Evaluation of Bone Height Gain Following Trans-crestal Sinus Floor Elevation

Maxillary Sinus Disease Clinical Trial

Official title:

Evaluation of Bone Height Gain Following Trans-crestal Sinus Floor Elevation Using the Densifying Bur in Comparison to The Conventional Osteotome In Patients With Atrophic Posterior Maxillae: A Randomized Controlled Clinical Trial

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT05411510
• Other study ID #: 2022
• Status: Not yet recruiting
• Phase: N/A
• Start date: August 20, 2022
• Est. completion date: December 20, 2023

Study information

• Verified date: June 2022
• Source: Cairo University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Missing teeth usually result in functional and cosmetic deficits. Traditionally, they have been restored with dentures or fixed bridges. However, dental implants represent an excellent alternative which rely on the maintenance of a direct structural and functional connection between living bone and implant surface, which is termed osseointergration . When sufficient bone is available in maxilla, implant rehabilitation has shown high success rates of 84-92 %. Atrophy of the alveolar crest and pneumatization of the maxillary sinus limits the quality and quantity of residual bone, therefore complicating the placement of implants in the posterior maxillary area.

Description:

Among the techniques used to overcome low vertical bone height in the maxilla is maxillary sinus floor augmentation. It can be performed either through a lateral window, or via a crestal access. Many long term studies and systematic reviews have showed that osteotome mediated sinus floor elevation (OSFE) technique is a highly predictable method for rehabilitation of patients with atrophied posterior maxilla with survival rates ranging from 92 % to 100 %. However, endoscopic studies have demonstrated the risk of membrane perforation while performing transalveolar sinus floor elevation. Moreover, the Summers technique can cause some complications as headache and paroxysmal positional vertigo. Additionally, the activity of osteotomes during the application of malleting pressure is difficult to control, resulting in unwanted instrument and/or graft penetration into the sinus cavity, potentially causing membrane penetration.

However, Huwais invented a new technology termed osseodensification for enhancing implant primary stability in 2015. This technology is performed with the use of specially developed drill bits (Densah burs) that combine the benefits of osteotomes with tactile control during the expansion. They have four or more lands with a negative rake angle, which prevents the bur's edges from cutting the bone and so compacts it smoothly. These drills have a tapered shank and a cutting chisel edge. They can thus go deeper into the osteotomy site, while the drill's gradually increasing diameter aids in the site's gradual enlargement. Drills are utilized to enter into the bone in a clockwise rotation (Cutting mode) until the appropriate depth of the osteotomy is reached. Afterwards, counterclockwise rotations (Densifying mode) generate a robust and dense layer of bone tissue along the osteotomy's walls and base. Through controlled deformation, this procedure burnishes bone along the inner layer of the osteotomy site. The goal is to construct a condensed layer of autografted bone along the implant's periphery and apex. This would improve the bone-implant contact, hence increasing insertion torque values and, as a result, implant primary stability.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 20
• Est. completion date: December 20, 2023
• Est. primary completion date: February 20, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 23 Years to 60 Years

Eligibility

Inclusion Criteria:

• ? Patients having one missing upper posterior tooth with residual bone height beneath maxillary sinus from 5-8 mm.

• A minimum of 6 mm residual bone width at site of implant placement.

• The recipient site of the implant should be free from any pathological conditions.

• No diagnosed bone disease or medication known to affect bone metabolism.

• Patients who are cooperative, motivated and hygiene conscious.

• Patients having adequate inter-occlusal space of 8-10 mm

Exclusion Criteria:

• ? Systemic conditions/diseases that contraindicate surgery.

• Radiation therapy in the head and neck region or chemotherapy during the 12 months prior to surgery.

• Patients who have any habits that might jeopardize the osseointegration process, such as current smokers.

• Patients with parafunctional habits that produce overload on implant, such as bruxism and clenching.

• Patients that have any pathology in the maxillary sinuses.

Related Conditions & MeSH terms

• Maxillary Sinus Disease
• Paranasal Sinus Diseases

Intervention

Procedure:
• Densah bur
Surgical treatment

Locations

Country	Name	City	State
Egypt	Cairo University	Cairo
Egypt	Faculty of Dentistry	Cairo

Sponsors (1)

Lead Sponsor	Collaborator
Ahmed Mohamed Said Rozeik

Country where clinical trial is conducted

Egypt, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Bone gain height	It will be measured using Cone beam computed tomography (CBCT) in mm	6 months