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Evaluation of Ice Cream Cone Technique With Immediate Implant Placement in Patients With Labial Plate Dehiscence

Not Applicable
Conditions
Dental Implant
Guided Bone Regeneration
Registration Number
NCT04679766
Lead Sponsor
Cairo University
Brief Summary

Immediate tooth replacement with immediate implants into fresh extraction sockets has become a common and promising clinical procedure in daily practice in regard of implant survival, osseointegration and esthetic outcomes . However, there are some challenges encountered in the treatment of patients with labial bone plate dehiscence. Deficiency of facial bone anatomy has a negative impact on esthetics and is a critical causative factor for esthetic implant complications and failures ..

Few studies investigated the reconstitution of labial bone plate dehiscence using ice cream cone technique and their results showed adequate bone regeneration 4 to 6 months where no labial plate was present prior to grafting technique. Ice cream cone technique as a flapless grafting technique in conjunction with immediate implant placement in patients with labial bone plate dehiscence requires further studies for its clinical relevance and approval.

Detailed Description

Classical methods of guided bone regenerative methods succeeded to partially reconstitute the lost labial plate of bone using different grafting materials with barrier membranes.

This might be attributed to the necessity of using a full mucoperiosteal flap which interrupts the vascular supply to the bone and jeopardizing the process of total facial bone regenerative process. Therefore, Tan-Chu et al., (2014) described in a case report an innovative technique using resorbable collagen membrane in the shape of ice cream cone and allograft in the reconstitution of labial plate in patients with socket type II after extraction with folding the membrane to seal the socket and containing the blood clot to allow for occupation of osteogenic cell population without raising a flap. This technique showed an adequate bone regeneration with net result of 1.32 mm prior to no labial plate present before grafting. Hence, using immediate implant placement with the conjunction of the ice cream cone technique in regeneration of labial plate of bone needs to be further assessed to evaluate its clinical outcomes.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
10
Inclusion Criteria
  1. Non-restorable teeth in maxillary inter-bicuspid region.
  2. All teeth have labial plate dehiscence (socket type II) after extraction.
  3. Patients free from any systemic conditions that may affect healing.
  4. Adequate bone volume for the placement of immediate implant.
  5. Presence of the adjacent teeth.
  6. Compliant patients.
Exclusion Criteria
  1. Smokers.
  2. Pregnant females.
  3. Patients who were taking or currently taking any of the bisphosphonates.
  4. Any disease that might affect bone metabolism as osteoporosis.
  5. Insufficient inter-occlusal distance or mesio-distal space to place an implant supported restoration.
  6. The presence of any signs of acute infection in the surgical site or the adjacent natural teeth.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Primary Outcome Measures
NameTimeMethod
Changes in buccal/labial vertical bone dimensions6 months post operative

Vertical bone dimension will be measured at day 0 and 6 months post-operative

Secondary Outcome Measures
NameTimeMethod
Keratinized tissue width6 months

Measured using william's graduated probe

Gingival thickness6 months

Measured using william's graduated probe

Changes in labial/buccal plate thickness6 months

Measured at day 0 and 6 months post-operative using Cone beam tomography

Post operative pain measured with VAS scale1 week -2 weeks

VAS scale from 0 to 10, where 0 no pain and 10 with highest pain

Post-operative patient satisfaction with Yes or No question6 months

Yes or No question of overall patient satisfaction of the procedure

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