Badly Decayed Anterior Maxillary Teeth Clinical Trial
Official title:
Evaluation of Marginal Bone Loss After Immediate Implant Placement in Maxillary Esthetic Zone With Coral Bone Versus Xenograft
Autogenous bone graft is considered to be the golden standard for grafting as it has
osteoconductive , osteoinductive and osteogenic functions , however it has the problems of
donor site morbidity , the need for two surgeries as well as post operative swelling and
discomfort of the patient , so alternative bone grafts as alloplast has been introduced.
Coral bone has a structure which is similar to that of cancellous bone , its mechanical
properties is similar to that of bone and it consists of high content of calcium carbonate
scaffolds that has the advantages of being biodegradable , biocompatible and osteoconductive
, they act as a carrier for growth factors and allow cell attachment , growth , spreading ,
differentiation and has been found to be effective bone graft
Immediate implant placement has the advantages of better esthetics , reduction in the number
of surgeries (one surgery is needed) and reduction in the time of treatment so it is more
suitable and comfortable for patients .
Immediate implant placement in fresh extraction socket after tooth extraction may reduce the
incidence of bone loss compared to implant placement in the healed bone.
Certain studies showed that bone resorption occurs with immediate implant placement and there
is high risk of failure and complications.
The gold standard for immediate implant placement is placing bone graft around the implant to
fill the jumping gap between the implant and the socket.
Certain studies showed that if the jumping gap is 1-2 mm so no grafting is needed , but if
the gap is more than 2mm then bone grafting is needed .
Immediate implant placement has the disadvantage of ; difficulty in obtaining primary
stability , lack of adequate soft tissue coverage and also the control of the implant
position is difficult in addition to the cost of the graft.
Despite these disadvantages the success rates of immediate implants is very high.
Autogenous bone graft is considered to be the golden standard for grafting as it has
osteoconductive , osteoinductive and osteogenic functions , however it has the problems of
donor site morbidity , the need for two surgeries as well as post operative swelling and
discomfort of the patient , so alternative bone grafts as alloplast has been introduced.
Coral bone has a structure which is similar to that of cancellous bone , its mechanical
properties is similar to that of bone and it consists of high content of calcium carbonate
scaffolds that has the advantages of being biodegradable , biocompatible and osteoconductive
, they act as a carrier for growth factors and allow cell attachment , growth , spreading ,
differentiation and has been found to be effective bone graft.
Certain studies showed that coral bone has similar results as autogenous bone and that it is
encouraging for the osteoregenerative process resulting in tissue organization that allows
for mechanical stability and function which is similar to that of native bone.
6b. Choice of the comparator: Xenografts are one of the most successful and widely used
grafting materials nowadays as a replacement for autogenous bone grafts.
Studies showed that xenografts are very successful because of their osteoconductive
properties , their denisty which provides stabilization to the graft and implant and they
supply the necessary minerals for bone formation as xenograft don't resorb completely.
Xenografts undergoes deprotienaization by heating to eliminate the allergic reactions and
risk of disease transmission .
The survival rate of implants with the use of xenografts as grating material is the same as
implants using autogenous bone grafts .
Xenografts has the disadvantages of that there is a risk of cross contamination and possible
development of immune reaction as there is no way to adequately screen them .
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| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Not yet recruiting |
NCT03676244 -
Immediate Implant Placement With Immediate Provisionalization Into Extraction Sockets With Labial Plate Dehiscence Defects Within the Maxillary Esthetic Zone
|
N/A |