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Impact of Keratinized Mucosa Augmentation on Treatment Outcomes of Peri-implant Mucositis

Not Applicable
Recruiting
Conditions
Peri-implant Mucositis
Interventions
Procedure: Non-surgical treatment
Procedure: Free gingival graft
Registration Number
NCT06305000
Lead Sponsor
Biruni University
Brief Summary

This study aims to observe the effects of keratinized mucosa width on peri-implant tissues by evaluating clinical and biochemical parameters. The main question it aims to answer is:

Would increasing the width of the keratinized mucosa with free gingival graft (FGG) in peri-implant mucositis be beneficial in terms of clinical periodontal parameters and peri-implant crevicular fluid levels of inflammatory cytokines compared to non-surgical therapy alone?

Our study consists of 4 groups:

Peri-implant healthy group with sufficient keratinized mucosa (≥ 2mm) (n=16), peri-implant mucositis group with sufficient keratinized mucosa (n=16), peri-implant mucositis group with insufficient keratinized mucosa (\< 2mm) receiving only non-surgical treatment (n=16), peri-implant mucositis group with insufficient keratinized mucosa receiving FGG in addition to non-surgical treatment (n=16). Clinical and biochemical measurements will be recorded at the baseline, 1st month, 4th month and 7th month of the study. Peri-implant crevicular fluid samples will be collected at baseline, 1st month, 4th month and 7th month. IL-1β, RANKL, OPG levels, and RANKL/OPG ratio will be analyzed from collected samples.

Researchers will evaluate the possible benefits of FGG application in addition to non-surgical therapy by comparing the biochemical and clinical changes in areas with and without FGG application in the treatment of peri-implant mucositis.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
64
Inclusion Criteria
  • Individual dental implants with a fixed prosthetic restoration that has been functional for at least 1 year
  • No systemic disease and medication use that may affect periodontal or peri-implanter tissues
  • Not receiving periodontal treatment in the last 6 months
  • Volunteering to participate in the study
Exclusion Criteria
  • Prosthetic restorations with an excessive contour which do not allow peri-implant pocket measurement
  • Being pregnant or breastfeeding,
  • Autoimmune and/or inflammatory diseases of the oral cavity,
  • Active periodontal disease
  • Smokers (≥ 10 cigarettes per day)
  • Improperly positioned implants

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Peri-implant mucositis group with sufficient keratinized mucosa (≥ 2mm)Non-surgical treatmentOnly non-surgical therapy will apply
Peri-implant mucositis group with insufficient keratinized mucosa (< 2mm)Non-surgical treatmentOnly non-surgical therapy will apply
Peri-implant mucositis group with insufficient keratinized mucosa (< 2mm) receiving FGGNon-surgical treatmentFree gingival graft will apply following non-surgical therapy
Peri-implant mucositis group with insufficient keratinized mucosa (< 2mm) receiving FGGFree gingival graftFree gingival graft will apply following non-surgical therapy
Primary Outcome Measures
NameTimeMethod
Inflammatory parameter levels in peri-implant crevicular fluid7th month

Peri-implant crevicular fluid samples will be collected from 3 sites (mesiobuccal, buccal, distobuccal) of the implants using methylcellulose strips PerioPaper® (Oralflow Inc., Smithtown, NY, USA) gently placed into the cleansed and dried pocket for 30 sec. Interleukin-1beta, RANKL and OPG levels and RANKL/ OPG ratio will be evaluated.

Secondary Outcome Measures
NameTimeMethod
Plaque index (Silness & Löe, 1964)7th month

0: Absence of microbial plaque

1. Thin plaque layer at the mucosal margin, only detectable by scraping with a probe

2. Moderate layer of plaque in the along the mucosal margin; interdental spaces free, but plaque is visible to naked eye

3. Abundant plaque along with the mucosal margin; interdental places filled with plaque

Probing depth7th month

The distance from the base of the pocket to the mucosal margin. Measurements will be made at six points on all teeth/ implants (mesiobuccal, midbuccal, distobuccal, mesiolingual, midlingual, and distolingual) using a periodontal probe.

Bleeding on probing (Ainamo & Bay 1975)7th month

Bleeding on probing A bleeding-on-probing percentage score assessed as the proportion of bleeding sites (dichotomous yes/no evaluation) when stimulated by a standardized manual probe with a controlled (\~25 g) force to the bottom of the sulcus/pocket at six sites (mesiobuccal, buccal, distobuccal, mesiolingual, lingual, distolingual) on all present teeth/ implants.

Gingival Index ( Löe & Silness,1963)7th month

0: normal gingiva

1. mild inflammation - slight change in color and slight edema but no bleeding on probing

2. moderate inflammation - redness, edema and glazing, bleeding on probing

3. severe inflammation - marked redness and edema, ulceration with tendency to spontaneous bleeding

Keratinized mucosa width7th month

The apical-coronal distance from the mucosal margin to the mucogingival junction (MGJ). Measurements will be made at three points on implants (mesiobuccal, midbuccal, distobuccal) using a periodontal probe.

Trial Locations

Locations (1)

Biruni University

🇹🇷

Istanbul, Turkey

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