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Implant-Abutment Interface Design on Bone and Soft Tissue Levels Around Implants Placed Using Different Transcrestal Sinus Floor Elevation

Primary Purpose

Tooth Loss

Status
Unknown status
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Anorganic Bovine Bone Graft Material
Collagen Membrane
Shelta Platform Switching Premium Implants
Shelta Platform Matching Premium Implants
Sponsored by
NYU College of Dentistry
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Tooth Loss

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Subjects must have read, understood and signed an informed consent form.
  2. Subjects must be 18 to 70 years of age.
  3. Subjects must be able and willing to follow study procedures and instructions.
  4. Subject must maintain good oral hygiene.
  5. Subjects must have a single tooth missing in the pre-molar or molar region of the maxilla (ADA tooth positions 2-4 and 13-15; FDI tooth positions 15-17 and 25-27).
  6. The mesio-distal distance of the tooth gap at bone level must be at least 6.8 mm to allow for placement of the Ø3.8 mm implant with a minimal distance of 1.5 mm from the implant shoulder to the adjacent tooth at bone level. A minimum of 7.8 mm of buccal-lingual ridge to allow 2 mm of buccal and lingual plate will be required.
  7. No apical disorder/inflammation at the area of the implant site.
  8. Residual bone height ranging from 6 to 9 mm.
  9. The implant must penetrate at least 2 mm into the sinus on the mesial or distal sides.
  10. Sufficient bone width in the edentulous region (≥ 6mm).
  11. Subjects must be committed to the study and attend the required follow-up visits.

Exclusion Criteria:

  1. Subjects with a systemic disease that would preclude dental implant surgery (e.g. serious internal medical problems, disorders of bone metabolism, uncontrolled bleeding disorders, weakened immune system, illness requiring periodic use of steroids, uncontrollable endocrine disorders, uncontrolled diabetes).
  2. Subjects who have failed to maintain good plaque control.
  3. Subjects with any contraindications for oral surgical procedures (e.g. inadequate wound healing capacity, poor oral hygiene, maxillary and mandibular growth not completed, xerostomia).
  4. Subjects with mucosal diseases (e.g., erosive lichen planus) in the localized area around the study implant site.
  5. Subjects presenting with maxillary sinus pathology.
  6. Subjects with a history of local irradiation therapy in the head/neck region.
  7. Subjects with severe bruxing, parafunctional habits, or temporomandibular joint dysfunction.
  8. Subjects receiving, or having a history of receiving intravenous or subcutaneous antiresorptive agents associated with osteonecrosis of the jaw, such as bisphosphonates.
  9. Oblique sinus floor (> 45 inclination).
  10. Subjects with any untreated endodontic lesions or untreated periodontal disease.
  11. Subjects who are heavy smokers (defined as >10 cigarettes per day or >1 cigar per day) or chew tobacco, including within 3 months prior to enrollment.
  12. Subjects who have physical or mental handicaps that would interfere with the ability to perform adequate oral hygiene.
  13. Subjects who are pregnant or intending to become pregnant during the duration of the study.
  14. Subjects requiring bone augmentation or socket grafting prior to surgery.
  15. Subject allergic to collagen or porcine derived products.
  16. Subjects with 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 or unreliability.

Sites / Locations

  • Bluestone Center for Clinical Research

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Arm Label

Arm 1

Arm 2

Arm 3

Arm 4

Arm Description

Transcrestal Sinus Floor Elevation using platform switched implant with bone graft material.

Transcrestal Sinus Floor Elevation using platform switched implant with no bone graft material.

Transcrestal Sinus Floor Elevation using platform matching implant with bone graft material.

Transcrestal Sinus Floor Elevation using platform matching implant with no bone graft material.

Outcomes

Primary Outcome Measures

Mean crestal bone level changes measured in mm using periapical radiographs and CT scans.
Mean crestal bone level change around the implants will be determined by periapical radiographs of mesial and distal bone levels. CT scans will be used to determine buccal and lingual bone level change between implant placement and 12 months, following placement of a platform switched implants or platform matching implants.
Mean periapical sinus bone level changes measured in mm using periapical radiographs and CT scans.
Mean periapical sinus bone level change between implant placement and 12 months will be determined by radiographic measurement (using periapical radiographs and CT scans) following placement of a platform switched implant or platform matching implant in the posterior region of the maxilla, with bone graft material or without bone graft material.
Implant survival measured through observation.
Implant survival will be measured at implant loading and 12 months following implant placement will be assessed through clinical observation.
Implant success rate measured by percentage.
Implant success rate will be assessed at implant loading and 12 months following implant placement measured by percentage.

Secondary Outcome Measures

Crestal bone height changes measured in mm using periapical radiographs.
Additional crestal bone height change determined by measurements of periapical radiographs of mesial and distal bone levels between implant placement and implant loading, and between implant loading and 12 months post-implant placement.
Implant Stability Quotient (ISQ) measured in N/cm.
Implant Stability Quotient (ISQ) between implant placement and implant loading and at 6 months and between implant loading.
Periodontal Pocket Depths measured in mm.
Periodontal Pocket Depths assessed at screening, implant loading, and 12 months post-implant placement.
Subject satisfaction assessed through questionnaire.
Subject satisfaction at implant placement, immediate post-operative, and 12 months post-implant placement.
Changes in sinus anatomy measured in mm compared to implant survival.
Changes in the sinus anatomy measured in mm compared to implant survival.
Changes in sinus anatomy measured in mm compared to implant success.
Changes in the sinus anatomy measured in mm compared to implant success.
Changes in sinus anatomy measured in mm compared to crestal bone changes.
Changes in the sinus anatomy measured in mm compared to crestal bone level changes. implant stability (ISQ).
Changes in sinus anatomy measured in mm compared to implant stability.
Changes in the sinus anatomy measured in mm compared to implant stability (ISQ).
Changes residual crestal bone height measured in mm compared to implant survival.
Changes in residual crestal bone height compared to implant survival.
Changes residual crestal bone height measured in mm compared to implant success.
Changes in residual crestal bone height compared to implant success.
Changes residual crestal bone height measured in mm compared to implant stability.
Changes in residual crestal bone height compared to implant stability (ISQ).
Changes residual crestal bone height measured in mm compaierd to sinus bone levels.
Changes in residual crestal bone height compared to sinus bone levels.
Bleeding on probing measured by present or not present.
Bleeding on probing assessed at screening, implant loading, and 12 months post-implant placement.
Gingival Recession measured in mm.
Gingival recession assessed at screening, implant loading, and 12 months post-implant placement.

Full Information

First Posted
September 26, 2016
Last Updated
March 6, 2021
Sponsor
NYU College of Dentistry
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1. Study Identification

Unique Protocol Identification Number
NCT02953392
Brief Title
Implant-Abutment Interface Design on Bone and Soft Tissue Levels Around Implants Placed Using Different Transcrestal Sinus Floor Elevation
Official Title
Evaluation of Implant-Abutment Interface Design on Bone and Soft Tissue Levels Around Implants Placed Using Two Different Transcrestal Sinus Floor Elevation Approaches: A Multi-Center, Double Blind, Randomized Trial
Study Type
Interventional

2. Study Status

Record Verification Date
March 2021
Overall Recruitment Status
Unknown status
Study Start Date
May 10, 2016 (Actual)
Primary Completion Date
December 2021 (Anticipated)
Study Completion Date
December 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
NYU College of Dentistry

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Sixty patients with partially edentulous posterior maxilla requiring a transcrestal sinus floor elevation technique to insert one implant will be selected. The purpose of this multi-center, prospective, double blind, and randomized investigation is to analyze a platform switched implant when placed at limited maxillary residual bone height with low bone density compared to a platform matching implant with or without bone graft material.
Detailed Description
Approximately 60 subjects who require at least one posterior maxilla implant in the areas of the second pre-molars or (first or second) molars with 6 to 9 mm of crestal bone below the sinus floor, as determined on the computerized axial tomographic (CT) scan, will be recruited for the study. Subjects will receive dental implants to replace a missing tooth (second pre-molar or first/second molar) on one side of the maxillary arch. Each subject will receive one type of implant: platform switched (PS) or platform matching (PM). Each site will receive either a bone graft material composed of anorganic bovine bone mineralized (ABBM, Bio-Oss, Geistlich Pharma) or no graft material (collagen membrane used for wound healing (Collatape, Zimmer)). At implant placement surgery and post-surgical follow-ups, the treated site will be examined, clinically measured, and radiographs and photographs will be taken. The central hypothesis is that the mean crestal bone level for the platform switched (test implants) implants will be superior to the mean crestal bone level for the platform matching (control implants) implants when placed in limited maxillary residual bone in the posterior regions, regardless of the use of bone graft material or collagen membrane.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Tooth Loss

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantOutcomes Assessor
Allocation
Randomized
Enrollment
60 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Arm 1
Arm Type
Active Comparator
Arm Description
Transcrestal Sinus Floor Elevation using platform switched implant with bone graft material.
Arm Title
Arm 2
Arm Type
Active Comparator
Arm Description
Transcrestal Sinus Floor Elevation using platform switched implant with no bone graft material.
Arm Title
Arm 3
Arm Type
Active Comparator
Arm Description
Transcrestal Sinus Floor Elevation using platform matching implant with bone graft material.
Arm Title
Arm 4
Arm Type
Active Comparator
Arm Description
Transcrestal Sinus Floor Elevation using platform matching implant with no bone graft material.
Intervention Type
Device
Intervention Name(s)
Anorganic Bovine Bone Graft Material
Intervention Description
Anorganic bovine bone graft material is intended for augmentation or reconstructive treatment of the alveolar ridge, filling periodontal defects, filling defects after root resection, apicoectomy, and cystectomy, filling extraction sockets to enhance preservation of the alveolar ridge, and elevation of maxillary sinus floor.
Intervention Type
Device
Intervention Name(s)
Collagen Membrane
Intervention Description
Collagen dental wound dressing is intended for the management of oral wounds and sores, including; dental sores, oral ulcers, periodontal surgical wounds, suture sites, burns, extraction sites, surgical wounds, and traumatic wounds.
Intervention Type
Device
Intervention Name(s)
Shelta Platform Switching Premium Implants
Intervention Description
Shelta implant systems are intended for immediate placement and function on single tooth and/or multiple tooth applications when good primary stability is achieved, with appropriate occlusal loading, in order to restore chewing function.
Intervention Type
Device
Intervention Name(s)
Shelta Platform Matching Premium Implants
Intervention Description
Shelta implant systems are intended for immediate placement and function on single tooth and /or multiple tooth applications when good primary stability is achieved, with appropriate occlusal loading, in order to restore chewing function.
Primary Outcome Measure Information:
Title
Mean crestal bone level changes measured in mm using periapical radiographs and CT scans.
Description
Mean crestal bone level change around the implants will be determined by periapical radiographs of mesial and distal bone levels. CT scans will be used to determine buccal and lingual bone level change between implant placement and 12 months, following placement of a platform switched implants or platform matching implants.
Time Frame
12 months
Title
Mean periapical sinus bone level changes measured in mm using periapical radiographs and CT scans.
Description
Mean periapical sinus bone level change between implant placement and 12 months will be determined by radiographic measurement (using periapical radiographs and CT scans) following placement of a platform switched implant or platform matching implant in the posterior region of the maxilla, with bone graft material or without bone graft material.
Time Frame
12 months
Title
Implant survival measured through observation.
Description
Implant survival will be measured at implant loading and 12 months following implant placement will be assessed through clinical observation.
Time Frame
12 months
Title
Implant success rate measured by percentage.
Description
Implant success rate will be assessed at implant loading and 12 months following implant placement measured by percentage.
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Crestal bone height changes measured in mm using periapical radiographs.
Description
Additional crestal bone height change determined by measurements of periapical radiographs of mesial and distal bone levels between implant placement and implant loading, and between implant loading and 12 months post-implant placement.
Time Frame
12 months
Title
Implant Stability Quotient (ISQ) measured in N/cm.
Description
Implant Stability Quotient (ISQ) between implant placement and implant loading and at 6 months and between implant loading.
Time Frame
6 months
Title
Periodontal Pocket Depths measured in mm.
Description
Periodontal Pocket Depths assessed at screening, implant loading, and 12 months post-implant placement.
Time Frame
12 months
Title
Subject satisfaction assessed through questionnaire.
Description
Subject satisfaction at implant placement, immediate post-operative, and 12 months post-implant placement.
Time Frame
12 months
Title
Changes in sinus anatomy measured in mm compared to implant survival.
Description
Changes in the sinus anatomy measured in mm compared to implant survival.
Time Frame
12 months
Title
Changes in sinus anatomy measured in mm compared to implant success.
Description
Changes in the sinus anatomy measured in mm compared to implant success.
Time Frame
12 months
Title
Changes in sinus anatomy measured in mm compared to crestal bone changes.
Description
Changes in the sinus anatomy measured in mm compared to crestal bone level changes. implant stability (ISQ).
Time Frame
12 months
Title
Changes in sinus anatomy measured in mm compared to implant stability.
Description
Changes in the sinus anatomy measured in mm compared to implant stability (ISQ).
Time Frame
12 months
Title
Changes residual crestal bone height measured in mm compared to implant survival.
Description
Changes in residual crestal bone height compared to implant survival.
Time Frame
12 months
Title
Changes residual crestal bone height measured in mm compared to implant success.
Description
Changes in residual crestal bone height compared to implant success.
Time Frame
12 months
Title
Changes residual crestal bone height measured in mm compared to implant stability.
Description
Changes in residual crestal bone height compared to implant stability (ISQ).
Time Frame
12 months
Title
Changes residual crestal bone height measured in mm compaierd to sinus bone levels.
Description
Changes in residual crestal bone height compared to sinus bone levels.
Time Frame
12 months
Title
Bleeding on probing measured by present or not present.
Description
Bleeding on probing assessed at screening, implant loading, and 12 months post-implant placement.
Time Frame
12 months
Title
Gingival Recession measured in mm.
Description
Gingival recession assessed at screening, implant loading, and 12 months post-implant placement.
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Subjects must have read, understood and signed an informed consent form. Subjects must be 18 to 70 years of age. Subjects must be able and willing to follow study procedures and instructions. Subject must maintain good oral hygiene. Subjects must have a single tooth missing in the pre-molar or molar region of the maxilla (ADA tooth positions 2-4 and 13-15; FDI tooth positions 15-17 and 25-27). The mesio-distal distance of the tooth gap at bone level must be at least 6.8 mm to allow for placement of the Ø3.8 mm implant with a minimal distance of 1.5 mm from the implant shoulder to the adjacent tooth at bone level. A minimum of 7.8 mm of buccal-lingual ridge to allow 2 mm of buccal and lingual plate will be required. No apical disorder/inflammation at the area of the implant site. Residual bone height ranging from 6 to 9 mm. The implant must penetrate at least 2 mm into the sinus on the mesial or distal sides. Sufficient bone width in the edentulous region (≥ 6mm). Subjects must be committed to the study and attend the required follow-up visits. Exclusion Criteria: Subjects with a systemic disease that would preclude dental implant surgery (e.g. serious internal medical problems, disorders of bone metabolism, uncontrolled bleeding disorders, weakened immune system, illness requiring periodic use of steroids, uncontrollable endocrine disorders, uncontrolled diabetes). Subjects who have failed to maintain good plaque control. Subjects with any contraindications for oral surgical procedures (e.g. inadequate wound healing capacity, poor oral hygiene, maxillary and mandibular growth not completed, xerostomia). Subjects with mucosal diseases (e.g., erosive lichen planus) in the localized area around the study implant site. Subjects presenting with maxillary sinus pathology. Subjects with a history of local irradiation therapy in the head/neck region. Subjects with severe bruxing, parafunctional habits, or temporomandibular joint dysfunction. Subjects receiving, or having a history of receiving intravenous or subcutaneous antiresorptive agents associated with osteonecrosis of the jaw, such as bisphosphonates. Oblique sinus floor (> 45 inclination). Subjects with any untreated endodontic lesions or untreated periodontal disease. Subjects who are heavy smokers (defined as >10 cigarettes per day or >1 cigar per day) or chew tobacco, including within 3 months prior to enrollment. Subjects who have physical or mental handicaps that would interfere with the ability to perform adequate oral hygiene. Subjects who are pregnant or intending to become pregnant during the duration of the study. Subjects requiring bone augmentation or socket grafting prior to surgery. Subject allergic to collagen or porcine derived products. Subjects with 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 or unreliability.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ismael E Khouly, DDS, MS, PhD
Organizational Affiliation
Bluestone Center for Clinical Research
Official's Role
Principal Investigator
Facility Information:
Facility Name
Bluestone Center for Clinical Research
City
New York
State/Province
New York
ZIP/Postal Code
10010
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Implant-Abutment Interface Design on Bone and Soft Tissue Levels Around Implants Placed Using Different Transcrestal Sinus Floor Elevation

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