Bone Augmentation Using Particulated Biomaterial and Autogenous Bone, Stabilized by Collagen Membrane and Pins (PaMP)

Study Overview
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Brief Summary
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Twenty four patients with bone resorption on the anterior maxilla will be divided into two groups with different kinds of grafting: bone block associated with particulated biomaterial and particulated mixture of autogenous bone and biomaterial stabilized by collagen membrane and pins. The techniques will be compared according to volume gain, quality of graft osseointegration, implant survival and maintenance of the level of soft tissues.

Detailed Description
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Twenty four patients will be selected analysing the resorption on the front maxilla and will be divided into two groups. Experimental group will receive a particulated mixture of autogenous and lyophilized bovine bone, stabilized with a collagen membrane and pins over the vertical and/or horizontal defect, while Control group will receive a bone block graft, stabilized with fixation screws , covered with lyophilized bone and a collagen membrane. After a period of nine months, the volume increase will be measured trough the difference found between the initial computerized tomography and the final computerized tomography. Dental implants will be placed according to the prosthetic need and bone cylinders will be removed from the respective location. The cylinders will be histologically analysed in order to verify the quality of the graft osteointegration. After the prosthesis installation, the implant survival and the soft and hard tissues will be followed up for a minimum period of 24 months.

Official Title
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Maxillary Horizontal and Vertical Bone Augmentation Using Particulated Biomaterial Associated With Autogenous Bone, Covered and Stabilized by a Collagen Membrane and Pins

Conditions
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Alveolar Bone Grafting, Bone Augmentation

Intervention / Treatment
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* Procedure: Biopsy
* Radiation: Computerized Tomography
* Other: Standardized periapical radiographs
* Other: Intraoral scanning


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: absence of teeth at anterior maxilla need of vertical or horizontal bone reconstruction at anterior maxilla Exclusion Criteria: smoking habits diabetes systemic diseases which interfere with osseous metabolism active periodontal disease

Ages Eligible for Study
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Minimum Age: 18 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: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Sausage graft<br>Bone graft performed with a mixture of particulated autogenous and lyophilized bovine bone, stabilized with collagen membrane and pins. | Procedure: Biopsy<br>* A cylinder of grafted bone will be removed from the location elected for the implant installation with an appropriate trephine<br>Radiation: Computerized Tomography<br>* An initial computerized tomography will be made before the first surgery, and a final computerized tomography will be made after 9 months, previously to the second surgery<br>Other: Standardized periapical radiographs<br>* A device will be adopted for the standardization, and radiographs will be taken at day 0, 3 months, 6 months, 12 months, 18 months, 24 months after implant installation<br>Other: Intraoral scanning<br>* Intraoral scanning will be made before the graft, at implant installation, 3 months, 6 months, 12 months, 18 months, 24 months after implant installation<br>|
| Active Comparator: Bone block graft<br>Bone graft performed with a block of autogenous bone stabilized by a screw associated with lyophilized bovine bone and collagen membrane. | Procedure: Biopsy<br>* A cylinder of grafted bone will be removed from the location elected for the implant installation with an appropriate trephine<br>Radiation: Computerized Tomography<br>* An initial computerized tomography will be made before the first surgery, and a final computerized tomography will be made after 9 months, previously to the second surgery<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| vertical gain | Measures will be taken from computerized tomography in axial sections | 9 months | 
| horizontal gain | Measures will be taken from computerized tomography in transverse sections | 9 months | 
| implants survival | Clinical examination and standardized radiographs will be taken periodically | 24 months | 
| soft tissue volume | Measures will be taken from images generated by intraoral scanning in an occlusal view | 24 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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pin, particulated graft, bone augmentation, vertical augmentation, horizontal augmentation