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Accuracy of Dental Implant Placement Using a Collaborative Surgery Robot

Not Applicable
Active, not recruiting
Conditions
Dental Implant
Interventions
Procedure: Freehand surgery
Procedure: Robot system
Registration Number
NCT05919862
Lead Sponsor
Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University
Brief Summary

For free hand dental implant placement, a key difficulty is to accurately control the position. Improving precision of dental implant placement is considered important for safety and efficacy of tooth replacement with dental implants. The goal of this randomized controlled trial is to compare the positional implant accuracy, and patient reported outcomes comparing two methods of implant placement: the use of a robotic assisted surgery and freehand surgery. Patients requiring single tooth replacement with a dental implant will be digitally planned using a CBCT and an intraoral digital scan. Subjects will be randomized to one of the two treatment modalities based on the plan. The accuracy of placement will be assessed evaluating the difference between the planned and the actual position using a CBCT immediately after surgery. Subjects will be followed up for one year to assess both patient reported and professional outcomes.

Detailed Description

For free hand dental implant placement, a key difficulty is to accurately control the position. Improving precision of dental implant placement is considered important for safety and efficacy of tooth replacement with dental implants. In particular, more precise implant placement is expected to yield a better restoration both in terms of aesthetics and ability for self-performed oral hygiene and thus prevention of peri-implant diseases. The goal of this randomized controlled trial is to compare the positional implant accuracy, and patient reported outcomes comparing two methods of implant placement: the use of a robotic assisted surgery and freehand surgery. Patients requiring single tooth replacement with a dental implant will be digitally planned using a CBCT and an intraoral digital scan. Subjects will be randomized to one of the two treatment modalities based on the plan. The accuracy of placement will be assessed evaluating the difference between the planned and the actual position using a CBCT immediately after surgery. Subjects will be followed up for one year to assess both patient reported and professional outcomes.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
20
Inclusion Criteria
  • Patient with a single missing tooth to be replaced with a dental implant
  • With sufficient bone volume and keratinized tissue at edentulous site
  • Willing to comply with research appointments/schedule.
Exclusion Criteria
  • Pregnancy or intention to become pregnant at any point during the study duration
  • With any systemic diseases/conditions that are contraindications to dental implant treatment
  • Inability or unwillingness of individual to give written informed consent
  • Inability of follow-up according to the protocol.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Freehand surgeryFreehand surgeryFreehand implant placement by experienced surgeon.
Robot systemRobot systemProsthetically guided Implant placement utilising robotic surgery based on a digital plan.
Primary Outcome Measures
NameTimeMethod
Implant positional accuracyImmediately after surgery

Implant accuracy will be measured as distance discrepancy at implant platform and implant apex, and angular discrepancy of implant axis between the digital plan and the actual position of the implant assessed digitally at the end of the procedure. Pre- and post-operative CBCT will be used for measurement.

Peri-implant soft tissue health12 month follow-up

Bleeding on probing and probing depth will be recorded, by probing gently around implant-supported restoration at six points: mesial-buccal, mid-buccal, distal-buccal, mesial-lingual, mid-lingual, and distal-lingual, using UNC-15 periodontal probe. This is defined according to the peri-implant health case definition by Berglundh et al 2017 and the ID-COSM international consensus conference

Secondary Outcome Measures
NameTimeMethod
Local integrity of the alveolar boneImmediately after surgery

The thickness of the buccal and lingual bone plates 1, 3, and 5 mm apical to the implant platform on post-surgery CBCT

Pain perceptionimmediately after surgery, and 1 to 7 days after surgery

Patient pain perception after surgery will be recorded using visual analogue scale (VAS with range from 0 to 10 with 10 being the highest possible pain experience) .

Cytokine concentrations in PISF12-months follow-up after delivery of crown

Cytokine concentration in peri-implant sulcus fluid assesed by MULTIPLEX ELISA as concentrations of IL-1, TNF, IL-6 with lower concentrations reflecting less local inflammation

Submarginal microbiome12-months follow-up after delivery of crown

16S assessment of microbiome diversity (Shannon index) with greater diversity representing a more stable microbiome

Discomfort perceptionDuring surgery

Patient discomfort perception during surgery will be recorded using visual analogue scale (VAS with range from 0 to 10 with 10 being the highest possible pain experience)

Esthetics of the restoration12-months follow-up after delivery of crown

Assessed using the PES-WES scale as reported by Belser et al.with the scale ranging from 0 to 14 (worst to best)

Trial Locations

Locations (1)

Department of Oral and Maxillofacial Implantology

🇨🇳

Shanghai, Shanghai, China

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