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Influence of the Implant-prosthetic Connection in the Marginal Bone Loss and Bacterial Leakage

Primary Purpose

Dental Implant, Bone Loss, Bacterial Infections

Status
Unknown status
Phase
Not Applicable
Locations
Spain
Study Type
Interventional
Intervention
Dental Implant Placement
Sponsored by
University of Barcelona
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Dental Implant focused on measuring Dental Implant, Internal Connection, External Connection, Conical Connection, Marginal Bone Loss, Implant Prosthetic Connection, Bacterial Leakage

Eligibility Criteria

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

Inclusion Criteria:

  • Subjects who accept signing voluntarily the informed consent before doing any action related to the study.
  • ≥18-years-old patients.
  • Edentulous single spaces or edentulous posterior maxilla or mandible (from the first premolar to the second molar) with screw-retained single fixed crowns.
  • Single implants successfully osseointegrated placed at least 16 weeks post-extraction.
  • O'Leary plaque index and or bleeding on probing ≤25%.
  • Dental implants with screwed-retained prosthesis.

Exclusion Criteria:

  • Systemic diseases that can interfere dental implant placement.
  • Any contraindication for surgery procedures.
  • Heavy smokers (> 20cig/day).
  • Background of drug abuse or other factors such as psychiatric diseases that, in opinion of the examiner, could interfere with the ability of the patient to cooperate and compliment with the study.
  • Patients who have had participated with another clinical trial the last 30 days.
  • Pregnant women or in lactation.
  • Patients with bad oral hygiene or not motivated.
  • Probing pockets depths with bleeding of ≥4 mm on a tooth adjacent to the edentulous space.
  • Guided bone regeneration required in the same time of the implant placement.

Sites / Locations

  • University of BarcelonaRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Active Comparator

Active Comparator

Arm Label

Ocean E.C.®, Avinent Implant System S.L.

Ocean I.C.®, Avinent Implant System S.L.

Ocean C.C.®, Avinent Implant System S.L.

Arm Description

Dental implant with geometry adapted to the biologic architecture of the bone, with platform switching with a positive angle and machined surface with micro-threads in the cervical region. Asymmetric and progressive threads in its body with a double thread pitch. Point-ratio geometry on its apical region, Biomimetic Advanced Surface and external hexagon connection.

Dental implant with geometry adapted to the biologic architecture of the bone, with platform switching with a positive angle and machined surface with micro-threads in the cervical region. Asymmetric and progressive threads in its body with a double thread pitch. Point-ratio geometry on its apical region, Biomimetic Advanced Surface and internal hexagon connection.

Dental implant with geometry adapted to the biologic architecture of the bone, with platform switching with a positive angle and machined surface with micro-threads in the cervical region. Asymmetric and progressive threads in its body with a double thread pitch. Point-ratio geometry on its apical region, Biomimetic Advanced Surface and conical connection.

Outcomes

Primary Outcome Measures

Change in Vertical Marginal Bone Loss (VMBL)
Distance in millimetres between the implant platform and the point of the intra-bone defect that is more apical.

Secondary Outcome Measures

Vertical Marginal Bone Loss Tax
Vertical bone loss in millimetres per implant and unit of time.
Early implant failure
Implant with mobility or failure of the osseointegration process before the prosthesis placement.
Late implant failure
Implant with mobility or failure of the osseointegration process after the prosthesis placement.
Probing pocket depth
Distance in millimetres from the gingival margin to the bottom of the periodontal pocket measured with the periodontal probe. Determined in six points per tooth or implant (Buccal: mesial, medial and distal. Palatal or lingual: mesial, medial and distal).
Mucosal recession
Distance in millimetres from the cemento-enamel junction of the tooth or from the implant platform to the gingival margin when it is located apically. Determined in six points per tooth or implant (Buccal: mesial, medial and distal. Palatal or lingual: mesial, medial and distal).
Mucosal hyperplasia
Distance in millimetres from the gingival margin to the cemento-enamel junction of the tooth or to the implant platform when the gingiva is located more coronal than them. Determined in six points per tooth or implant (Buccal: mesial, medial and distal. Palatal or lingual: mesial, medial and distal).
Clinical attachment level
Probing pocket depth (mm) plus the recession (mm) or probing pocket depth minus the hyperplasia (mm). Determined in six points per tooth or implant (Buccal: mesial, medial and distal. Palatal or lingual: mesial, medial and distal).
O'Leary plaque index
Plaque presence in the dentogingival or implantogingival union. Determined in four points per tooth or implant (Buccal: mesial, medial and distal. Palatal or lingual). Expressed as the percentage (%) of tooth or implant surfaces with plaque presence divided with the total of tooth or implant surfaces in mouth and multiplied per 100.
Bleeding on probing
Presence of blood in the gingival margin after determining the probing pocket depth. Determined in six points per tooth or implant (Buccal: mesial, medial and distal. Palatal or lingual: mesial, medial and distal). Expressed as the percentage (%) of tooth or implant surfaces with blood divided with the total of tooth or implant surfaces in mouth and multiplied per 100.
Suppuration on probing
Presence of purulent material in the gingival margin after determining the probing pocket depth. Determined in six points per tooth or implant (Buccal: mesial, medial and distal. Palatal or lingual: mesial, medial and distal). Expressed as the percentage (%) of tooth or implant surfaces with pus divided with the total of tooth or implant surfaces in mouth and multiplied per 100.
Prosthetic complications
Screw (which connects the crown with the implant) fracture or prosthesis fracture, chipping of the ceramic prosthesis, loosening of the screw (which connects the crown with the implant) or any other prosthetic components.
Bacterial leakage
Quantitative PCR in real time to determine the total amount of bacteria and in particular, of 10 pathogenic species: Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythensis, Treponema denticola, Prevotella intermedia, Peptostreptococcus micros, Fusobacterium nucleatum, Campylobacter rectus, Eikenella corrodens and Candida albicans.

Full Information

First Posted
June 21, 2018
Last Updated
March 27, 2020
Sponsor
University of Barcelona
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1. Study Identification

Unique Protocol Identification Number
NCT04328051
Brief Title
Influence of the Implant-prosthetic Connection in the Marginal Bone Loss and Bacterial Leakage
Official Title
Influence of the Implant-prosthetic Connection in the Marginal Bone Loss and Bacterial Leakage. A Randomized Controlled Trial
Study Type
Interventional

2. Study Status

Record Verification Date
March 2020
Overall Recruitment Status
Unknown status
Study Start Date
June 13, 2018 (Actual)
Primary Completion Date
June 13, 2021 (Anticipated)
Study Completion Date
December 13, 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Barcelona

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study consists in a double-blinded randomized controlled trial which objective is to assess the effect of the implant-abutment connection type -external hexagon, internal hexagon and conical connection- in the periimplant marginal bone loss in vertical side and the bacterial leakage 12 months after prosthesis placement.
Detailed Description
Location: This study is going to take place in the Dentistry Hospital of the University of Barcelona (Campus of Bellvitge). Study subjects: The sample (105 patients) consists of patients with single tooth edentulous spaces or posterior maxillary and/or mandible edentulous spaces in need of dental implants with screw-retained single fixed crowns. All of them are being properly informed about the study according to the Comité Ético (CEIC) del Hospital Odontològic Universitat de Barcelona guidelines, and informed consent must be signed prior to the interventions. Material: Registration papers for the study, dental implants, surgery material, prosthetic components, Florida Probe Software®, Periapical x-rays, computer, Software Stata 14 and Software ImageJ®. Determinations: Clinical, radiographic and microbiologic measures since implant placement, prosthesis placement and 3, 6, 9 and 12 months after it.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Dental Implant, Bone Loss, Bacterial Infections
Keywords
Dental Implant, Internal Connection, External Connection, Conical Connection, Marginal Bone Loss, Implant Prosthetic Connection, Bacterial Leakage

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Active comparator: Ocean E.C.®, Avinent Implant System S.L., Santpedor, Spain. Active comparator: Ocean I.C.®, Avinent Implant System S.L., Santpedor, Spain. Active comparator: Ocean C.C.®, Avinent Implant System S.L., Santpedor, Spain.
Masking
ParticipantOutcomes Assessor
Masking Description
Patient will not know the type of connection of his or her implant until the study has finished. Outcome Assessor will be blinded. In the radiographic evaluation the implant-abutment connection will be hidden to assess the marginal bone loss.
Allocation
Randomized
Enrollment
105 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Ocean E.C.®, Avinent Implant System S.L.
Arm Type
Active Comparator
Arm Description
Dental implant with geometry adapted to the biologic architecture of the bone, with platform switching with a positive angle and machined surface with micro-threads in the cervical region. Asymmetric and progressive threads in its body with a double thread pitch. Point-ratio geometry on its apical region, Biomimetic Advanced Surface and external hexagon connection.
Arm Title
Ocean I.C.®, Avinent Implant System S.L.
Arm Type
Active Comparator
Arm Description
Dental implant with geometry adapted to the biologic architecture of the bone, with platform switching with a positive angle and machined surface with micro-threads in the cervical region. Asymmetric and progressive threads in its body with a double thread pitch. Point-ratio geometry on its apical region, Biomimetic Advanced Surface and internal hexagon connection.
Arm Title
Ocean C.C.®, Avinent Implant System S.L.
Arm Type
Active Comparator
Arm Description
Dental implant with geometry adapted to the biologic architecture of the bone, with platform switching with a positive angle and machined surface with micro-threads in the cervical region. Asymmetric and progressive threads in its body with a double thread pitch. Point-ratio geometry on its apical region, Biomimetic Advanced Surface and conical connection.
Intervention Type
Other
Intervention Name(s)
Dental Implant Placement
Other Intervention Name(s)
Surgery
Intervention Description
Antibiotic prophylaxis will be done. After rinsing with 0.12 % chlorhexidine, patients will receive local anaesthesia. A crestal incision will be done and a mucoperiostic flap will be raised. As the commercial specifies, progressive diameter drills will be used under constant sterile saline irrigation to prepare the implant site. Once finished the drilling sequence, one investigator will open the opaque envelope to know which type of implant, depending on the connection, has to be placed by the surgeon. Dental implant will be placed crestally and depending if it has primary stability or not, it will be leaded submerged or non-submerged. The flap will be repositioned and sutured without tension with 4/0 polyamide. Postoperative instructions and medication will be prescribed and explained.
Primary Outcome Measure Information:
Title
Change in Vertical Marginal Bone Loss (VMBL)
Description
Distance in millimetres between the implant platform and the point of the intra-bone defect that is more apical.
Time Frame
Since implant placement (Timing 0) through study completion (Timing 5), an average of 1 year.
Secondary Outcome Measure Information:
Title
Vertical Marginal Bone Loss Tax
Description
Vertical bone loss in millimetres per implant and unit of time.
Time Frame
12 months after prosthesis placement.
Title
Early implant failure
Description
Implant with mobility or failure of the osseointegration process before the prosthesis placement.
Time Frame
Since implant placement (Timing 0) through prosthesis placement (Timing 1).
Title
Late implant failure
Description
Implant with mobility or failure of the osseointegration process after the prosthesis placement.
Time Frame
Since prosthesis placement (Timing 1) through study completion (Timing 5), an average of 1 year.
Title
Probing pocket depth
Description
Distance in millimetres from the gingival margin to the bottom of the periodontal pocket measured with the periodontal probe. Determined in six points per tooth or implant (Buccal: mesial, medial and distal. Palatal or lingual: mesial, medial and distal).
Time Frame
Since prosthesis placement (Timing 1) through study completion (Timing 5), an average of 1 year.
Title
Mucosal recession
Description
Distance in millimetres from the cemento-enamel junction of the tooth or from the implant platform to the gingival margin when it is located apically. Determined in six points per tooth or implant (Buccal: mesial, medial and distal. Palatal or lingual: mesial, medial and distal).
Time Frame
Since prosthesis placement (Timing 1) through study completion (Timing 5), an average of 1 year.
Title
Mucosal hyperplasia
Description
Distance in millimetres from the gingival margin to the cemento-enamel junction of the tooth or to the implant platform when the gingiva is located more coronal than them. Determined in six points per tooth or implant (Buccal: mesial, medial and distal. Palatal or lingual: mesial, medial and distal).
Time Frame
Since prosthesis placement (Timing 1) through study completion (Timing 5), an average of 1 year.
Title
Clinical attachment level
Description
Probing pocket depth (mm) plus the recession (mm) or probing pocket depth minus the hyperplasia (mm). Determined in six points per tooth or implant (Buccal: mesial, medial and distal. Palatal or lingual: mesial, medial and distal).
Time Frame
Since prosthesis placement (Timing 1) through study completion (Timing 5), an average of 1 year.
Title
O'Leary plaque index
Description
Plaque presence in the dentogingival or implantogingival union. Determined in four points per tooth or implant (Buccal: mesial, medial and distal. Palatal or lingual). Expressed as the percentage (%) of tooth or implant surfaces with plaque presence divided with the total of tooth or implant surfaces in mouth and multiplied per 100.
Time Frame
First visit
Title
Bleeding on probing
Description
Presence of blood in the gingival margin after determining the probing pocket depth. Determined in six points per tooth or implant (Buccal: mesial, medial and distal. Palatal or lingual: mesial, medial and distal). Expressed as the percentage (%) of tooth or implant surfaces with blood divided with the total of tooth or implant surfaces in mouth and multiplied per 100.
Time Frame
Since first visit through study completion (Timing 5), an average of 1 year.
Title
Suppuration on probing
Description
Presence of purulent material in the gingival margin after determining the probing pocket depth. Determined in six points per tooth or implant (Buccal: mesial, medial and distal. Palatal or lingual: mesial, medial and distal). Expressed as the percentage (%) of tooth or implant surfaces with pus divided with the total of tooth or implant surfaces in mouth and multiplied per 100.
Time Frame
Since first visit through study completion (Timing 5), an average of 1 year.
Title
Prosthetic complications
Description
Screw (which connects the crown with the implant) fracture or prosthesis fracture, chipping of the ceramic prosthesis, loosening of the screw (which connects the crown with the implant) or any other prosthetic components.
Time Frame
Since prosthesis placement (Timing 1) through study completion (Timing 5), an average of 1 year.
Title
Bacterial leakage
Description
Quantitative PCR in real time to determine the total amount of bacteria and in particular, of 10 pathogenic species: Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythensis, Treponema denticola, Prevotella intermedia, Peptostreptococcus micros, Fusobacterium nucleatum, Campylobacter rectus, Eikenella corrodens and Candida albicans.
Time Frame
12 months after prosthesis placement.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Subjects who accept signing voluntarily the informed consent before doing any action related to the study. ≥18-years-old patients. Edentulous single spaces or edentulous posterior maxilla or mandible (from the first premolar to the second molar) with screw-retained single fixed crowns. Single implants successfully osseointegrated placed at least 16 weeks post-extraction. O'Leary plaque index and or bleeding on probing ≤25%. Dental implants with screwed-retained prosthesis. Exclusion Criteria: Systemic diseases that can interfere dental implant placement. Any contraindication for surgery procedures. Heavy smokers (> 20cig/day). Background of drug abuse or other factors such as psychiatric diseases that, in opinion of the examiner, could interfere with the ability of the patient to cooperate and compliment with the study. Patients who have had participated with another clinical trial the last 30 days. Pregnant women or in lactation. Patients with bad oral hygiene or not motivated. Probing pockets depths with bleeding of ≥4 mm on a tooth adjacent to the edentulous space. Guided bone regeneration required in the same time of the implant placement.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Laura Rubianes-Porta, DDS, MS
Phone
+34630873804
Email
od074964@uic.es
First Name & Middle Initial & Last Name or Official Title & Degree
Octavi J. Camps-Font, DDS, MS
Phone
+34665980569
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Rui Figueiredo, DDS, MS, PhD
Organizational Affiliation
University of Barcelona
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Eduard Valmaseda-Castellón, DDS, MS, PhD
Organizational Affiliation
University of Barcelona
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Octavi Camps-Font, DDS, MS
Organizational Affiliation
University of Barcelona
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Roxana Ghiorghiu, DDS, MS
Organizational Affiliation
University of Barcelona
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Laura Rubianes-Porta, DDS, MS
Organizational Affiliation
University of Barcelona
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Anna Piñol-Olea, DDS, MS
Organizational Affiliation
University of Barcelona
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Barcelona
City
L'Hospitalet De Llobregat
State/Province
Catalunya
ZIP/Postal Code
08903
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Octavi Camps-Font, DDS, MS
Phone
+34665980569
Email
occafo@gmail.com
First Name & Middle Initial & Last Name & Degree
Rui Figueiredo, DDS, MS, PhD
Phone
+34667378126
Email
ruipfigueiredo@hotmail.com
First Name & Middle Initial & Last Name & Degree
Roxana Ghiorghiu, DDS, MS
First Name & Middle Initial & Last Name & Degree
Laura Rubianes-Porta, DDS, MS
First Name & Middle Initial & Last Name & Degree
Anna Piñol-Olea, DDS, MS

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
Under request
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Influence of the Implant-prosthetic Connection in the Marginal Bone Loss and Bacterial Leakage

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