Patient-reported Outcome Measures Comparing Static Computer-aided Implant Surgery and Conventional Implant Surgery

Quality of Life Clinical Trial

Official title:

Patient-reported Outcome Measures (PROMs) Comparing Static Computer-aided Implant Surgery (s-CAIS) and Conventional Implant Surgery (CIS) for Single-tooth Replacement: A Randomized Controlled Trial

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04950491
• Other study ID #: DT 071/2019
• Status: Completed
• Phase: N/A
• Start date: July 9, 2019
• Est. completion date: March 11, 2021

Study information

• Verified date: June 2021
• Source: Mahidol University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The aim of this randomized controlled trial was to compare PROMs in patients receiving single tooth replacement in posterior sites by s-CAIS and CIS.

Description:

Since current patient-reported outcome measures (PROMs) evidence related to static computer-aided implant surgery (s-CAIS) compared with conventional implant surgery (CIS), particularly in partial edentulous patients, were still limited. The aim of this randomized controlled trial was to compare PROMs in patients receiving single tooth replacement in posterior sites by s-CAIS and CIS.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 40
• Est. completion date: March 11, 2021
• Est. primary completion date: November 27, 2020
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 25 Years to 80 Years

Eligibility

Inclusion Criteria:

• Healthy or well-controlled systemic disease (ASA classification I,II)
• A partially edentulous ridge in the premolar-molar region with existing two-sided interproximal as well as antagonist contacts
• No sign of acute oral infection
• Periodontally healthy (or successfully treated)
• More than 2 mm of keratinized gingiva at the site of surgery
• Sufficient bony ridge for implant placement with or without simultaneous bone grafting

Exclusion Criteria:

• Diabetes mellitus
• Smoking more than ten cigarettes per day
• Pregnancy
• Psychiatric disorder
• History of radiation therapy at head and neck area and chemotherapy
• Bony pathologies, namely osseous dysplasia, odontogenic cyst, tumor
• History of soft tissue grafting at the prospective implant site
• Inadequate bony ridge with the need of bone augmentation prior to implant placement

Related Conditions & MeSH terms

• Computer-assisted Surgery
• Dental Anxiety
• Dental Implantation
• Oral Health
• Patient Outcome Assessment
• Postoperative Pain
• Quality of Life

Intervention

Other:
• Modified Dental Anxiety Score (MDAS) questionnaire
MDAS was used to measure the patients' anxiety toward dental treatment before implant surgery (Humphris, Dyer, &Robinson, 2009). Originally, the MDAS questionnaire included five questions answered with a 5-category Likert scale. The original MDAS questionnaire does not cover anxiety toward implant surgery. Therefore, a question enquiring about patients' feelings towards implant surgery was added.
• Pain questionnaire
Patients were asked to describe the worst pain feeling using a standard 10 cm Visual Analog Scale (VAS) and the proportion of time spent in severe pain using a 5 category Likert scale. The number of analgesics taken per day was also asked.
• Oral Health-Related Quality of Life (OHRQoL) questionnaire
The OHRQoL comprises 14 questions covering problems the patient may in three main categories: oral function, daily activity, and post-operative symptoms (Chaushu, Becker, Zeltser, Vasker, & Chaushu, 2004). Patients answered using a 5-category Likert scale.

Locations

Country	Name	City	State
Thailand	Faculty of Dentistry, Mahidol University	Ratchathewi	Bangkok

Sponsors (2)

Lead Sponsor	Collaborator
Mahidol University	ITI Foundation

Country where clinical trial is conducted

Thailand, 

References & Publications (27)

Arisan V, Karabuda CZ, Ozdemir T. Implant surgery using bone- and mucosa-supported stereolithographic guides in totally edentulous jaws: surgical and post-operative outcomes of computer-aided vs. standard techniques. Clin Oral Implants Res. 2010 Sep;21(9):980-8. doi: 10.1111/j.1600-0501.2010.01957.x. Epub 2010 May 24. — View Citation

Bielemann AM, Marcello-Machado RM, Del Bel Cury AA, Faot F. Systematic review of wound healing biomarkers in peri-implant crevicular fluid during osseointegration. Arch Oral Biol. 2018 May;89:107-128. doi: 10.1016/j.archoralbio.2018.02.013. Epub 2018 Feb 22. Review. — View Citation

Buser D, Chappuis V, Kuchler U, Bornstein MM, Wittneben JG, Buser R, Cavusoglu Y, Belser UC. Long-term stability of early implant placement with contour augmentation. J Dent Res. 2013 Dec;92(12 Suppl):176S-82S. doi: 10.1177/0022034513504949. Epub 2013 Oct 24. — View Citation

Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations. Int J Oral Maxillofac Implants. 2004;19 Suppl:43-61. Review. — View Citation

Calvert M, Brundage M, Jacobsen PB, Schünemann HJ, Efficace F. The CONSORT Patient-Reported Outcome (PRO) extension: implications for clinical trials and practice. Health Qual Life Outcomes. 2013 Oct 29;11:184. doi: 10.1186/1477-7525-11-184. — View Citation

Chaushu S, Becker A, Zeltser R, Vasker N, Chaushu G. Patients' perceptions of recovery after surgical exposure of impacted maxillary teeth treated with an open-eruption surgical-orthodontic technique. Eur J Orthod. 2004 Dec;26(6):591-6. — View Citation

Coolidge T, Hillstead MB, Farjo N, Weinstein P, Coldwell SE. Additional psychometric data for the Spanish Modified Dental Anxiety Scale, and psychometric data for a Spanish version of the Revised Dental Beliefs Survey. BMC Oral Health. 2010 May 13;10:12. doi: 10.1186/1472-6831-10-12. — View Citation

D'haese J, Ackhurst J, Wismeijer D, De Bruyn H, Tahmaseb A. Current state of the art of computer-guided implant surgery. Periodontol 2000. 2017 Feb;73(1):121-133. doi: 10.1111/prd.12175. Review. — View Citation

De Bruyn H, Raes S, Matthys C, Cosyn J. The current use of patient-centered/reported outcomes in implant dentistry: a systematic review. Clin Oral Implants Res. 2015 Sep;26 Suppl 11:45-56. doi: 10.1111/clr.12634. Review. — View Citation

Feine J, Abou-Ayash S, Al Mardini M, de Santana RB, Bjelke-Holtermann T, Bornstein MM, Braegger U, Cao O, Cordaro L, Eycken D, Fillion M, Gebran G, Huynh-Ba G, Joda T, Levine R, Mattheos N, Oates TW, Abd-Ul-Salam H, Santosa R, Shahdad S, Storelli S, Sykaras N, Treviño Santos A, Stephanie Webersberger U, Williams MAH, Wilson TG Jr, Wismeijer D, Wittneben JG, Yao CJ, Zubiria JPV. Group 3 ITI Consensus Report: Patient-reported outcome measures associated with implant dentistry. Clin Oral Implants Res. 2018 Oct;29 Suppl 16:270-275. doi: 10.1111/clr.13299. — View Citation

Fortin T, Bosson JL, Isidori M, Blanchet E. Effect of flapless surgery on pain experienced in implant placement using an image-guided system. Int J Oral Maxillofac Implants. 2006 Mar-Apr;21(2):298-304. — View Citation

Giri J, Pokharel PR, Gyawali R, Bhattarai B. Translation and Validation of Modified Dental Anxiety Scale: The Nepali Version. Int Sch Res Notices. 2017 Jan 29;2017:5495643. doi: 10.1155/2017/5495643. eCollection 2017. — View Citation

Humphris G, King K. The prevalence of dental anxiety across previous distressing experiences. J Anxiety Disord. 2011 Mar;25(2):232-6. doi: 10.1016/j.janxdis.2010.09.007. Epub 2010 Sep 19. — View Citation

Humphris GM, Dyer TA, Robinson PG. The modified dental anxiety scale: UK general public population norms in 2008 with further psychometrics and effects of age. BMC Oral Health. 2009 Aug 26;9:20. doi: 10.1186/1472-6831-9-20. — View Citation

Humphris GM, Morrison T, Lindsay SJ. The Modified Dental Anxiety Scale: validation and United Kingdom norms. Community Dent Health. 1995 Sep;12(3):143-50. — View Citation

Iqbal MK, Kim S. A review of factors influencing treatment planning decisions of single-tooth implants versus preserving natural teeth with nonsurgical endodontic therapy. J Endod. 2008 May;34(5):519-29. doi: 10.1016/j.joen.2008.01.002. Review. — View Citation

Joda T, Derksen W, Wittneben JG, Kuehl S. Static computer-aided implant surgery (s-CAIS) analysing patient-reported outcome measures (PROMs), economics and surgical complications: A systematic review. Clin Oral Implants Res. 2018 Oct;29 Suppl 16:359-373. doi: 10.1111/clr.13136. — View Citation

McGrath C, Lam O, Lang N. An evidence-based review of patient-reported outcome measures in dental implant research among dentate subjects. J Clin Periodontol. 2012 Feb;39 Suppl 12:193-201. doi: 10.1111/j.1600-051X.2011.01841.x. Review. — View Citation

Nkenke E, Eitner S, Radespiel-Tröger M, Vairaktaris E, Neukam FW, Fenner M. Patient-centred outcomes comparing transmucosal implant placement with an open approach in the maxilla: a prospective, non-randomized pilot study. Clin Oral Implants Res. 2007 Apr;18(2):197-203. — View Citation

Sancho-Puchades M, Alfaro FH, Naenni N, Jung R, Hämmerle C, Schneider D. A Randomized Controlled Clinical Trial Comparing Conventional And Computer-Assisted Implant Planning and Placement in Partially Edentulous Patients. Part 2: Patient Related Outcome Measures. Int J Periodontics Restorative Dent. 2019 Jul/Aug;39(4):e99-e110. doi: 10.11607/prd.4145. — View Citation

Sculean A, Gruber R, Bosshardt DD. Soft tissue wound healing around teeth and dental implants. J Clin Periodontol. 2014 Apr;41 Suppl 15:S6-22. doi: 10.1111/jcpe.12206. Review. — View Citation

Tarnow DP, Cho SC, Wallace SS. The effect of inter-implant distance on the height of inter-implant bone crest. J Periodontol. 2000 Apr;71(4):546-9. — View Citation

Vercruyssen M, Fortin T, Widmann G, Jacobs R, Quirynen M. Different techniques of static/dynamic guided implant surgery: modalities and indications. Periodontol 2000. 2014 Oct;66(1):214-27. doi: 10.1111/prd.12056. Review. — View Citation

Vercruyssen M, van de Wiele G, Teughels W, Naert I, Jacobs R, Quirynen M. Implant- and patient-centred outcomes of guided surgery, a 1-year follow-up: An RCT comparing guided surgery with conventional implant placement. J Clin Periodontol. 2014 Dec;41(12):1154-60. doi: 10.1111/jcpe.12305. Epub 2014 Oct 11. — View Citation

von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med. 2007 Oct 16;147(8):573-7. Erratum in: Ann Intern Med. 2008 Jan 15;148(2):168. — View Citation

Wismeijer D, Joda T, Flügge T, Fokas G, Tahmaseb A, Bechelli D, Bohner L, Bornstein M, Burgoyne A, Caram S, Carmichael R, Chen CY, Coucke W, Derksen W, Donos N, El Kholy K, Evans C, Fehmer V, Fickl S, Fragola G, Gimenez Gonzales B, Gholami H, Hashim D, Hui Y, Kökat A, Vazouras K, Kühl S, Lanis A, Leesungbok R, van der Meer J, Liu Z, Sato T, De Souza A, Scarfe WC, Tosta M, van Zyl P, Vach K, Vaughn V, Vucetic M, Wang P, Wen B, Wu V. Group 5 ITI Consensus Report: Digital technologies. Clin Oral Implants Res. 2018 Oct;29 Suppl 16:436-442. doi: 10.1111/clr.13309. — View Citation

Yuan S, Freeman R, Lahti S, Lloyd-Williams F, Humphris G. Some psychometric properties of the Chinese version of the Modified Dental Anxiety Scale with cross validation. Health Qual Life Outcomes. 2008 Mar 25;6:22. doi: 10.1186/1477-7525-6-22. — View Citation

* Note: There are 27 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change of post-operative pain for 7 days: Visual Analog Scale	Patients were asked to describe the worst post-operative pain feeling using a standard 10 cm Visual Analog Scale.	Patients were instructed to answer every day for 7 days starting from the day of surgery 1 hour before bedtime.
Primary	Change of the proportion of time spent in severe pain for 7 days: 5-category Likert scale	Patients were asked to describe the proportion of time spent in severe pain using 5-category Likert scale (None, Low, Moderate, High, Very high).	Patients were instructed to answer every day for 7 days starting from the day of surgery 1 hour before bedtime.
Primary	Change of the analgesics taken per day for 7 days: the number of tablets per day	Patients were asked to describe the number of analgesics taken per day.	Patients were instructed to answer every day for 7 days starting from the day of surgery 1 hour before bedtime.
Primary	Change of Oral Health-Related Quality of Life (OHRQoL) for 7 days: 5-category Likert scale	The OHRQoL questionnaire comprises 14 questions covering problems the patient may in three main categories: oral function, daily activity, and post-operative symptoms derived from Chaushu's study (Chaushu, Becker, Zeltser, Vasker, & Chaushu, 2004). Patients answered this questionnaire using a 5-category Likert scale (Not at all, Very little, A little, Quite a lot, Very much).	Patients were instructed to answer the OHRQoL every day for 7 days starting from the day of surgery 1 hour before bedtime.
Secondary	The Modified Dental Anxiety Score (MDAS)	The MDAS was used to measure patient anxiety toward dental treatment (Humphris, Dyer, & Robinson, 2009). The MDAS consists of five questions answered with a 5-category Likert scale, ranging from 'not anxious' to 'extremely anxious'. The original MDAS questionnaire does not cover anxiety toward implant surgery. Therefore, a question enquiring about patients' feelings towards implant surgery was added.	1 day (Patients completed the modified MDAS once, while waiting for the surgery in the waiting room.)