Edentulous Jaw Clinical Trial
Official title:
Prospektive Langzeitstudie Zur Implantatprothetischen Versorgung
The study population comprises 20 completely edentulous patients aged 60 years and older with severe mandible resorption. Each patient receives two inter-foraminal implants (Neoss Ltd., Harrogate, UK). Following randomization, implants are loaded either immediately after dental implant surgery or three months after implant placement with the Locator®-abutment system. At follow-up visits 3, 6 12, 24 and 36 months after loading, implant stability is evaluated with Periotest® and Ostell®.
Hypothesis:
Especially for gerontoprosthetics, the Locator® abutment system offers the possibility of a
minimally invasive retention of prosthetic total restorations of edentulous mandibles. The
reduced number of 2 interforaminal implants is intended to ensure implantological anchoring
with minimal surgical, technical, financial and time expenditure.
Research Question:
How safe is this minimally invasive and cost-effective implant and anchoring system in terms
of long-term outcome? Are the two implant-prosthetic procedures (immediate versus late
restoration) different in terms of implant survival time?
Materials and methods
Enrollment:
- 20 patients without relevant pre-existing conditions, from the age of 60 years
- edentulous mandible, alveolar ridge atrophy
Statistical Analysis:
When planning the study, it is estimated that bone resorption in the peri-implant area of the
immediate-care implants is greater than in the late-treated implants. 10 patients per group
are required with a t-test (α = 0.05) and a power of 80% if the null hypothesis is formulated
as follows: -difference of means is 0 and the alternative - expected difference of means is
1mm, common standard deviation is 0.75.
Collective A (open healing - immediate loading): Insertion of a new, prefabricated total
mandibular prosthesis on the day of the operation immediately postoperatively after screwing
in the Locator® abutments.
Polymerization of the corresponding Locator® matrices in the newly incorporated lower jaw
denture in the patient's mouth.
Collective B (closed implant healing - conventional loading): 3 months after implantation
Exposure of the primary closed implants. Immediately following insertion of the prefabricated
full-thickness UK prosthesis and retention by the implants using Locator® abutments.
Test parameters:
1. Intraoperative torque measurement in Ncm
2. Radiological measurement of periimplant bone height using orthopantomogram
3. 4-point measurement of peri-implant probing depth using WHO periodontal probe. The
measurement is mesial, distal, buccal and lingual of the implant.
4. Measurement of bleeding on probing (parameters of peri-implant inflammation) using the
WHO periodontal probe.
5. Analysis of implant stability using the Periotest® and Osstell® measuring instruments
according to a standardized scheme: The strength values are performed in a measuring
range consisting of a straight line through the center of the implant and the resulting
180 ° circle sector anterior to this line results. After multiple measurements (5-fold)
the lowest numerical value for the Periotest® and for the RFA (Osstell®) the lowest
value documented.
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