Evaluation of Healing at Molar Extraction Sites With Ridge Preservation Using Freeze Dried Bone Allograft and a Collagen Wound Dressing
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 27
- 主要终点
- Radiographic bone width changes (in mm)
研究概览
简要总结
Currently, it is not known what the dimensional changes might be following a molar site extraction which has been grafted with FDBA and covered with a collagen wound dressing. The purpose of the proposed study is to examine the clinical healing following ridge preservation using freeze dried bone allograft (FDBA) with a collagen wound dressing barrier (CollaPlug®) in a molar extraction site.
I
详细描述
It is well known that a tooth socket will undergo significant resorption and remodeling following tooth extraction. Pietrokovsky and Massler documented alveolar bone dimension changes subsequent to tooth extraction forty-five years ago. Schropp et al. evaluated tissue changes on models following premolar and molar extractions and concluded that 50% of the ridge width was lost within one year following extraction. Two thirds of this resorption happened during the first 3 months.
In addition to alveolar ridge resorption in a horizontal dimension (decrease in width), changes in the vertical dimension of the ridge have been documented following tooth extraction in a canine model. The healing pattern of the extraction socket observed in the preclinical setting was further confirmed in human investigations). A systematic review concluded that greater loss of ridge width is to be expected following extraction compared to loss of ridge height. Clinical mean reductions of 3.87mm and 1.87mm in ridge width and height, respectively, were reported. Radiographically, the mean reduction amounted 1.21mm and 1.53mm for ridge width and height, respectively. These results were confirmed by another systematic review.
If the extracted tooth is to be replaced, the unfavorable dimensional changes resulting from this healing process may necessitate advanced and technique sensitive guided bone regeneration (GBR) procedures prior to dental implant placement. In order to avoid GBR and limit these dimensional changes, grafting of the extraction socket with or without membrane coverage, also called ridge preservation procedure, have been advocated. In order to perform ridge preservation, typically, a graft material and some sort of a barrier (e.g. non-resorbable and resorbable membranes or collagen wound dressing) are used. A large variety of materials are available on the market for the purpose of ridge preservation. No material gold standard has yet been identified to date, which would ensure the best dimensional stability of the alveolar ridge.
Current materials used as part of standard care in clinical practice include freeze dried bone allograft (FDBA) as a grafting material and a dense polytetrafluroethylene (dPTFE) non-resorbable membrane or a collagen wound dressing (Collaplug®, Zimmer Dental, Carlsbad, CA) to protect the extraction grafted site. It is currently now known how the use of a collagen wound dressing would compare to a non-resorbable membrane (which has been documented) and if any would lead to any substantial clinical advantages.
Therefore, the proposed research project will answer the following question:
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Other
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 99 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •One molar tooth that has been identified by dental faculty as requiring a single tooth extraction
- •A dental implant is indicated and treatment planned to replace the missing molar tooth
- •Have adequate restorative space for a dental implant-retained restoration
- •Have at least 10mm of alveolar bone height, without impinging on the maxillary sinus or inferior alveolar canal.
排除标准
- •Patients will not be entered who are mentally incompetent, prisoners, or pregnant.
- •Pregnant women or women intending to become pregnant during the study period.
- •Patients who become pregnant during the study will be withdrawn and standard care will be delivered.
- •Clinical and/or radiographic determinations which will preclude inclusion in this study are:
- •Active localized or systemic infection other than periodontitis.
- •Untreated periodontal diseases
- •Inadequate bone dimensions or restorative space dimensions to place a dental implant
- •Presence of a disease entity, medical condition or therapeutic regimen which decreases probability of soft tissue and bony healing, e.g., poorly controlled diabetes, chemotherapeutic and immunosuppressive agents, or autoimmune diseases.
- •Positive medical history of endocarditis following oral or dental surgery.
研究组 & 干预措施
Ridge preservation in molar sites
Patient who will need a single molar site extracted as part of their treatment will be screened and consented for this research study.
Ridge preservation will be performed in single molar extraction site. The site will be grafted with freezed dried bone allograft (FDBA) and covered with a collagen wound dressing (Collaplug). This is already part of clinical standard care using FDA approved products in an FDA approved fashion. The study aims at documenting the clinical outcome of such accepted procedure more precisely and compare it existing data using other materials.
干预措施: Ridge preservation (Procedure)
Ridge preservation in molar sites
Patient who will need a single molar site extracted as part of their treatment will be screened and consented for this research study.
Ridge preservation will be performed in single molar extraction site. The site will be grafted with freezed dried bone allograft (FDBA) and covered with a collagen wound dressing (Collaplug). This is already part of clinical standard care using FDA approved products in an FDA approved fashion. The study aims at documenting the clinical outcome of such accepted procedure more precisely and compare it existing data using other materials.
干预措施: FDBA (Device)
Ridge preservation in molar sites
Patient who will need a single molar site extracted as part of their treatment will be screened and consented for this research study.
Ridge preservation will be performed in single molar extraction site. The site will be grafted with freezed dried bone allograft (FDBA) and covered with a collagen wound dressing (Collaplug). This is already part of clinical standard care using FDA approved products in an FDA approved fashion. The study aims at documenting the clinical outcome of such accepted procedure more precisely and compare it existing data using other materials.
干预措施: Collagen wound dressing (Device)
结局指标
主要结局
Radiographic bone width changes (in mm)
时间窗: 3 months
Following extraction and ridge preservation the alveolar bone around the extraction socket will remodel and some resorption is expected. Alveolar ridge width change (in mm) at the extraction site will be recorded by means of Cone Beam Computed Tomography (CBCT)
次要结局
- Radiographic bone height changes (in mm)(3 months)
研究者
Guy Huynh-Ba
Associate Professor - Clinical
The University of Texas Health Science Center at San Antonio