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Clinical Trial Details — Status: Not yet recruiting

Administrative data

NCT number NCT03559777
Other study ID # closed sinus lifiting
Secondary ID
Status Not yet recruiting
Phase N/A
First received
Last updated
Start date July 1, 2018
Est. completion date August 1, 2019

Study information

Verified date June 2018
Source Cairo University
Contact taha amer, master
Phone +201095896951
Email tahaamer181290@gmail.com
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This study is aiming to evaluate primary stability of implant in closed sinus lifting cases by Densah bur in compared to Osteotome in partially edentulous patients hoping that densah bur can lift the sinus membrane and improve primary stability of implant.


Description:

The osteotome technique is effective in certain cases, but the most sensitive aspect is the tapping force, which should be sufficient enough to infracture the sinus floor cortical bone but restrained enough to prevent the osteotome tip from traumatizing the Schneiderian membrane.

Several surgical techniques have been proposed to minimize the sinus membrane perforation rate by using a piezosurgical device, balloon, hydrostatic pressure.

The success of therapy in posterior maxilla is not only dependent on the success of the sinus elevation but also the primary stability of the implant that allow bone apposition on the implant surface without any micromovement for osseeointegration.

Later, densah burs are introduced as another treatment option for internal transalveolar approach of sinus floor elevation with improving primary stability of implant by osseodensification.

As treatment options of edentulous maxillary today may include dental implants, the practitioner must be familiar with various sinus lift surgical techniques in order to choose an ideal treatment option for the patient.


Recruitment information / eligibility

Status Not yet recruiting
Enrollment 14
Est. completion date August 1, 2019
Est. primary completion date July 1, 2019
Accepts healthy volunteers Accepts Healthy Volunteers
Gender All
Age group 18 Years to 65 Years
Eligibility Inclusion Criteria:

- Both males as well as females without any active periodontal disease.

- All patients were in a good health with no systemic diseases.

- All selected patients were non-smokers and non-alcoholics.

- Patient were free from T.M.J troubles, abnormal oral habits such as bruxism.

- The edentulous ridges were covered with optimal thickness of soft tissue.

- Remaining natural teeth had good.

- Periodontal tissue support and occlusion showed sufficient inter arch space.

- On the local level, patients with maxillary sinus diseases and unfavorable inter maxillary relationship were excluded.

Exclusion Criteria:

- Patients with residual bone height less than 6mm.

- Patients with systemic disease that may affect bone quality.

- Patients with poor oral hygiene and active periodontal diseases.

- Patient with limited mouth opening.

Study Design


Related Conditions & MeSH terms


Intervention

Other:
closed sinus lifting by Osteotome
Local anesthesia will be injected intra-orally A full thickness flap will be elevated A pilot drill will be used to start the osteotomy preparation, which should be ended 1mm short of sinus floor. The widening drills can be sequentially used to widen the osteotomy site to the same level An osteotome of diameter a little less than the planned implant body, will be inserted in the prepared osteotomy site and gently tapped to reach the same level. The osteotome will be tapped gently to fracture up the sinus floor. Xenograft will be added to the osteotomy as the grafting material. Once the desired height of sinus elevation will be gained and grafted, the implant fixture will be inserted. Smart peg will be placed on implant and Ostell will be used to record ISQ. Healing collar will be placed on implant. Suturing the flab around healing collar.
closed sinus lifting by Densah bur
Local anesthesia will be injected intra-orally A full thickness flap will be elevated A pilot drill will be used to start the osteotomy , which should be ended 1mm short of sinus floor. Change the drill motor to reverse- densifying Mode with the densah bur (2.5mm) until 1 mm short of the sinus floor. Use the next wider Densah Bur (3.0) in densifying-mode until feeling the haptic feedback of the bur reaching the dense sinus floor, modulate pressure with a gentle pumping motion to advance past the sinus floor in 1 mm increments. densah burs (3.5mm) advance in the osteotomy. Xenograft will be added to the osteotomy . Once the desired height of sinus elevation will be gained and grafted, the implant fixture will be inserted. Smart peg will be placed on implant and Ostell will be used to record ISQ. Healing collar will be placed on implant. Suturing the flab around healing collar.

Locations

Country Name City State
n/a

Sponsors (1)

Lead Sponsor Collaborator
Cairo University

References & Publications (22)

Atwood DA. Reduction of residual ridges: a major oral disease entity. J Prosthet Dent. 1971 Sep;26(3):266-79. — View Citation

Bartee BK. Extraction site reconstruction for alveolar ridge preservation. Part 1: rationale and materials selection. J Oral Implantol. 2001;27(4):187-93. Review. — View Citation

Büchter A, Kleinheinz J, Wiesmann HP, Kersken J, Nienkemper M, Weyhrother Hv, Joos U, Meyer U. Biological and biomechanical evaluation of bone remodelling and implant stability after using an osteotome technique. Clin Oral Implants Res. 2005 Feb;16(1):1-8. — View Citation

Chen L, Cha J. An 8-year retrospective study: 1,100 patients receiving 1,557 implants using the minimally invasive hydraulic sinus condensing technique. J Periodontol. 2005 Mar;76(3):482-91. — View Citation

Chrcanovic BR, Albrektsson T, Wennerberg A. Reasons for failures of oral implants. J Oral Rehabil. 2014 Jun;41(6):443-76. doi: 10.1111/joor.12157. Epub 2014 Mar 11. Review. — View Citation

Di Girolamo M, Napolitano B, Arullani CA, Bruno E, Di Girolamo S. Paroxysmal positional vertigo as a complication of osteotome sinus floor elevation. Eur Arch Otorhinolaryngol. 2005 Aug;262(8):631-3. Epub 2005 Feb 27. — View Citation

Garbacea A, Lozada JL, Church CA, Al-Ardah AJ, Seiberling KA, Naylor WP, Chen JW. The incidence of maxillary sinus membrane perforation during endoscopically assessed crestal sinus floor elevation: a pilot study. J Oral Implantol. 2012 Aug;38(4):345-59. doi: 10.1563/AAID-JOI-D-12-00083. — View Citation

Geckili O, Bilhan H, Geckili E, Cilingir A, Mumcu E, Bural C. Evaluation of possible prognostic factors for the success, survival, and failure of dental implants. Implant Dent. 2014 Feb;23(1):44-50. doi: 10.1097/ID.0b013e3182a5d430. — View Citation

Lundgren S, Cricchio G, Hallman M, Jungner M, Rasmusson L, Sennerby L. Sinus floor elevation procedures to enable implant placement and integration: techniques, biological aspects and clinical outcomes. Periodontol 2000. 2017 Feb;73(1):103-120. doi: 10.1111/prd.12165. Review. — View Citation

Meyer, E, and S Huwais, 'Osseodensification Is a Novel Implant Preparation Technique That Increases Implant Primary Stability by Compaction and Auto-Grafting Bone', American Academy of Periodontology, 2014

Nóbrega AR, Norton A, Silva JA, Silva JP, Branco FM, Anitua E. Osteotome versus conventional drilling technique for implant site preparation: a comparative study in the rabbit. Int J Periodontics Restorative Dent. 2012 Jun;32(3):e109-15. — View Citation

Pietrokovski J, Massler M. Alveolar ridge resorption following tooth extraction. J Prosthet Dent. 1967 Jan;17(1):21-7. — View Citation

Pjetursson BE, Tan WC, Zwahlen M, Lang NP. A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. J Clin Periodontol. 2008 Sep;35(8 Suppl):216-40. doi: 10.1111/j.1600-051X.2008.01272.x. Review. — View Citation

Rosen PS, Summers R, Mellado JR, Salkin LM, Shanaman RH, Marks MH, Fugazzotto PA. The bone-added osteotome sinus floor elevation technique: multicenter retrospective report of consecutively treated patients. Int J Oral Maxillofac Implants. 1999 Nov-Dec;14(6):853-8. — View Citation

Schwartz-Arad D, Herzberg R, Dolev E. The prevalence of surgical complications of the sinus graft procedure and their impact on implant survival. J Periodontol. 2004 Apr;75(4):511-6. — View Citation

Sharan A, Madjar D. Maxillary sinus pneumatization following extractions: a radiographic study. Int J Oral Maxillofac Implants. 2008 Jan-Feb;23(1):48-56. — View Citation

Stavropoulos A, Nyengaard JR, Lang NP, Karring T. Immediate loading of single SLA implants: drilling vs. osteotomes for the preparation of the implant site. Clin Oral Implants Res. 2008 Jan;19(1):55-65. Epub 2007 Oct 22. — View Citation

Summers RB. A new concept in maxillary implant surgery: the osteotome technique. Compendium. 1994 Feb;15(2):152, 154-6, 158 passim; quiz 162. — View Citation

Tan WC, Lang NP, Zwahlen M, Pjetursson BE. A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. Part II: transalveolar technique. J Clin Periodontol. 2008 Sep;35(8 Suppl):241-54. doi: 10.1111/j.1600-051X.2008.01273.x. Review. — View Citation

Tatum H Jr. Maxillary and sinus implant reconstructions. Dent Clin North Am. 1986 Apr;30(2):207-29. — View Citation

Valentini P, Abensur DJ. Maxillary sinus grafting with anorganic bovine bone: a clinical report of long-term results. Int J Oral Maxillofac Implants. 2003 Jul-Aug;18(4):556-60. — View Citation

Zohrabian VM, Sonick M, Hwang D, Abrahams JJ. Dental Implants. Semin Ultrasound CT MR. 2015 Oct;36(5):415-26. doi: 10.1053/j.sult.2015.09.002. Epub 2015 Sep 12. Review. — View Citation

* Note: There are 22 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary stability of implant After implant placement, Implant stability will be measured by Ostell Implant stability will be measured intraoperative at time of surgery
Primary stability of implant Implant stability will be measured by Ostell Implant stability will be measured at second week
Primary stability of implant Implant stability will be measured by Ostell Implant stability will be measured at fourth week
Primary stability of implant Implant stability will be measured by Ostell Implant stability will be measured at the sixth week
Primary stability of implant Implant stability will be measured by Ostell Implant stability will be measured at The eighth week
See also
  Status Clinical Trial Phase
Completed NCT00868777 - The Influence of Dimensional Anatomic Variables on the Outcomes of Maxillary Sinus Grafting Procedures Phase 4
Completed NCT04136509 - Microarchitecture of the Augmented Bone Following Sinus Elevation N/A