Effect of Implant Surface Material and Topography on Bone Regeneration: A Two-centre, Parallel-group, Pilot Study
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Dental Implant
- Sponsor
- Queen Mary University of London
- Enrollment
- 12
- Locations
- 2
- Primary Endpoint
- Changes in the expression of inflammatory, angiogenesis and osseous biomarkers of PICF and saliva
- Status
- Completed
- Last Updated
- last year
Overview
Brief Summary
Dental implants have been on the market for several years and they are routinely used to replace single/multiple missing teeth with a high success rate. However, there is still a limited number of studies comparing hydrophilic titanium and zirconia implants. In addition, there is no data available on the signalling pathways and the expression of healing biomarkers involved in the early stages of osseointegration around zirconia surface implants placed with guided bone regeneration (GBR).
This study aims 1) to describe and compare the early wound healing molecular pathways, and the 2) vascularization patterns of mucosal tissues after the placement of hydrophilic titanium or zirconia implants with simultaneous guided bone regeneration (GBR).
In this study, the investigators will assess the expression of inflammatory, angiogenesis and osseous biomarkers of PICF at 3, 7, 15 and 30 days after the placement of hydrophilic titanium or zirconia dental implants with simultaneous GBR and of saliva at day 1, 3, 7, 15 and 30.
Detailed Description
This is a two-centre prospective, parallel-group pilot study which will consist of 10-11 visits over a minimum period of 14 months. The study will take place at the Centre for Oral Clinical Research (COCR), at the Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (main centre), United Kingdom and at Clinic of Reconstructive Dentistry, University of Zurich, Zurich in accordance with local guidelines and procedures/interventions detailed below.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Males and females, ≥ 25 years old
- •Good/controlled medical and psychological health
- •Good oral hygiene (full mouth plaque scores \[FMPS\< 30%\])
- •Need of a single-tooth replacement in the aesthetic (incisor, canine or premolar) region
- •At least one neighbouring natural tooth present
- •A functional occlusion with a minimum of four occlusal units (i.e., pairs of occluding posterior teeth)
- •At least 3 months of post-extraction socket healing had occurred in the edentulous site and no ridge preservation was performed
- •After implant placement, presence of buccal bone dehiscence/fenestration or thin buccal bone plate (\<2mm) requiring guided bone regeneration (GBR) (including contour augmentation) \[to be confirmed after implant placement\]
- •Willingness to read and sign a copy of the Informed Consent Form (ICF) after reading the Patient Information Sheet (PIS), and after the nature of the study has been fully explained and potential questions fully answered
Exclusion Criteria
- •Any known systemic disease severely affecting bone metabolism (e.g., Cushing's syndrome, Crohn's disease, rheumatoid arthritis, osteoporosis or diabetes type I and uncontrolled diabetes type II)
- •Self-reported HIV or viral hepatitis
- •Self-reported alcoholism or chronic drug abuse
- •Smokers (including current smokers or former smokers who had quit for \< 3 months); patients reporting use of vape/ e-cigarettes will also be excluded
- •Self-reported pregnancy or lactation (this criterion is due to oral tissue changes related to pregnancy and nursing, which can affect interpretation of study results)
- •Chronic treatment (i.e., 2 weeks or more) with any medication known to affect oral status or bone metabolism (e.g., bisphosphonates, hormone replacement therapy, immunosuppressants) within 1 month before baseline visit
- •Chronic treatment with anticoagulants (including aspirin), corticosteroids, immunosuppressants or other medications that may influence blood coagulation/count
- •Antibiotic or anti-inflammatory therapy during the month preceding the baseline exam.
- •Untreated caries lesions and untreated/uncontrolled periodontal disease. If patients require periodontal treatment (non-surgical and/or surgical), this will be arranged outside the study protocol and completed prior to enrolment
- •Inadequate keratinized tissue width (\<2 mm) in the mid-buccal aspect of the area to be treated in the study
Outcomes
Primary Outcomes
Changes in the expression of inflammatory, angiogenesis and osseous biomarkers of PICF and saliva
Time Frame: 1,3, 7, 15 and 30 days after the placement of hydrophilic titanium or zirconia dental implants.
The expression of inflammatory, angiogenesis and osseous biomarkers of PICF at 3, 7, 15 and 30 days after the placement of hydrophilic titanium or zirconia dental implants with simultaneous GBR and of saliva at day 1, 3, 7, 15 and 30.
Secondary Outcomes
- Peri-implant bone level(6 months after implant loading)
- Gingival recession (REC)(6 months after implant loading)
- Soft tissue volume changes(immediately after,1, 3, 7, 15, 30 days and 3 months after IP, at loading and 6 months after implant loading)
- Probing pocket depth (PPD)(6 months after implant loading)
- Changes in the white esthetic score (WES)(6 months after implant loading)
- Clinical attachment level (CAL)(6 months after implant loading)
- Suppuration(6 months after implant loading)
- Changes in the papilla fill index (PFI)(6 months after implant loading)
- Blood flow changes(immediately after, 1, 3, 7, 15 and 30 days after the placement of hydrophilic titanium or zirconia dental implants)
- Full mouth plaque score (FMPS)(6 months after implant loading)
- Full mouth bleeding score (FMBS)(6 months after implant loading)
- Patient satisfaction at 6 months after loading(6 months after implant loading)
- Changes in the pink esthetic score (PES)(6 months after implant loading)