Tooth Loss Clinical Trial
Official title:
Evaluation of a Lateral Window Technique Augmentation for Maxillary Sinus Lift Using Ultrasound Activated Resorbable Poly-D-L-lactide Pins in Maxillary Sinus Lift - a Split Mouth Randomized Control Trial
Ultrasound activated pins have been used for the promotion of bone healing in combination with biodegradable membranes during bone grafting procedures. In the jaws, these pins have been successfully tested for both maxillary and mandibular ridge augmentaton. However, the usefulness of these pins in maxillary sinus lift procedures has not been tested. This study aims to use a bilateral split mouth design to compare the bone formation, healing and post-operative complications after the use of ultrasonic guided pins in a lateral window maxillary sinus augmentation procedure in comparison to lateral window maxillary sinus augmentation procedure procedure performed without the use of these pins.
The study proposes to use a prospective split mouth crossover randomized control trial
design to study the success of implant placement in cases with sinus lift procedures
performed using the Sonic Weld® (KLS-Martin GmbH , Mulheim, Germany) ultrasound guided bone
welding system with a membrane (Resorb X Membrane) on one side, and placement of Biomend
collagen membrane to stabilize the graft
Patient selection:
20 patients requiring bilateral maxillary sinus lift procedure (40 procedures) will be
selected from the patients reporting for implant placement to both the Riyadh Colleges of
Dentistry and Pharmacy and the Riyadh Dental Center, King Saud Medical City.
Graft Placement:
Each patient will receive both the pin stabilized and the conventional graft placement
procedures with standardized allografts (Purus® Cancellous Allograft?) on both sides of the
maxilla. The grafts will be placed using the lateral window technique. The patients will be
randomly assigned into either those who receive the pin first (Group A) or those who receive
the conventional technique (using collagen membranes) first (Group B). The patients will
have a one week gap between the sinus lift on the right and left sides.
Evaluations of the sinus lift procedure:
The sinus lift will be evaluated clinically radiographically and histologically using
previously established criteria. Cone Beam CTs (Gallelios Comfort plus, Sirona Dental,
Salzburg, Austria) will be taken preoperatively and at three month intervals to help assess
the osseous outcomes of the graft.
At the end of one year the site will be evaluated clinically for the placement of implants.
At the time of placement of the implant a trephine biopsy will be performed and H&E staining
will be used to determine the histological outcomes of the graft procedure.
Statistical Analysis:
The paired t test will be used to compare the thickness of bone before and after the
completion of the sinus lift procedure. The multiple measures paired ANOVA will be used to
compare the thickness of bone at each follow up vist.
The student's t test will be used to compare the thickness of bone between the two types of
sinus lift procedure.
The chi-square test will be used to compare differences (if any) in the histological
patterns obtained at the end of the study.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment
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