Clinical Trials Logo

Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT03191448
Other study ID # HSC20150708H
Secondary ID
Status Completed
Phase N/A
First received June 15, 2017
Last updated April 6, 2018
Start date November 11, 2015
Est. completion date April 6, 2018

Study information

Verified date April 2018
Source The University of Texas Health Science Center at San Antonio
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Currently, it is not known what the dimensional changes might be following a molar site extraction which has been grafted with FDBA and covered with a collagen wound dressing. The purpose of the proposed study is to examine the clinical healing following ridge preservation using freeze dried bone allograft (FDBA) with a collagen wound dressing barrier (CollaPlug®) in a molar extraction site.

I


Description:

It is well known that a tooth socket will undergo significant resorption and remodeling following tooth extraction. Pietrokovsky and Massler documented alveolar bone dimension changes subsequent to tooth extraction forty-five years ago. Schropp et al. evaluated tissue changes on models following premolar and molar extractions and concluded that 50% of the ridge width was lost within one year following extraction. Two thirds of this resorption happened during the first 3 months.

In addition to alveolar ridge resorption in a horizontal dimension (decrease in width), changes in the vertical dimension of the ridge have been documented following tooth extraction in a canine model. The healing pattern of the extraction socket observed in the preclinical setting was further confirmed in human investigations). A systematic review concluded that greater loss of ridge width is to be expected following extraction compared to loss of ridge height. Clinical mean reductions of 3.87mm and 1.87mm in ridge width and height, respectively, were reported. Radiographically, the mean reduction amounted 1.21mm and 1.53mm for ridge width and height, respectively. These results were confirmed by another systematic review.

If the extracted tooth is to be replaced, the unfavorable dimensional changes resulting from this healing process may necessitate advanced and technique sensitive guided bone regeneration (GBR) procedures prior to dental implant placement. In order to avoid GBR and limit these dimensional changes, grafting of the extraction socket with or without membrane coverage, also called ridge preservation procedure, have been advocated. In order to perform ridge preservation, typically, a graft material and some sort of a barrier (e.g. non-resorbable and resorbable membranes or collagen wound dressing) are used. A large variety of materials are available on the market for the purpose of ridge preservation. No material gold standard has yet been identified to date, which would ensure the best dimensional stability of the alveolar ridge.

Current materials used as part of standard care in clinical practice include freeze dried bone allograft (FDBA) as a grafting material and a dense polytetrafluroethylene (dPTFE) non-resorbable membrane or a collagen wound dressing (Collaplug®, Zimmer Dental, Carlsbad, CA) to protect the extraction grafted site. It is currently now known how the use of a collagen wound dressing would compare to a non-resorbable membrane (which has been documented) and if any would lead to any substantial clinical advantages.

Therefore, the proposed research project will answer the following question:

What are the dimensional changes of the hard and soft tissues encountered following molar extractions with ridge preservation using FDBA and a collagen wound dressing?


Recruitment information / eligibility

Status Completed
Enrollment 27
Est. completion date April 6, 2018
Est. primary completion date April 6, 2018
Accepts healthy volunteers Accepts Healthy Volunteers
Gender All
Age group 18 Years to 99 Years
Eligibility Inclusion Criteria:

- One molar tooth that has been identified by dental faculty as requiring a single tooth extraction

- A dental implant is indicated and treatment planned to replace the missing molar tooth

- Have adequate restorative space for a dental implant-retained restoration

- Have at least 10mm of alveolar bone height, without impinging on the maxillary sinus or inferior alveolar canal.

Exclusion Criteria:

- Patients will not be entered who are mentally incompetent, prisoners, or pregnant.

- Pregnant women or women intending to become pregnant during the study period.

- Patients who become pregnant during the study will be withdrawn and standard care will be delivered.

- Clinical and/or radiographic determinations which will preclude inclusion in this study are:

1. Active localized or systemic infection other than periodontitis.

2. Untreated periodontal diseases

3. Inadequate bone dimensions or restorative space dimensions to place a dental implant

4. Presence of a disease entity, medical condition or therapeutic regimen which decreases probability of soft tissue and bony healing, e.g., poorly controlled diabetes, chemotherapeutic and immunosuppressive agents, or autoimmune diseases.

5. Positive medical history of endocarditis following oral or dental surgery.

Study Design


Related Conditions & MeSH terms


Intervention

Procedure:
Ridge preservation
Ridge preservation consists of grafting an extraction socket with a bone substitute and /or cover it with a membrane or a dressing. This intervention is aiming at limiting the osseous dimensional changes that would have taken place if the extraction would have been left to heal spontaneously.
Device:
FDBA
Ridge preservation consists of grafting an extraction socket with a bone substitute and /or cover it with a membrane or a dressing. This intervention is aiming at limiting the osseous dimensional changes that would have taken place if the extraction would have been left to heal spontaneously. In this study a freezed dried bone allograft (FDBA) will be used and the site will be covered with a collagen wound dressing (Collaplug)
Collagen wound dressing
Ridge preservation consists of grafting an extraction socket with a bone substitute and /or cover it with a membrane or a dressing. This intervention is aiming at limiting the osseous dimensional changes that would have taken place if the extraction would have been left to heal spontaneously. In this study a freezed dried bone allograft (FDBA) will be used and the site will be covered with a collagen wound dressing (Collaplug)

Locations

Country Name City State
n/a

Sponsors (1)

Lead Sponsor Collaborator
The University of Texas Health Science Center at San Antonio

References & Publications (15)

Araújo MG, Lindhe J. Dimensional ridge alterations following tooth extraction. An experimental study in the dog. J Clin Periodontol. 2005 Feb;32(2):212-8. — View Citation

Araújo MG, Lindhe J. Ridge preservation with the use of Bio-Oss collagen: A 6-month study in the dog. Clin Oral Implants Res. 2009 May;20(5):433-40. doi: 10.1111/j.1600-0501.2009.01705.x. — View Citation

Barone A, Aldini NN, Fini M, Giardino R, Calvo Guirado JL, Covani U. Xenograft versus extraction alone for ridge preservation after tooth removal: a clinical and histomorphometric study. J Periodontol. 2008 Aug;79(8):1370-7. doi: 10.1902/jop.2008.070628 . — View Citation

Braut V, Bornstein MM, Lauber R, Buser D. Bone dimensions in the posterior mandible: a retrospective radiographic study using cone beam computed tomography. Part 1--analysis of dentate sites. Int J Periodontics Restorative Dent. 2012 Apr;32(2):175-84. — View Citation

Brownfield LA, Weltman RL. Ridge preservation with or without an osteoinductive allograft: a clinical, radiographic, micro-computed tomography, and histologic study evaluating dimensional changes and new bone formation of the alveolar ridge. J Periodontol. 2012 May;83(5):581-9. doi: 10.1902/jop.2011.110365. Epub 2011 Sep 26. — View Citation

Darby I, Chen ST, Buser D. Ridge preservation techniques for implant therapy. Int J Oral Maxillofac Implants. 2009;24 Suppl:260-71. Review. — View Citation

Ferrus J, Cecchinato D, Pjetursson EB, Lang NP, Sanz M, Lindhe J. Factors influencing ridge alterations following immediate implant placement into extraction sockets. Clin Oral Implants Res. 2010 Jan;21(1):22-9. doi: 10.1111/j.1600-0501.2009.01825.x. Epub 2009 Nov 13. — View Citation

Huynh-Ba G, Pjetursson BE, Sanz M, Cecchinato D, Ferrus J, Lindhe J, Lang NP. Analysis of the socket bone wall dimensions in the upper maxilla in relation to immediate implant placement. Clin Oral Implants Res. 2010 Jan;21(1):37-42. doi: 10.1111/j.1600-0501.2009.01870.x. — View Citation

Iasella JM, Greenwell H, Miller RL, Hill M, Drisko C, Bohra AA, Scheetz JP. Ridge preservation with freeze-dried bone allograft and a collagen membrane compared to extraction alone for implant site development: a clinical and histologic study in humans. J Periodontol. 2003 Jul;74(7):990-9. — View Citation

Nevins M, Camelo M, De Paoli S, Friedland B, Schenk RK, Parma-Benfenati S, Simion M, Tinti C, Wagenberg B. A study of the fate of the buccal wall of extraction sockets of teeth with prominent roots. Int J Periodontics Restorative Dent. 2006 Feb;26(1):19-29. — View Citation

Oghli AA, Steveling H. Ridge preservation following tooth extraction: a comparison between atraumatic extraction and socket seal surgery. Quintessence Int. 2010 Jul-Aug;41(7):605-9. — View Citation

Spray JR, Black CG, Morris HF, Ochi S. The influence of bone thickness on facial marginal bone response: stage 1 placement through stage 2 uncovering. Ann Periodontol. 2000 Dec;5(1):119-28. — View Citation

Tan WL, Wong TL, Wong MC, Lang NP. A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans. Clin Oral Implants Res. 2012 Feb;23 Suppl 5:1-21. doi: 10.1111/j.1600-0501.2011.02375.x. Review. — View Citation

Van der Weijden F, Dell'Acqua F, Slot DE. Alveolar bone dimensional changes of post-extraction sockets in humans: a systematic review. J Clin Periodontol. 2009 Dec;36(12):1048-58. doi: 10.1111/j.1600-051X.2009.01482.x. Review. — View Citation

Vignoletti F, Matesanz P, Rodrigo D, Figuero E, Martin C, Sanz M. Surgical protocols for ridge preservation after tooth extraction. A systematic review. Clin Oral Implants Res. 2012 Feb;23 Suppl 5:22-38. doi: 10.1111/j.1600-0501.2011.02331.x. Review. — View Citation

* Note: There are 15 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Radiographic bone width changes (in mm) Following extraction and ridge preservation the alveolar bone around the extraction socket will remodel and some resorption is expected. Alveolar ridge width change (in mm) at the extraction site will be recorded by means of Cone Beam Computed Tomography (CBCT) 3 months
Secondary Radiographic bone height changes (in mm) Following extraction and ridge preservation the alveolar bone around the extraction socket will remodel and some resorption is expected. Alveolar ridge height change (in mm) at the extraction site will be recorded by means of Cone Beam Computed Tomography (CBCT) 3 months
See also
  Status Clinical Trial Phase
Completed NCT04166890 - Comparison of the Efficacy and Safety of Two Homologous Active Principles for Local Dental Anesthesia Phase 4
Active, not recruiting NCT02952209 - The Effect of Alveolar Ridge Preservation After Tooth Extraction in the Posterior Maxilla N/A
Completed NCT02155764 - Ridge Preservation With New Class of Osteoplastic Materials Phase 2
Completed NCT01588444 - Ridge Preservation After Tooth Extraction Using Cortical Versus Cancellous Freeze Dried Bone Allograft N/A
Completed NCT00387140 - A Study to Evaluate the Safety and Efficacy of an Investigational Drug in the Treatment of Postoperative Dental Pain (MK-2295-005) Phase 2
Recruiting NCT06245161 - Efficacy of Computer Controlled Intraosseous Anesthesia in Pediatric Dental Patients N/A
Recruiting NCT05615272 - Treatment of Alveolar Osteitis: Traditional or Regenerative? N/A
Completed NCT05101954 - Platelet Rich Fibrin and Concentrated Growth Factors on Osseointegration of Immediate Implants N/A
Completed NCT03985033 - The Clinical and Biological Effects of Leucocyte and Platelet-rich Fibrin (L-PRF) on Post-extraction Sockets Healing N/A
Completed NCT04082598 - Antibiotic Therapy in Erupted Tooth Extractions Phase 4
Completed NCT01924390 - Histological Comparison of Ridge Preservation Using Mineralized FDBA Alone Versus a Combined Mineralized-Demineralized Freeze Dried Bone Allograft N/A
Completed NCT04930497 - Vestibular Socket Therapy With and Without Bone Grafting N/A
Completed NCT03211312 - Prediction Model of Cardiac Risk for Dental Extraction in Elderly Patients With Cardiovascular Diseases
Withdrawn NCT06038695 - Immediate Implant Placement Using Volume-Stable Collagen Matrix Combined With rhPDGF-BB N/A
Completed NCT05845437 - On Adequacy of Referrals to Oral and Maxillofacial Surgery
Recruiting NCT05220462 - Remimazolam vs Midazolam Cognitive and Motor Recovery After Intravenous Conscious Sedation for Dental Extractions. Phase 3
Active, not recruiting NCT03943680 - Plasma Rich in Growth Factors in Post-extraction Sockets N/A
Recruiting NCT05106855 - Comparative Study of Immediate Single Unit Implants in Early Loading Protocols, With or Without Photobiomodulation. N/A
Completed NCT03487718 - A 14 Weeks Longitudinal Study to Investigate the Effect of Leukocyte- Platelet Rich Fibrin Plug on the Quality of the Newly Formed Bone in Ridge Preservation Procedure Following a Tooth Extraction. It is a Clinical, Radiographic and Histomorphometric Study. N/A
Active, not recruiting NCT04705181 - The Indications of First Molar Extraction at Tufts University, School of Dental Medicine