Using the Roots of a Non Restorable Wisdom Tooth as a Block for Augmentation of Localized Defects

Study Overview
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Brief Summary
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assess and compare the efficacy and safety of autogenous tooth roots for lateral alveolar ridge augmentation with staged implant placement in comparison to autogenous bone block.

Detailed Description
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A total of 14 patients in need of implant therapy and lateral ridge augmentation were allocated to parallel groups receiving either 1) healthy autogenous tooth roots (e.g. retained wisdom or impacted teeth or 2) cortical autogenous bone blocks harvested from the retromolar area. After 26 weeks of submerged healing the horizontal bone gain were assessed both clinically and radiographically. A core biopsy was taken during the implant placement to assess the histology of the newly formed bone.

Official Title
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The Effect of Autogenous Tooth Roots for Lateral Alveolar Ridge Augmentation and Staged Implant Placement (A Controlled Clinical Study With Histological Assessment)

Conditions
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Augmentation

Intervention / Treatment
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* Procedure: tooth block
* Procedure: autogenous bone block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Candidate for lateral ridge augmentation Insufficient bone ridge width at the recipient site for implant placement Sufficient bone height at the recipient site for implant placement Healthy oral mucosa, at least 3 mm keratinized tissue. Presence of wisdom teeth free from periapical infection. Missing maxillary or mandibular tooth with moderate horizontal defect (4-8) according to cologne classification Exclusion Criteria: 1) Patients are systemically free according to Modified Cornell Medical Index 2) smokers patients. 3) Pregnant or lactating women.
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: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Autogenous bone block<br>the monocortical block grafts were harvested from the retromolar region (i.e. linea oblique) by using of rotating (i.e. carbide burs) | Procedure: autogenous bone block<br>* autogenous bone block were used to increase the bone width<br>|
| Experimental: Tooth block<br>In the first group, a second mucoperiosteal flap was elevated to surgically remove the respective wisdom tooth. After its removal and during the same surgery, the crown was decapitated at the cemento -enamel junction using a rotating carbide bur under gentle sterile saline cooling and the exposed pulp was preserved. The separated tooth root was adapted to match the size and shape of the defect area. To improve ankylosis between the graft and the defect site, the layer of cementum at the respective downward aspects of the root was carefully removed using a diamond bur until the underlying dentin was entirely exposed | Procedure: tooth block<br>* tooth root blocks were used to increase the bone width<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Clinical and radiographic assessment of alveolar bone width following autogenous tooth roots augmentation. |  | 6 months postoperatively | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Histological analysis of remodeled autogenous bone roots 4 months following horizontal ridge augmentation. Histological analysis of remodeled autogenous bone roots 4 months following horizontal ridge augmentation. |  | 6 months postoperatively | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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tooth block, Dental implants