Assessment of the Accuracy of the Clinical Parameters & Radiographs in Determining the Topography of Implant Bony Lesions

Peri-Implantitis Clinical Trial

Official title:

Assessment of the Accuracy of the Clinical Parameters and Radiographs in Determining the Topography of Implant Bony Lesions

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT03698851
• Other study ID #: 253/2017
• Status: Recruiting
• Phase: N/A
• Start date: March 2, 2018
• Est. completion date: January 20, 2025

Study information

• Verified date: November 2023
• Source: National Dental Centre, Singapore
• Contact: EDWIN LIU
• Phone: 63248879
• Email: edwin.liu.w.y[@]ndcs.com.sg
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

In recent years, dental implants have gained popularity as the treatment choice for replacement of missing teeth. With this, one of the late biological complications that arise is peri-implantitis. Based on a consensus conference in 2008, peri-implantitis was found in 28% and ≥ 56% of subjects and in 12% and 43% of implant sites (Zitzmann & Berglundh 2008). Detection of peri-implantitis is currently based on clinical parameters like probing depths and radiographic findings of bone loss. There is however no study that assess the variability of clinical probing and radiographic reading in relation to the true outline of the peri-implantitis lesion. The present study will measure variability of clinical probing and radiographs in relation to the true outline of the peri-implantitis lesion, as well as assess the use of 2 different bone substitutes in regenerating the lesions with a barrier membrane.

Description:

Identification of peri-implant bony lesions by clinical parameters or radiographs alone may sufficiently reflect the topographical outline of a peri-implant bony lesion. To date, no comparative studies are available that identify the accuracy of clinical parameters or radiographs in outlining the extent and the severity of the lesion. If these parameters are of sufficient accuracy, surgical procedures to regenerate the lesion may be more predictable to plan.

The study population will be patients undergoing regular implant maintenance care in the National Dental Centre Singapore, Periodontics Unit, Department of Restorative Dentistry and yielding peri-implantitis (residual probing depths ≥6mm and bleeding on probing, bone loss of ≥2mm documented on periapical radiographs).

In the first part of the study, the variability of the clinical parameters and periapical radiographs will be assessed and compared to the actual bony lesions revealed after surgical access. This prospective cohort study will encompass 24 subjects. In the second part of the study, a randomised controlled clinical trial will be staged exploring the clinical outcomes of regenerative therapy of the peri-implant lesions applying 2 different bone substitutes with a barrier membrane for the principle of guided bone regeneration (GBR).

First part of study:

The null hypothesis is that of no difference in the mesial and distal radiographic readings as compared to the measurement obtained by clinical probing of the actual peri-implant lesions. The null hypothesis is also that of no difference between probing depth measurements and the actual lesions measured under open access.

Second part of study:

The null hypothesis is that of no difference in clinical outcomes with the use of a synthetic membrane (Guidor®) with a compound of biphasic calcium phosphate, 60 % hydroxyapatite and 40 % beta-tricalcium phosphate (Guidor easy-graft® CRYSTAL) (test) when compared to the same membrane and phase-pure beta-tricalcium phosphate (Guidor easy-graft® CLASSIC ) (control), in GBR of peri- implantitis lesions.

End Points - Efficacy For the subjects, the potential benefits may include improvement in the clinical outcomes.

End Points - Safety The risks involved include complications that may result with all surgeries, i.e., risk of infection, swelling, pain and bruising.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 24
• Est. completion date: January 20, 2025
• Est. primary completion date: January 20, 2025
• Accepts healthy volunteers: No
• Gender: All
• Age group: 21 Years to 99 Years

Eligibility

Inclusion Criteria:

1. Medically healthy adults (ASA classification I-II), at least 21 years of age.

2. Diagnosed with peri-implantitis (at least one site with PPD of = 6 mm, a positive bleeding on probing (BOP) and radiographic bone loss of = 2 mm).

3. Had non-surgical therapy performed previously

4. Ability to comply with 6-month study follow-up.

Exclusion Criteria:

1. Medically compromised subjects (ASA classification III-V).

2. Had not gone through non-surgical therapy

3. Known allergy or other severe adverse reactions to the synthetic membrane and bone substitutes.

4. Self declared pregnancy or intend to conceive.

Related Conditions & MeSH terms

• Peri-Implantitis

Intervention

Device:
• Guidor® and Guidor easy-graft® CRYSTAL
A compound of biphasic calcium phosphate, 60 % hydroxyapatite and 40 % beta-tricalcium phosphate. The beta-tricalcium phosphate component completely resorbs via physiological dissolution in 5-15 months, while the interconnected hydroxyapatite remains embedded in the implantation site and forms an integrated long term osteoconductive scaffold with new bone.
• Guidor® and Guidor easy-graft® CLASSIC
Phase-pure beta-tricalcium phosphate that offers complete resorption via physiological dissolution in 5-15 months. This material has been used in oral surgery for more than 25 years and there are extensive research available on it.

Locations

Country	Name	City	State
Singapore	National Dental Centre Singapore	Singapore

Sponsors (2)

Lead Sponsor	Collaborator
National Dental Centre, Singapore	Sunstar, Inc.

Country where clinical trial is conducted

Singapore, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	The accuracy of clinical probing pocket depths to the true outline in peri-implantitis lesions	To determine the accuracy of clinical probing pocket depths (in mm) to the true outline in peri-implantitis lesions	6 months after GBR
Primary	The accuracy of peri-apical radiographic readings to the true outline in peri-implantitis lesions	To determine the accuracy of peri-apical radiographic readings (in mm) to the true outline in peri-implantitis lesions	6 months after GBR
Primary	Absolute change from baseline of probing pocket depth (PPD in mm) and the degree of bone fill at re-entry (6 months)	- To determine: Absolute change from baseline of probing pocket depth (PPD in mm) 6 months following GBR therapy in test and control; The degree of bone fill at re-entry (6 months), as well as radiographically (in mm) following GBR	6 months after GBR