Dimensional Changes of Peri-implant Facial Bone

Study Overview
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Brief Summary
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40 consecutive adult patients, requiring the insertion of dental implants in the aesthetic area (from second premolar to second premolar) will be enrolled in the study. At the time of surgery, a full thickness flap will be elevated, the implant bed will be prepared according to the manufacturer's instruction and the implants will be then seated into the bone. T0 corresponds to the time of implant insertion, T1 to the time of healing abutment's connection (T0=T1 for single stage implants), and T2 corresponds to 1-year follow-up from healing abutment's connection. Cone Beam Computed Tomography (CBCT) scans will be taken immediately after abutment connection (T1) and 1-year after (T2). The midsagittal cut of each implant will be identified, and measurements will be made at predetermined levels. Horizontal facial bone thickness (HFBT) and Vertical facial bone level (VFBL) will be measured. HFBT will be measured at 0, 3, 6 and 9 mm apical to the implant platform. VFBL wil be the perpendicular distance from the implant platform to the most coronal point of the facial bone. Changes between T1 and T2 will be calculated.

Detailed Description
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The long term results and benefit of implant insertion in the aesthetic area have been well documented. In the past few years, facial dimensional changes to the alveolar process following implant placement are object os study for both humans and animals investigations Recent studies suggest that platform switching decreases bone loss by 30% to 50%. It seems that the creation of a biologic width affects peri-implant bone loss to a significant extent and that platform switching is effective when the mucosal thickness allows the establishment of an horizontal biologic width. A new implant with an hybrid surface (T3) has been recently launched by Biomet 3i.Aim of the present study will be to evaluate the degree of 3D marginal bone remodelling around T3 Prevail implants. MATERIALS & METHODS: 40 consecutive adult patients, requiring the insertion of dental implants in the aesthetic area (from second premolar to second premolar) will be enrolled in the study. At the time of surgery, a full thickness flap will be elevated, the implant bed will be prepared according to the manufacturer's instruction and the implants will be then seated into the bone. Implants can be placed both with a single-stage or two-stage procedure. Implants inserted with a two-stage procedure will be re-opened after a submerged period of three months. T0 corresponds to the time of implant insertion, T1 to the time of healing abutment's connection (T0=T1 for single stage implants), and T2 corresponds to 1-year follow-up from healing abutment's connection. It is supposed that the creation of the biological width starts with the healing abutment's connection. CBCT scans will be taken immediately after abutment connection (T1) and 1-year after (T2). The midsagittal cut of each implant will be identified, and measurements will be made at predetermined levels. Horizontal facial bone thickness (HFBT) and Vertical facial bone level (VFBL) will be measured. HFBT will be measured at 0, 3, 6 and 9 mm apical to the implant platform. VFBL wil be the perpendicular distance from the implant platform to the most coronal point of the facial bone. Changes between T1 and T2 will be calculated.

Official Title
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Horizontal and Vertical Dimensional Changes of Peri-implant Facial Bone Following Placement of T3 Implants: a 1-year Cone Beam Computed Tomography Study

Conditions
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Jaw, Edentulous, Partially

Intervention / Treatment
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* Procedure: implant insertion and abutment connection
* Device: osseointegrated implant


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Healthy adult patients requiring implant insertion - Exclusion Criteria: Pregnancy history of malignancy history of radiotherapy or chemotherapy in the last 5 years long term steroidal or antibiotic therapy -

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: standard implant, switching platform<br>osseointegrated implant insertion and abutment connection Implants inserted in healed ridge, prosthetic connection with switching platform | Procedure: implant insertion and abutment connection<br>* After implant insertion, immediate or in healed ridge, the titanium abutment with switching platform will be connected<br>Device: osseointegrated implant<br>* Osseointegrated Implant Insertion<br>* Other names: T3 implant, Biomet 3i;|
| Active Comparator: immediate implant, switching platform<br>osseointegrated implant insertion and abutment connection Implants inserted in immediate post-extraction sites, prosthetic connection with switching platform | Procedure: implant insertion and abutment connection<br>* After implant insertion, immediate or in healed ridge, the titanium abutment with switching platform will be connected<br>Device: osseointegrated implant<br>* Osseointegrated Implant Insertion<br>* Other names: T3 implant, Biomet 3i;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| horizontal buccal bone thickness | On Cone Beam images, the horizontal dimensional changes of peri-implant facial bone will be measured | 12 months after abutment connection | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| vertical bone level | On Cone Beam images, the vertical dimensional changes of peri-implant facial bone will be measured | 1 year after abutment connection | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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osseointegrated Implant, bone level