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Effect Alb-PRF & A-PRF in Alveolar Ridge Preservation in Diabetes Patients - A RCCT

Not Applicable
Not yet recruiting
Conditions
Tooth Extraction Status Nos
Interventions
Procedure: Study Group
Procedure: Control Group
Registration Number
NCT06147310
Lead Sponsor
The University of Hong Kong
Brief Summary

This study aim to investigate the effect of albumin gel- and platelet- rich fibrin(Alb-PRF) combined with advanced platelet-rich fibrin (A-PRF) on alveolar ridge preservation by comparing alveolar ridge morphometric changes (hard and soft tissue), prospects and treatment complexity for placement of prosthetically guided dental implant, early oral wound healing outcomes evaluated by the Inflammatory Proliferative Remodeling Scale, and patient reported outcome measures, in Type I/II Diabetes Mellitus patient, versus spontaneous healing

Detailed Description

Diabetes is a well-established risk factor for oral diseases that often lead to extractions and tooth loss in the population, while diabetic patients also have increased susceptibility to wound infections.

Albumin gel-platelet-rich fibrin (Alb-PRF) and advanced platelet-rich fibrin (A-PRF) are third-generation of platelet concentrates derived from a donor's blood by following a simple centrifugation protocol, heat treatment of platelet-poor plasma, and mixing of liquid-PRF from the same preparation.

This study proposes a novel alveolar ridge preservation technique based on the application of A-PRF inside the extraction socket to sustain the release of growth factors during the early wound healing phase, together with periosteum inhibition by overlaying an Alb-PRF membrane with slow biodegradation and space maintenance properties over the bone to reduce post-extraction alveolar ridge resorption.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
74
Inclusion Criteria

Not provided

Exclusion Criteria

i. Patients with conditions or circumstances, in the opinion of the Investigator, which would prevent completion of study participation or interfere with analysis of study results, such as history of non-compliance or unreliability.

ii. Pregnancy or intention to become pregnant at any point during the study duration.

iii. Smoker /alcoholic iv. Has platelet dysfunction/ thrombocytopenia/ blood dyscrasia v. On bisphosphonates or drugs that will significantly alter bone metabolism. vi. ASA III/IV.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Study GroupStudy GroupAlveolar ridge preservation with Alb-PRF + A-PRF after extraction
Control GroupControl GroupSpontaneous healing after extraction
Primary Outcome Measures
NameTimeMethod
Ridge horizontal widthUp to 20 weeks

Ridge horizontal width changes (1mm, 3mm, 5mm apical to most coronal crest at buccal/oral) Method: CBCT

Secondary Outcome Measures
NameTimeMethod
Cytokines and growth factorsUp to 56 days

Changes in concentrations of cytokines and growth factors in wound fluid during early to mid-term wound healing events

Implant planning related outcomeUp to 20 weeks

Ability to place prosthetically guided implant, need for additional augmentation

Histological assessmentUp to 24 weeks

Bone volume to total tissue volume ratio and bone microstructure Method: Core biopsy with trephine at day of implant placement, micro CT and histomorphometric assessment

Keratinized tissue width changesUp to 20 weeks

Changes in keratinized tissue width Method: Periodontal probe with fixed landmarks

Patient-reported outcome measuresUp to 28 days

Patient will be asked to record their pre-operative anxiety level, intraoperative pain level and pain levels at follow up visits on a visual analogue scale (0-10)

Ridge volume and profileUp to 20 weeks

Changes in ridge volume and profilometric changes Method: Intraoral scan, CBCT

Ridge heightUp to 20 weeks

Ridge height changes (buccal and oral) Method: CBCT

Inflammatory proliferative remodellingUp to 28 days

IPR score will be assessed by independent assessors with photos of wound site at different itme points

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