Comparative Study of Implant Surfaces to Enhance Stabilization in Patients With Type 2 Diabetes
Primary Purpose
Partially Edentulous Mandible, Type 2 Diabetes
Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
dental implant and modified dental implant
Sponsored by
About this trial
This is an interventional treatment trial for Partially Edentulous Mandible focused on measuring dental implant, implant stabilization, type 2 diabetes, glycated hemoglobin 8.0-12.0%
Eligibility Criteria
Inclusion Criteria:
- Males and females must be at least 18 years of age, and having a diagnosis of type 2 diabetes mellitus occurring over 1 year prior to enrollment (self-reported and verified with physician report, test results, and/or treatment record)
- Type 2 diabetic patients may be on a modified diet, oral medication, insulin, or combination therapies
- Glycated hemoglobin A1c (HbA1c) levels of at least 8.0% up to and including 12.0% as reported within 4 weeks of implant placement
- Have at least two missing teeth in the posterior mandible in FDI positions 4, 5, 6, or 7
- The tooth at the implant site must have been extracted or lost at least 4 months before the date of implantation
- Adequate bone quantity at the implant site to permit the insertion of a Straumann Standard or Standard Plus 4.1 mm diameter implant at least 8 mm in length without the use of concurrent bone augmentation techniques, i.e. Implant insertion sites must have sufficient bone height such that the implant will not encroach on vital structures and sufficient width that a minimum of 1 mm lingual and buccal bone will remain
- Patients must have signed the informed consent form. They must be committed to the study. If the treating clinicians doubt that the patient is willing or will be able to attend all study follow-up visits then the patient should not be admitted to the study
Exclusion Criteria:
- Patients with a history of systemic disease other than type 2 diabetes mellitus that may preclude dental implant therapy (including cardiovascular, hepatic, renal, gastrointestinal, metabolic, neurologic, pulmonary, endocrine, autoimmune, or psychiatric disorders)
- Presence of conditions requiring chronic routine prophylactic use of antibiotics (e.g., bacterial endocarditis, cardiac valvular anomalies, prosthetic joint replacements)
- Diabetic retinopathy requiring imminent or planned surgical intervention
- Diabetic neuropathy of sufficient severity as to require treatment for control of symptoms
- Serum creatinine > 1.6 mg/dl
- AST (SGOT) or ALT (AGPT) > 2 times upper limit of normal laboratory range
- Hypertension, with or without medications, having a systolic pressure > 185mm Hg or diastolic pressure > 105mm Hg
- Patient has significant untreated oral infections or inflammatory lesions
- Medical conditions requiring prolonged use of steroids
- History of leukocyte dysfunction and deficiencies
- History of bleeding disorders
- Patients with history of renal failure
- Patients with metabolic bone disorders
- Physical handicaps that would interfere with the ability to perform adequate oral hygiene
- Use of any investigational drug or device within the 30 day period immediately prior to implant surgery on study day 0
- Patients who smoke >10 cigarettes per day or cigar equivalents, or who chew tobacco
- Conditions or circumstances, in the opinion of the investigator, which would prevent completion of study participation or interfere with analysis of study results, such as history of non-compliance, unreliability
Local Factors:
- Signs of oral inflammation, such as untreated periodontitis around the teeth or erosive lichen planus in the non-tooth associated areas
- History of head/neck irradiation therapy
- Presence of bone defects in the jaw preventing implant placement
- Unhealed extraction sites (less than 4 months post extraction of teeth in intended sites)
- Bone surgery (bone grafts, guided tissue regeneration technique for bone enhancement) less than 6 months prior to implant placement
- Patients requiring bone grafting at the surgical sites at the time of surgery
- Severe teeth grinding or clenching habits
- Persistent intraoral infection
- Lack of sufficient stability of the implant at surgery to allow for proper healing.
- Patients with inadequate oral hygiene or unmotivated for adequate home care
Sites / Locations
- University of Texas Health Science Center at San Antonio
Arms of the Study
Arm 1
Arm Type
Other
Arm Label
dental implant
Arm Description
standard SLA surface and chemically modified surface
Outcomes
Primary Outcome Measures
Implant Stability Quotient (ISQ)
resonance frequency analysis employed to determine implant stability quotient on a 1-100 point scale with 100 representing the greatest stability.
Secondary Outcome Measures
Clinical Success of Implants
Full Information
NCT ID
NCT01142297
First Posted
April 29, 2010
Last Updated
December 4, 2017
Sponsor
The University of Texas Health Science Center at San Antonio
Collaborators
Institut Straumann AG
1. Study Identification
Unique Protocol Identification Number
NCT01142297
Brief Title
Comparative Study of Implant Surfaces to Enhance Stabilization in Patients With Type 2 Diabetes
Official Title
A Randomized, Controlled Trial Comparing the Stability of SLA Implants and SLActive Implants Using Resonance Frequency Analysis for Patients With Type 2 Diabetes Mellitus
Study Type
Interventional
2. Study Status
Record Verification Date
September 2016
Overall Recruitment Status
Completed
Study Start Date
July 2008 (undefined)
Primary Completion Date
May 2012 (Actual)
Study Completion Date
May 2012 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
The University of Texas Health Science Center at San Antonio
Collaborators
Institut Straumann AG
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
This study compares the patterns of dental implant stabilization between a standard and chemically modified implant surface in patients with type 2 diabetes. It is hypothesized that the chemically modified surface will enhance early healing events (first 4 months following placement)in diabetes patients with compromises in rate of implant integration.
Detailed Description
This is a prospective randomized study design whereby type 2 diabetic patients will receive 2 implants in the mandible or maxilla to assess implant integration. One implant will be a regular SLA implant; the other will have a SLActive surface. The primary objective of this randomized controlled study is to evaluate the stability of Straumann 4.1 mm diameter implants in the posterior mandible or maxilla of type 2 diabetic patients during the first 12 weeks after implantation using resonance frequency analysis. The control implant is a standard Straumann implant with an SLA® surface and the test implant the same implant design with SLActive® surface. Assessments will utilize resonance frequency analysis (RFA), as a measure of implant integration, and clinical outcomes of implant success. This study will enroll type 2 diabetes patients having glycated hemoglobin (HbA1c) levels from 8.0% to 12% at baseline.
The primary objective is to test for statistically significant differences in ISQ values between the test and control implants at 2, 3, 4, 6, 7, 8 weeks and 3 months after surgery. If a difference of 2 Osstell RFA ISQ units is detected at any time point it will be considered that the implant having achieved the higher value is better osseointegrated. This split-mouth study design will assess changes in implant stability from baseline as the primary outcome at the implant level. This study will require 20 patients to detect this difference (SD=2.0 ISQ units) with a power of 80% at the P=0.05 level.
Secondary objectives include:
Implant survival and implant success at 1-year post loading.
The nature and frequency of adverse events/complications between the 2 groups will be compared.
Prosthesis success
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Partially Edentulous Mandible, Type 2 Diabetes
Keywords
dental implant, implant stabilization, type 2 diabetes, glycated hemoglobin 8.0-12.0%
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
24 (Actual)
8. Arms, Groups, and Interventions
Arm Title
dental implant
Arm Type
Other
Arm Description
standard SLA surface and chemically modified surface
Intervention Type
Device
Intervention Name(s)
dental implant and modified dental implant
Intervention Description
standard SLA surface and chemically modified surface
Primary Outcome Measure Information:
Title
Implant Stability Quotient (ISQ)
Description
resonance frequency analysis employed to determine implant stability quotient on a 1-100 point scale with 100 representing the greatest stability.
Time Frame
4 months
Secondary Outcome Measure Information:
Title
Clinical Success of Implants
Time Frame
1 year
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Males and females must be at least 18 years of age, and having a diagnosis of type 2 diabetes mellitus occurring over 1 year prior to enrollment (self-reported and verified with physician report, test results, and/or treatment record)
Type 2 diabetic patients may be on a modified diet, oral medication, insulin, or combination therapies
Glycated hemoglobin A1c (HbA1c) levels of at least 8.0% up to and including 12.0% as reported within 4 weeks of implant placement
Have at least two missing teeth in the posterior mandible in FDI positions 4, 5, 6, or 7
The tooth at the implant site must have been extracted or lost at least 4 months before the date of implantation
Adequate bone quantity at the implant site to permit the insertion of a Straumann Standard or Standard Plus 4.1 mm diameter implant at least 8 mm in length without the use of concurrent bone augmentation techniques, i.e. Implant insertion sites must have sufficient bone height such that the implant will not encroach on vital structures and sufficient width that a minimum of 1 mm lingual and buccal bone will remain
Patients must have signed the informed consent form. They must be committed to the study. If the treating clinicians doubt that the patient is willing or will be able to attend all study follow-up visits then the patient should not be admitted to the study
Exclusion Criteria:
Patients with a history of systemic disease other than type 2 diabetes mellitus that may preclude dental implant therapy (including cardiovascular, hepatic, renal, gastrointestinal, metabolic, neurologic, pulmonary, endocrine, autoimmune, or psychiatric disorders)
Presence of conditions requiring chronic routine prophylactic use of antibiotics (e.g., bacterial endocarditis, cardiac valvular anomalies, prosthetic joint replacements)
Diabetic retinopathy requiring imminent or planned surgical intervention
Diabetic neuropathy of sufficient severity as to require treatment for control of symptoms
Serum creatinine > 1.6 mg/dl
AST (SGOT) or ALT (AGPT) > 2 times upper limit of normal laboratory range
Hypertension, with or without medications, having a systolic pressure > 185mm Hg or diastolic pressure > 105mm Hg
Patient has significant untreated oral infections or inflammatory lesions
Medical conditions requiring prolonged use of steroids
History of leukocyte dysfunction and deficiencies
History of bleeding disorders
Patients with history of renal failure
Patients with metabolic bone disorders
Physical handicaps that would interfere with the ability to perform adequate oral hygiene
Use of any investigational drug or device within the 30 day period immediately prior to implant surgery on study day 0
Patients who smoke >10 cigarettes per day or cigar equivalents, or who chew tobacco
Conditions or circumstances, in the opinion of the investigator, which would prevent completion of study participation or interfere with analysis of study results, such as history of non-compliance, unreliability
Local Factors:
Signs of oral inflammation, such as untreated periodontitis around the teeth or erosive lichen planus in the non-tooth associated areas
History of head/neck irradiation therapy
Presence of bone defects in the jaw preventing implant placement
Unhealed extraction sites (less than 4 months post extraction of teeth in intended sites)
Bone surgery (bone grafts, guided tissue regeneration technique for bone enhancement) less than 6 months prior to implant placement
Patients requiring bone grafting at the surgical sites at the time of surgery
Severe teeth grinding or clenching habits
Persistent intraoral infection
Lack of sufficient stability of the implant at surgery to allow for proper healing.
Patients with inadequate oral hygiene or unmotivated for adequate home care
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
thomas w oates, dmd, phd
Organizational Affiliation
University of Texas
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Texas Health Science Center at San Antonio
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229-3900
Country
United States
12. IPD Sharing Statement
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Comparative Study of Implant Surfaces to Enhance Stabilization in Patients With Type 2 Diabetes
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