Clinical And Radiographic Evaluation Of The Use Of Pontic Shield Technique For Alveolar Ridge Preservation In The Esthetic Region . A Case Series
Trial Snapshot
- Phase
- Not Applicable
- Sponsor
- Cairo University
- Enrollment
- 10
- Locations
- 1
- Primary Endpoint
- Bucco-lingual ridge dimension
Study Overview
Brief Summary
To assess bucco-lingual dimension of the ridge while using pontic shield technique as a treatment modality for ridge preservation
Detailed Description
• Patients with non-restorable teeth in the esthetic area will be recruited from Faculty of Dentistry in Cairo University A pre-operative cone beam computed tomography ( CBCT ) will be taken to examine the non-restorable tooth , measure bucco-lingual width and exclude any fenestration or dehiscence in the labial bone plate
A non-surgical phase one therapy will be done for the patient as a preparatory phase
Proper oral hygiene measures and chlorohexidene mouthwash will be prescribed after the the first
Reassessment of the case to assure absence of any signs of inflammation and prescence of normal tissues before the surgical procedure
- The area will be anaesthetized using infiltration technique in labial site with 1.5ml of anaesthetic solution and palatal site with 0.3 ml of anaesthetic solution
- Decoronation of the tooth , if the crown is available, will be done to obtain a concave mesio-distal root
- A long shank root resection bur will be used to section the root mesiodistally as far apical as possible , in order to obtain the buccal half attached to the labial bone plate and together the apical and the palatal half will be attached to the palatal bone
- Periotome will be used to distort the periodontal ligaments between the palatal half of the root and palatal alveolar socket wall
- Together the apical and the palatal portions of the root will be delivered , using micro forceps
- Bone curettage will be done in the presence of peraipical infection
- Explorer will be used to exclude mobility of the buccal portion of the root
- The thickness of the buccal portion will be reduced to 2mm
- A large round bur will be used to reduce the height of the buccal portion in a mesiodistal direction.
- A bone grafting material will be placed in the remaining socket
Study Design
- Study Type
- Interventional
- Allocation
- Na
- Intervention Model
- Single Group
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 21 Years to 50 Years (Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •1-Inclusion Criteria:
- •1a- non-restorable teeth in the anterior esthetic zone
- •1b-Teeth not indicated for immediate implant placement for reasons such as acute periapical infection, insufficient buccolingual width, poor economical status
- •1c- Full mouth plaque score (FMPS )<25% at baseline
- •1d- Full mouth bleeding score (FMBS )<25% at baseline
- •1e -Systemically healthy
Exclusion Criteria
- •2a- Fenestration or dehiscence in buccal plate 2b- Periodontally compromised tooth 2c- Mobility of the tooth or remaining root 2d- Smokers 2e- Pregnancy and lactation
Arms & Interventions
Patients recruited from Cairo University
After Cone beam CT assessment , The patient is assigned for nonsurgical periodontal phase then an impression is taken for stent formation to facilitate tissue thickness measurement .
> After 2 weeks , the patient is assigned for surgical phase to extract the palatal and apical aspect of the tooth and leave the buccal portion .
Socket preservation is attempted in the socket , using 'genbioss ' bone graft. Modified free gingival graft is done on the pontic site to cover the buccal root shield and the bone graft .
Post operative instructions include :
- Analgesics (Prufen 400 mg ) three times for three days
- Antibiotic (Augmentin 1gm ) twice daily for one week The patient will be assured to contact the operator of any unexpected complications occured .
Intervention: Pontic Shield Technique (Procedure)
Outcomes
Primary Outcomes
Bucco-lingual ridge dimension
Time Frame: 6 months
To assess the stability of the ridge after surgical procedure using bone calliper and CBCT via subtractive method technique
Secondary Outcomes
- Gingival thickness(3 months)
- Labial bone thickness(6 months)
Investigators
Ramy Mohamed Salah ELdin Thabet
Postgraduate
Cairo University