Socket Preservation Using Socket Shield Technique Comparison of Socket Preservation Using Socket Shield Technique With Autogenous Dentin Graft Versus Alloplast Graft Material

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 autogenous dentine was introduced to preserve the periodontal ligaments. this study aim to evaluate of socket preservation using alloplast with socket shield versus Autogenous dentin graft with socket shield through radiographic analysis of alveolar bone dimension change and mean bone density in addition to histological and histomorphometric analysis for the quality of the formed bone.

Official Title
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Comparison of Socket Preservation Using Socket Shield Technique With Autogenous Dentin Graft Versus Alloplast Graft Material (Clinical and Histological Study)

Conditions
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Extraction Tooth Socket

Intervention / Treatment
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* Procedure: Modified socket shield technique with autogenous dentin graft material (in one side)
* Procedure: Modified socket shield technique with alloplast graft material (in contralateral side)


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 maxillary aesthetic regions (incisors, premolars) in both side Intact labial periodontal tissues. 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, radio/chemotherapy of the oral and maxillofacial region, treatment with oral and/or intravenous amino-bisphosponates). Untreated periodontal disease. Vertical root fractures on the labial aspect. Tooth /teeth with horizontal fractures below bone level. Tooth /teeth with external or internal resorptions.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 45 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: Single Group Assignment
Interventional Model Description: A single group in a split-mouth design, right and left sides are randomly allocated to the intervention group (16 sides in 8 patients)
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Study group (in one side)<br>Modified socket shield technique with autogenous dentin graft | Procedure: Modified socket shield technique with autogenous dentin graft material (in one side)<br>* The crown of the hopeless tooth will be decoronated, the root will then be sectioned, the lingual root fragment will be carefully retrieved, the remaining buccal root fragment will be thinned and concaved, The coronal part of this shield will be beveled to make a lingual slope then Tooth particles will be demineralized using 2% HNO3 (El-Gomhouria CO. Egypt) for 20 minutes to expose the dentin organic matrix.<br>|
| Active Comparator: Control group (in contrlateral side)<br>Modified socket shield technique with alloplast | Procedure: Modified socket shield technique with alloplast graft material (in contralateral side)<br>* The crown of the hopeless tooth will be decoronated, the root will then be sectioned, the lingual root fragment will be carefully retrieved, the remaining buccal root fragment will be thinned and concaved, The coronal part of this shield will be beveled to make a lingual slope then alloplast graft will be used<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| post opertaive edema | This will be assessed in the 1st week postoperatively and measured as follows: None (no inflammation) Mild (intraoral swelling confined to the surgical field) Moderate (extraoral swelling in the surgical zone) Severe (extraoral swelling spreading beyond the surgical zone). | after 7 days | 
| change in pain score | it will be assessed using VAS It rates pain on a scale from 1-10, with 0 representing no pain and 10 very much pain | 1 week and 3 months | 
| Change in bone density | it will be assessed using CBCT | at baseline and 3 months | 
| Change in bone height | it will be assessed using CBCT | at baseline and 3 months |