measured
and a coefficient was obtained by dividing the real diameter to measurement on image. In the
images, the distance between the most coronal point of the implant neck and the point where
the implant bone contact first occurred was measured. This distance was divided by the
coefficient obtained and its actual values are obtained in mm.The difference between these
distances at two time points were recorded in patient forms as marginal bone loss. In
statistical analysis, comparisons between groups were made.
All the individuals included in the study came to the control appointments on the 3rd and 7th
days after implant surgery, and the sutures were also taken on the 7th day. All patients were
asked to fill the Turkish translation of Oral Health Impact Profile (OHIP-14) forms three
times: preoperatively, postoperative day 3, and postoperative day 7. Visual Analog Scale
(VAS) forms were asked to be marked by the patients on the 3rd and 7th days after the
operation. VAS forms were prepared as a horizontal line with one side being the lowest score
and the other side with highest score. VAS forms were prepared to be in 0-100 mm and the
point marked by the patient was measured in cm. In VAS forms, patients were asked to mark
according to their post-operative pain status.
Statistical analysis of the data in this study was done with Statistical Package for the
Social Sciences (SPSS) 20 (International Business Machines Corporation Somers, New York, USA)
package program.In the evaluation of the data, besides descriptive statistical methods (mean,
standard deviation), T test was used for comparisons between groups. ANOVA test was used for
multiple group comparisons. Statistical significance level was determined as p <0.05 .
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