Implant Placement in the Preserved Socket Using Socket Shield Technique With Autogenous Dentin Graft Versus Preserved Socket Using Socket Shield With Alloplast

Study Overview
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Brief Summary
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Alveolar bone resorption and labial bone plate reduction follow teeth extraction due to the deficiency of blood supply, derived from the loss of periodontal ligaments, and hence the socket shield technique with Bone graft was introduced to preserve the periodontal ligaments related perfusion and preserve socket dimensions for new bone formation. This study aims to compare implants placed in two differently preserved sockets, the first one preserved using Socket Shield technique with Autogenous Dentin Graft while the other socket preserved using socket shield technique with Alloplastic bone graft material

Official Title
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Evaluation of Implant Placement in Preserved Socket Using Socket Shield Technique With Autogenous Dentin Graft Versus Preserved Socket Using Socket Shield With Alloplast (Controlled Clinical and Radiographic Study)

Conditions
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Teeth Extraction, Tooth Socket

Intervention / Treatment
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* Procedure: socket shield technique with autogenous dentin graft
* Procedure: socket shield technique with alloplast graft


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: One or more of non-restorable (fractured or decayed) tooth/teeth in the upper aesthetic regions (incisors, premolars). Intact labial/buccal periodontal tissues. Sufficient bone volume to allow placement of an implant. Non-Smoker Ability to read and sign an informed consent form Exclusion Criteria: A medical history that contraindicates oral surgical treatment (uncontrolled/untreated diabetes mellitus, immunocompromised status,current radio/chemotherapy of the oral and maxillofacial region, treatment with oral and/or intravenous amino-bisphosponates). Untreated periodontal disease. [15,18] Vertical root fractures on the buccal aspect. [26] Tooth /teeth with horizontal fractures below bone level. [26] Tooth /teeth with external or internal resorptions.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 50 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: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Study group<br>patients will receive the implant in the previously preserved socket using Socket shield technique with Alloplastic graft material | Procedure: socket shield technique with autogenous dentin graft<br>* The crown of the hopeless tooth will be decoronated with a chamfer diamond bur and a large-head round diamond bur under copious irrigation, until the bone crest level. The root will then be sectioned along the long axis into buccal and palatal halves with a long shank fissure bur. The lingual root fragment will be carefully retrieved using microperiotome. The remaining buccal root fragment will be thinned and concaved slightly with a long shank fissure bur. The thickness of the buccal root fragment should be at least 1.5 mm to ensure resistance to fracture and resorption. The coronal part of this shield will be beveled to make a lingual slope for a better emergence profile with a large head round diamond bur. The socket shield will be checked for immobility so the implant could be inserted palatally into the socket shield. After the final preparation of the socket shield, Graft will be placed using autogenous dentin graft from the discarded palatal part of the tooth<br>|
| Active Comparator: Control group<br>patients will receive the implant in the previously preserved socket shield with Autogenous dentin graft | Procedure: socket shield technique with alloplast graft<br>* The crown of the hopeless tooth will be decoronated with a chamfer diamond bur and a large-head round diamond bur under copious irrigation, until the bone crest level. The root will then be sectioned along the long axis into buccal and palatal halves with a long shank fissure bur. The lingual root fragment will be carefully retrieved using microperiotome. The remaining buccal root fragment will be thinned and concaved slightly with a long shank fissure bur. The thickness of the buccal root fragment should be at least 1.5 mm to ensure resistance to fracture and resorption. The coronal part of this shield will be beveled to make a lingual slope for a better emergence profile with a large head round diamond bur. The socket shield will be checked for immobility so the implant could be inserted palatally into the socket shield. After final preparation of socket shield, Graft will be placed Alloplast graft<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in implant stability | it will be measured using Osstell ISQ, or Implant Stability Quotient, is a scale from 1 to 100 and is a measure of the stability of an implant. High stability means >70 ISQ, between 60-69 is medium stability and < 60 ISQ is considered as low stability. | immeditely and at 3 months | 
| change in bone density | it will be measured using CBCT | at baseline and 3 months | 
| change in bone height | it will be measured using CBCT | at baseline and 3 months | 
| change in Labio/Bucco-Palatal width | it will be measured using CBCT | at baseline and 3 months |