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Marginal Bone Changes in Fixed All-on-Four Mandibular Prosthesis Using OT Bridge Attachment System

Primary Purpose

Edentulous Jaw

Status
Not yet recruiting
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
patients reciveing all on 4 fixed mandibular prosthesis usimg conventionally screw retained multiunit abutments
all on 4 fixed mandibular prosthesis using OTbridge attachment system
Sponsored by
Cairo University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Edentulous Jaw focused on measuring OTbridge attachment, ALL ON 4, fixed supported implant prosthesis, conventional screw retained fixed prosthesis

Eligibility Criteria

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

Inclusion Criteria: Patients with completely edentulous patients Aged 40 years or older. Sufficient inter -arch space not less than 13 mm. Good oral hygiene Minimum bone height 10 mm and minimum bone diameter should be 6 mm Exclusion Criteria: General contraindications for oral surgery Heavy smokers (greater than 20 cigarettes a Local acute or chronic infections Substance abuse (drugs or alcohol) Patients with neuromuscular or psychiatric disorders. Treatment with intravenous bisphosphonates Irradiation of the neck or head area in the past 5 years Diabetic patients (HbA1c>7.5%)

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Active Comparator

    Experimental

    Arm Label

    All-on-four fixed mandibular prosthesis using conventionally screw retained multiunit abutments.

    All-on-four fixed mandibular prosthesis using OT bridge attachment system

    Arm Description

    Edentulous patients receiving All-on-four fixed mandibular prosthesis using conventionally screw retained multiunit abutments.

    Edentulous patients receiving All-on-four fixed mandibular prosthesis using OT bridge attachment system

    Outcomes

    Primary Outcome Measures

    marginal bone loss
    Radiographic follow up will be performed for marginal bone changes. Serial of standardized digital periapical radiographs using; long cone paralleling technique, XCP periapical film holder and an individually constructed radiographic acrylic template will be taken at the time fixed prosthesis insertion (baseline), 3,6,9,12 months. The software of the Digora system will be used for evaluation of the marginal bone changes. Lines parallel to the long axis of the mesial and distal surface of each abutment will be made. The distance in mm from the crest of alveolar bone to the apex of the tooth will be measured and the marginal bone changes in the subsequent measurements will be calculated.

    Secondary Outcome Measures

    prosthetic complications
    Type and incidence of prosthetic complications for the prothesis for each group will be evaluated in 3, 6,9 and 12 months, these complications included: loosening or fracture of the prosthetic screw, prosthesis mobility and fracture of the prosthesis

    Full Information

    First Posted
    June 6, 2023
    Last Updated
    September 4, 2023
    Sponsor
    Cairo University
    Collaborators
    British University In Egypt
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05924386
    Brief Title
    Marginal Bone Changes in Fixed All-on-Four Mandibular Prosthesis Using OT Bridge Attachment System
    Official Title
    Marginal Bone Changes in Fixed All-on-Four Mandibular Prosthesis Using OT Bridge Attachment System Versus Conventionally Screw Retained Multiunit Abutments: A Randomized Clinical Trial
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    December 1, 2023 (Anticipated)
    Primary Completion Date
    December 31, 2023 (Anticipated)
    Study Completion Date
    December 31, 2025 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Cairo University
    Collaborators
    British University In Egypt

    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
    Group I (control) Edentulous mandible receiving all on four fixed mandibular prosthesis using conventionally screw retained multiunit abutments. Group II (intervention) Edentulous mandible receiving all on four fixed prostheses using OT bridge attachments system. For both groups, the implant sites will be prepared aided by the surgical template. 4 implants with length 11-13 mm will be placed, two anterior implants will be aligned in an axial orientation and two posterior implants will be distally aligned according to the all-on-four concept in the inter foraminal area. Implants will be ideally placed at bone level. For both groups: After implant placement and surgical guide removal, healing abutments ( will be connected during healing periods (eight to twelve weeks). Group I ( control) After eight to twelve weeks from implant placement, multiunit abutments with appropriate heights and angulations will be connected to the implants. Group II ( intervention) After eight to twelve weeks from implant placement, narrow- and low-profile OT Equator abutment will be screwed onto the implants according to the manufacturer. marginal bone changes and prosthetic complications are the outcomes Radiographic follow up will be performed for marginal bone changes Serial of standardized digital periapical radiographs using will be taken at the time fixed prosthesis insertion (baseline), 3,6,9,12 months. Type and incidence of prosthetic complications for the prothesis for each group will be evaluated in 3, 6,9 and 12 months, these complications included: loosening or fracture of the prosthetic screw, prosthesis mobility and fracture of the prosthesis.
    Detailed Description
    Interventions will be conducted by principal investigator (N.O) General operative procedures: Eligible patients will be selected from outpatient clinic in prosthodontic department clinic. Patients Will be informed of the research work and informed consent will be obtained from each patient. Only motivated patients who show cooperation and has all the included criteria will be into the study. Group I (Control): Edentulous mandible receiving all on four fixed mandibular prosthesis using conventionally screw retained multiunit abutments. Group II (intervention): Edentulous mandible receiving all on four fixed prostheses using OT bridge attachments system. For both groups, a lower removable complete denture will be constructed for each eligible patient. The lower denture will be duplicated into clear acrylic resin which will be modified with radiopaque markers at the proposed implant sites. This clear stent will function as the scan appliance for CBCT scan for detecting the bone high and width, and for implant planning. Surgical phase: All patients in both groups will receive prophylactic antibiotic therapy: 2 g of amoxicillin (or clindamycin 600 mg if allergic to penicillin) 1 h before the intervention and rinse with chlorhexidine mouthwash 0.2% for one minute prior to the intervention. The implants will be placed with a fully surgical guided template, under local anesthesia (artcaine with adrenaline 1:100,000), and according to the manufacturer's instructions. For both groups, the implant sites will be prepared aided by the surgical template. 4 implants (Neobiotech Co., Ltd, Korea) with length 11-13mm will be placed, two anterior implants will be aligned in an axial orientation and two posterior implants will be distally aligned according to the all-on-four concept in the inter foraminal area. The standard sequence of the osteotomy site preparation will be followed to accommodate the selected implant size. Implants will be ideally placed at bone level. Page 12 of 22 Group I: After implant placement and surgical guide removal, screwed healing abutments ((Neobiotech Co., Ltd, Korea) will be connected during healing periods (eight to twelve weeks). Group II: After implant placement and surgical guide removal, screwed healing abutments of (Rhien'83) will be connected during the healing period (eight to twelve weeks). After the surgical procedures end, all the patients will receive drugs prescription, oral and written recommendations about the correct oral hygiene maintenance and diet. Prosthetic phase: Group I: After eight to twelve weeks from implant placement, multiunit abutments (Neo-biotech) with appropriate heights and angulations will be connected to the implants. Impressions will be taken using open tray impression technique for construction of framework superstructure, a posterior cantilever extended to the first molar tooth. The passivity of the metallic framework will be validated intraorally by means of using the single screw test. The non-passive fit will be corrected by sectioning and soldering. The acrylic veneering of the metal superstructure will be made. Group II: After eight to twelve weeks from implant placement, narrow- and low-profile OT Equator abutments (Rhein'83, Bologna, Italy) will be screwed onto the implants according to the manufacturer. The trans-mucosal height of the abutments will be chosen based on the soft tissue thickness and implant depth. Impressions will be taken using open tray impression technique for construction of framework superstructure a posterior cantilever extended to the first molar tooth. the cast framework superstructure splinting all implants will be constructed after placing the acetal rings (Seeger system, Rhein'83) between the subequatorial area of the OT Equators (Rhein'83) and the cylindrical "extra grade" framework connections. Then the prosthesis will be screwed twice at 20 N For both groups, occlusion will be checked using articulating paper for any occlusal interferences, and patients will be enrolled in a strictly follow-up protocol including occlusal adjustment and hygiene maintenance every 3 months. Outcomes: Primary outcome Marginal bone loss will be measured by using periapical X-ray with parallel technique (Digora system), unit of measurment is Millimeter. Prosthetic complications as: Loosening of prosthetic screw Fracture of prosthetic screw Prosthesis fracture These outcomes are Binary and will be measure if incidence of complication happened or not by using (Yes/No). Primary outcome:Radiographic follow up will be performed for marginal bone changes. Serial of standardized digital periapical radiographs using; long cone paralleling technique, XCP periapical film holder and an individually constructed radiographic acrylic template will be taken at the time fixed prosthesis insertion (baseline), 3,6,9,12 months. The software of the Digora system will be used for evaluation of the marginal bone changes. Lines parallel to the long axis of the mesial and distal surface of each abutment will be made. The distance in mm from the crest of alveolar bone to the apex of the tooth will be measured and the marginal bone changes in the subsequent measurements will be calculated. Secondary outcome: Type and incidence of prosthetic complications for the prothesis for each group will be evaluated in 3, 6,9 and 12 months, these complications included: loosening or fracture of the prosthetic screw, prosthesis mobility and fracture of the prosthesis.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Edentulous Jaw
    Keywords
    OTbridge attachment, ALL ON 4, fixed supported implant prosthesis, conventional screw retained fixed prosthesis

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Model Description
    edentulous patients
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    20 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    All-on-four fixed mandibular prosthesis using conventionally screw retained multiunit abutments.
    Arm Type
    Active Comparator
    Arm Description
    Edentulous patients receiving All-on-four fixed mandibular prosthesis using conventionally screw retained multiunit abutments.
    Arm Title
    All-on-four fixed mandibular prosthesis using OT bridge attachment system
    Arm Type
    Experimental
    Arm Description
    Edentulous patients receiving All-on-four fixed mandibular prosthesis using OT bridge attachment system
    Intervention Type
    Procedure
    Intervention Name(s)
    patients reciveing all on 4 fixed mandibular prosthesis usimg conventionally screw retained multiunit abutments
    Intervention Description
    Multiunit abutments is considered a gold standard screw retained abutments. Multi-unit abutments are used to correct for varying heights among the implants, to establish a level restorative platform for the prosthesis, as well as to situate the implant connection even with or just below the gingival surface. Also they are used to correct the angulation of implants, helping to keep the screw access holes away from the facial surfaces of the restoration, and facilitate the path of insertion of prosthesis.
    Intervention Type
    Procedure
    Intervention Name(s)
    all on 4 fixed mandibular prosthesis using OTbridge attachment system
    Intervention Description
    The OT bridge attachment system introduced by (Rhein 83) is a global, well-established system used in the removable prosthetic protocols, the presence of seeger acetal ring placed between the sub-equatorial area of the OT Equator and the cylindrical "Extragrade" abutment compensates the space between the extragrade abutment and the OT equator attachment correcting the minor misalignments that produced during the prosthetic procedure and resulting in more passive fit.
    Primary Outcome Measure Information:
    Title
    marginal bone loss
    Description
    Radiographic follow up will be performed for marginal bone changes. Serial of standardized digital periapical radiographs using; long cone paralleling technique, XCP periapical film holder and an individually constructed radiographic acrylic template will be taken at the time fixed prosthesis insertion (baseline), 3,6,9,12 months. The software of the Digora system will be used for evaluation of the marginal bone changes. Lines parallel to the long axis of the mesial and distal surface of each abutment will be made. The distance in mm from the crest of alveolar bone to the apex of the tooth will be measured and the marginal bone changes in the subsequent measurements will be calculated.
    Time Frame
    1 year follow up
    Secondary Outcome Measure Information:
    Title
    prosthetic complications
    Description
    Type and incidence of prosthetic complications for the prothesis for each group will be evaluated in 3, 6,9 and 12 months, these complications included: loosening or fracture of the prosthetic screw, prosthesis mobility and fracture of the prosthesis
    Time Frame
    1 year follow up

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    40 Years
    Accepts Healthy Volunteers
    Accepts Healthy Volunteers
    Eligibility Criteria
    Inclusion Criteria: Patients with completely edentulous patients Aged 40 years or older. Sufficient inter -arch space not less than 13 mm. Good oral hygiene Minimum bone height 10 mm and minimum bone diameter should be 6 mm Exclusion Criteria: General contraindications for oral surgery Heavy smokers (greater than 20 cigarettes a Local acute or chronic infections Substance abuse (drugs or alcohol) Patients with neuromuscular or psychiatric disorders. Treatment with intravenous bisphosphonates Irradiation of the neck or head area in the past 5 years Diabetic patients (HbA1c>7.5%)
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    nesma O elmosallamy
    Phone
    02001007702271
    Email
    nesma.osama@dentistry.edu.eg
    First Name & Middle Initial & Last Name or Official Title & Degree
    nada O elmosallamy
    Phone
    02001000107914
    Email
    nesma.elmosallamy@bue.edu.eg
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    nesma O elmosallamy
    Organizational Affiliation
    CAIRO UNIVERISTY
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No

    Learn more about this trial

    Marginal Bone Changes in Fixed All-on-Four Mandibular Prosthesis Using OT Bridge Attachment System

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