Modified Pedicle Subepithelial Connective Tissue Graft for Interdental Papillary Reconstruction Around Delayed Implants in the Esthetic Zone: A Case Series Trail

Study Overview
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Brief Summary
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This case series trial aims to evaluate the effect of a modified pedicle subepithelial connective tissue graft in creating anatomical papilla around one-stage delayed implant in the esthetic zone to establish better esthetics.

Detailed Description
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Preparation of the implant site will be prepared by a crestal incision on the ridge bisecting the existing keratinized mucosa and vertical releasing incisions extending to the vestibule. The papillae of the adjacent teeth are not included in the flap design. A full thickness flap will be raised buccally exposing the underlined ridge of the implant site. A surgical drill guide will be used for the precise placement of the pilot drill. After pilot drill application, the osteotomy will be prepared with the corresponding size of parallel drill. The implant will be placed in the recipient site by means of an insertion device. The implant neck will be positioned flushing with the crestal bone level. The healing abutment extension of the implant will be placed in such a way that the head of the implant protruded about 2 to 3 mm from the bone crest. Reassessment of the case to assure absence of any signs of inflammation and presence of normal tissues before the surgical procedure

Official Title
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تعديل النسيج الضام عنيق تحت الظهارة من أجل إعادة بناء حليمي بين الأسنان حول الزراعه المتأخره في المنطقة الجمالية

Conditions
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Papilla Reconstruction

Intervention / Treatment
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* Procedure: papilla reconstruction


Participation Criteria
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Eligibility Criteria
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Exclusion Criteria: Pregnant females. Smokers as smoking is a contraindication for any plastic periodontal surgery (Khuller, et al., 2009) Handicapped and mentally retarded patients. Patients undergoing radiotherapy. Presence of systemic disease that would affect wound healing
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Interventional Model Description: Case Series trial
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: delayed implant<br>Patients 18 years or older. Periodontally and systemically healthy. Sufficient bone width and height for implant placement Adequate mesiodistal width and inter-arch space for placement of a delayed implant. Full mouth plaque index less than 15% (Bentley and Disney, 1995) cooperative patients who will comply to follow up visits | Procedure: papilla reconstruction<br>* subepithelial connective tissue graft for interdental papillary reconstruction around delayed<br>* Other names: create papilla around delayed implant;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| papilla height | Periodontal probe and reference line | 3 month |