Clinical Research Directory

Diagnostic Accuracy of Large Language Models for Peri-Implant Marginal Bone Loss on Panoramic Radiographs

Dental implants are a routine treatment for missing teeth, but the number of implants affected by peri-implantitis, a progressive inflammatory disease of the tissues around implants, is increasing. The main radiographic sign of peri-implantitis is marginal bone loss around the implant. Early detection and correct grading of this bone loss in proportion to implant length are important for treatment planning and prognosis. Panoramic radiographs are widely used for general screening in dental practice, but judging bone loss on them is subjective, time-consuming and depends on the clinician's experience. Multimodal large language models (vision-language models) are increasingly able to interpret images, yet their ability to evaluate peri-implant bone loss on panoramic radiographs has not been tested. This single-center, retrospective, observational diagnostic accuracy study will evaluate how accurately five publicly available large language models (ChatGPT, Gemini, Claude, DeepSeek and Grok) detect and grade peri-implant marginal bone loss on anonymized, cropped panoramic radiographs of functionally loaded dental implants, compared with a reference standard established by three blinded clinicians (two periodontologists and one oral and maxillofacial radiologist). Bone loss will be graded with the Froum and Rosen (2012) classification: Score 0 (no visible bone loss), Score 1 (\<25% of implant length), Score 2 (25-50%) and Score 3 (\>50%). Approximately 784 implant sites (392 with and 392 without marginal bone loss) from existing panoramic radiographs in the hospital archive will be included. No new radiographs will be taken, no patient will be contacted and no treatment will be given; informed consent has been waived by the ethics committee. All images will be fully anonymized before evaluation.

Two Bovine Xenografts in Lateral Window Sinus Augmentation With or Without Bone Marrow Blood

The goal of this clinical trial is to learn whether adding a small amount of blood taken from the jawbone marrow improves new bone formation when two different bone graft materials are used in maxillary sinus lift surgery. The study includes adults aged 25 to 65 who need more bone height in the upper back jaw before receiving dental implants. The main questions it aims to answer are: * Does InterOss (a bovine bone graft material) form a similar amount of new living bone as Bio-Oss (a widely used bovine bone graft material)? * Does mixing either graft material with bone marrow blood from the lower jaw increase the amount of new living bone and the bone height gained? Researchers will compare four groups: Bio-Oss alone, InterOss alone, Bio-Oss mixed with jawbone marrow blood, and InterOss mixed with jawbone marrow blood. Each treated sinus is randomly assigned to one group. Patients treated on both sides receive a different treatment on each side. Participants will: * Have a sinus lift surgery through a small side window in the upper jaw, where the sinus floor is filled with the assigned graft material. In two of the groups, a small amount of marrow blood (about 0.5 mL) will be drawn from the lower jaw and mixed with the graft. * Have a 3D dental X-ray (cone beam CT) before surgery and 8 months after surgery to measure the bone height gained. * Have dental implants placed 8 months after the sinus lift. During this surgery, a small bone sample will be taken from the grafted area and examined under a microscope. * Receive their implant-supported teeth about 6 months later and attend yearly check-up visits with a clinical exam and X-rays.

The Application of a Biphasic Calcium Sulfate Graft Material in Sinus Floor Elevation

Pneumatization of the maxillary sinus may lead to insufficient bone volume for dental implant placement in the edentulous posterior maxilla. Sinus floor elevation (SFE) surgery with the lateral window technique is a safe and predictable surgical intervention to restore bone height in the maxillary premolar and molar areas. According to the literature, several bone graft materials may be successfully applied for SFE surgery. There is a lack of evidence regarding the application of biphasic calcium sulfate (BCS) for SFE. The healing period following staged SFE is 2-9 months. The aim of this study is: * to evaluate the success of SFE surgery using BCS as graft material, * to compare the microarchitecture of the augmented bone depending on the healing period, * to evaluate the success of dental implants placed in the augmented bone and that of the prostheses delivered on the dental implants.

Investigation of the Effect of Horizontal Platelet Rich Fibrin Placed in Tooth Extraction Sockets on Bone Formation

Dental implants, the treatment of complete and partial edentulous cases involving the restoration of lost teeth, have become a registered and widely used treatment option. Implants: It is an ideal option for the good oral health of the person who has lost his teeth due to periodontal disease, caries, trauma, or any other reason. When teeth are missing, melting occurs in the jawbone. Following tooth extraction, the loss of the implant and the amount of melting are significantly reduced. In implant treatments, which have become widely used today, successful results depend on the ideal volume and quality of hard and soft tissues. The amount of bone present in the edentulous area is important for the indication of the implant. The aim of this study is to evaluate the histological and immunohistochemical contribution of the H-PRF (horizontal-platelet rich fibrin) material placed in the extraction sockets to the quality of the newly formed bone tissue in order to make successful implants after tooth extractions for various reasons in humans. The research hypothesis is that H-PRF will contribute positively to the healing of tooth extraction sockets.

Effect of Collagen Membrane on Ridge Preservation

This study will evaluate whether adding a resorbable collagen membrane to an anorganic bone-collagen composite (ABCC) graft improves ridge preservation after tooth extraction. Ridge preservation is a procedure used to maintain the shape and volume of the jawbone following tooth removal, which is important for future dental implant placement. Participants will be randomly assigned to receive either ABCC alone or ABCC combined with a collagen membrane. Healing outcomes will be assessed after approximately 4 months using three-dimensional cone beam computed tomography (CBCT) scans. The primary outcome is the change in horizontal ridge dimension (width). Secondary outcomes include vertical and contour changes in ridge dimensions, changes in soft tissue contour assessed with digital scans, postoperative healing and complications (such as wound dehiscence, swelling, or infection), and patient-reported outcomes, including pain and satisfaction. In a subset of participants, bone healing will also be evaluated using laboratory and imaging analyses of bone samples obtained at the time of implant placement. The study will additionally assess whether the treatment allows implant placement in the ideal position without the need for further bone grafting.

Comparison of Two Dental Implant Types and Placement Depths on Bone Around the Implant in Adults Missing Back Teeth

The goal of this clinical trial was to compare two ways of placing and restoring dental implants in adults missing one or more back teeth. The main question it aimed to answer was: does a bone-level implant placed 2 mm below the bone crest, with a final abutment that is never removed, preserve more of the bone around the implant than a tissue-level implant placed at the level of the bone crest? Each implant was randomly assigned by coin toss to one of the two treatments. Researchers measured the bone level around the implants on dental X-rays at crown placement, 6 months after loading, and at a final visit 12 to 24 months after loading. They also measured two markers of inflammation (IL-1β and MMP-8) in the fluid around the implants 6 months after loading.

Melatonin Effect on Immediate Dental Implants in the Posterior Mandible

This pilot randomized controlled clinical trial aims to evaluate the feasibility, clinical safety, and preliminary radiographic osteogenic effects of applying topical 1% w/w melatonin gel during immediate implant placement in the posterior mandible. The study assesses surgical feasibility, soft-tissue healing, bone density, buccal bone thickness, and implant stability to provide preliminary effect size and variance estimates to inform future definitive clinical trials.

Biologically Oriented Alveolar Ridge Preservation (BARP) With and Without Advanced Platelet-Rich Fibrin Plus (A-PRF+)

Twenty patients were selected from the outpatient clinic of the Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Mansoura University seeking for extraction of non-restorable maxillary premolar teeth prior to delayed implant placement. Patients will be divided into 2 groups: * Group A: 10 implants were inserted after four months from extraction after socket preservation by putting two collagen sponge layers and in between deproteinized bovine bone. * Group B: 10 implants were inserted after four months after socket preservation by putting two collagen sponge and in between deproteinized bovine bone with addition of advanced PRF plus layer. * Closure of the flap was obtained without tension. Implants of all groups were immediately loaded .Some Clinical and Radiographic parameters and Histological and Volumetric evaluation were made at different time intervals along this study.

Injectable PRF in Non-Surgical Periodontal Treatment

This study aims to evaluate the clinical and microbiological effects of using injectable Platelet-Rich Fibrin (i-PRF) as an adjunct to non-surgical periodontal therapy (scaling and root planing) in patients with periodontitis. The study uses a split-mouth design where one side of the mouth receives the treatment with i-PRF and the other side receives standard treatment alone. Clinical parameters and bacterial counts will be compared at baseline, 1 month, and 3 months after intervention .

Bone and Soft Tissue Healing After Socket Preservation With NOVAMag or Permamem Membranes

After tooth extraction, the surrounding bone and soft tissue may undergo dimensional reduction. Socket preservation involves placement of a bone graft into the extraction socket and coverage with a membrane to support healing before dental implant placement. This study will compare two membranes used with the same allogeneic bone graft. One group will receive a resorbable magnesium membrane (NOVAMag), and the other group will receive a non-resorbable polytetrafluoroethylene membrane (permamem). Participants requiring tooth extraction followed by implant placement will be randomly assigned to one of the two groups. Extraction and grafting procedures will be standardized. Follow-up examinations will take place 7 days, 21 days, and 3 months after socket preservation. Soft tissue healing and postoperative complications will be assessed. Cone-beam computed tomography (CBCT) scans obtained before extraction and at 3 months will be used to evaluate changes in alveolar bone volume. During planned implant placement at 3 months, a bone sample will be collected from the treated site for microscopic examination. The study aims to compare bone and soft tissue healing between the two membrane groups.

Bone Marrow Mononuclear Cells for the Repair of Severe Maxillofacial Bone Defects

This is a single-center, single-arm, open-label clinical study conducted at the Department of Stomatology, Nanjing Drum Tower Hospital. The study aims to evaluate the safety and efficacy of autologous bone marrow-derived mononuclear cells (BMMNCs) combined with a bone graft material (Bio-Oss) for the repair of severe maxillofacial (alveolar/jaw) bone defects caused by inflammation, trauma, or other reasons. Approximately 20 patients aged 18-60 years with severe alveolar bone resorption requiring bone grafting will be enrolled. About 60 mL of autologous bone marrow will be aspirated from the iliac crest, and BMMNCs will be isolated by density-gradient centrifugation under GMP conditions without in vitro expansion. The BMMNCs will be mixed with Bio-Oss bone graft material and implanted into the bone defect, covered with a collagen membrane. Cone-beam CT (CBCT) will be performed postoperatively to assess new bone formation. Follow-up visits are scheduled at 1 week, 1 month, 3 months, and 6 months after surgery. The primary outcome is the new bone volume fraction in the grafted area measured by CBCT. Safety will be assessed by clinical examination of the implantation site and laboratory tests (blood routine, urinalysis, liver and kidney function, blood glucose).

Histological and Histomorphometric Assessment With Inflammatory Profile Analysis of Bone Tissue After Horizontal Ridge Augmentation Using Customized Porous Zirconia Shell

The goal of this clinical study is to learn whether a custom-made porous zirconia shell can support good-quality new bone when widening the lower back jaw before dental implant placement. The study includes adults whose jawbone in this area is too narrow for implants (Seibert Class I defects). The main question it aims to answer is: What is the quality of the new bone formed under a porous zirconia shell, and how much inflammation does the tissue show? Participants will: * Receive gum treatment and a CBCT scan before surgery * Have bone augmentation surgery, in which a digitally designed porous zirconia shell is fixed over a mixture of their own bone and xenograft * Return after 2 weeks for suture removal and a check of the wound * Return after 6 months for a CBCT scan, removal of the shell, collection of a small bone sample (biopsy), and dental implant placement

Autogenous Mesenchymal Stem Cell Culture-Derived Signalling Molecules as Enhancers of Bone Formation in Bone Grafting

This study aims to evaluate bone formation in grafts in terms of its quality (density), quantity (volume) and maturation obtained with the application of a tissue-engineered bone grafting compound containing concentrated autogenous cell-culture medium (CM) and a synthetic bone substitute. The present study was designed as an experimental prospective split-mouth randomized controlled clinical trial. After protocol approval by the Research Ethics Committee, a total of 20 consecutive participants in need of maxillary reconstruction aiming implant-supported oral rehabilitation will be invited to join the study. To collect autogenous adipose tissue-derived mesenchymal stem cells (hASCs), an outpatient lipoplasty procedure at the abdominal area of each patient will be performed. To isolate and expand hASCs from the lipoaspirate, specific cell culture protocols will be followed, resulting in cultured viable cells and their conditioned medium (CM). Cells and CM will be then separated by a sequence of filters and centrifugation, and isolated CM will be frozen. ELISA will analyze the presence of chemokines and their concentration in CM before grafting. Following pre-op surgical planning, both maxillary sinuses of each patient will be grafted internally applying a lateral window to each sinus. The bony floor of the test maxillary sinus will be augmented with synthetic bone substitute (BoneCeramic™ 1-2 mm) mixed with 10 to 15 ml of CM (test). The control site will receive bone substitute with saline. Lateral windows in both sinuses will be then closed with a collagen membrane (Bio-Gide™). After 6 months, first-stage implant surgery will be performed placing 6 implants in each patient. Registration of implant stability by manual torque wrench will be performed. Also, bone biopsies from each drilled implant site will be collected for histology, histomorphometry and immunohistochemistry (RT-PCR). Tomographic evaluation of the bone formation will include cone beam computed tomographies (CBCTs) at pre-operative \[Baseline\], 90 \[T1\] and 180 \[T2 = implant placement\] days for bone 3D image analysis.

Mineralized Dentin Graft Versus Beta-Tricalcium Phosphate for Alveolar Ridge Preservation

The goal of this clinical trial was to compare three ways of helping the jawbone heal after removal of a tooth. The jawbone that supports a tooth is called the alveolar ridge. This bone can become narrower after a tooth is removed. Participants were randomly assigned to one of three groups. One group received no bone graft material. One group received mineralized dentin graft made from the participant's extracted tooth. One group received beta-tricalcium phosphate, which is a synthetic bone graft material. Participants had cone-beam computed tomography, a three-dimensional dental X-ray, immediately after tooth removal and again after 6 months. During dental implant placement at 6 months, researchers collected a small bone sample to examine healing.

Ultrasound for Socket Healing Evaluation

The design is a single blinded, dual comparative study of ultrasound versus micro-CT/LASCA in one study group. Up to a total of 140 subjects registered will be recruited. Subjects who are treatment planned for extraction of a hopeless tooth and socket augmentation with bone graft and are planned for a dental implant surgery. The socket will be evaluated before the extraction and multi-time points during healing until an implant is placed with various evaluation tools, including ultrasound.

Guided Bone Regeneration Combined With PRGF for Atrophic Edentulous Maxilla

This prospective interventional clinical study evaluated guided bone regeneration combined with plasma rich in growth factors for vertical and horizontal augmentation of the atrophic edentulous maxilla. Participants with severe maxillary ridge atrophy requiring bone augmentation before implant-supported rehabilitation underwent guided bone regeneration using a composite graft of autogenous bone and anorganic bovine bone mineral combined with plasma rich in growth factors. Barrier membranes were stabilised with titanium pins, and lateral-window sinus floor elevation was performed when indicated. Implants were placed using a delayed protocol at re-entry after 6-9 months. Radiographic bone height and width were assessed by cone-beam computed tomography before surgery, immediately after surgery, at 6-9 months, and at 12 months. The study also recorded graft dimensional stability, implant placement, and surgical or postoperative complications.

Immediate Molar Implants With Customized Healing Abutments in Different Post-Extraction Socket Classes

Immediate implant placement into a fresh extraction socket shortens overall treatment time and reduces the number of surgical procedures, but the fit between the implant and the socket walls, and the resulting soft-tissue contour, differ substantially between socket types. This study evaluates immediate implant placement in the molar and posterior region combined with an individually fabricated (customized) healing abutment, or sulcus former, that seals the socket and shapes the emergence profile from the day of surgery. Consecutive patients with a non-restorable posterior tooth are treated with flapless atraumatic extraction, immediate implant placement, grafting of the residual gap, and a chairside customized healing abutment fabricated on a titanium temporary abutment. Participants are grouped by the class of the post-extraction socket (A, B or C) according to the interradicular septal bone available for primary stability. Outcomes are preservation of peri-implant soft-tissue volume assessed with an intraoral scanner, preservation of alveolar bone volume assessed on cone-beam computed tomography, implant stability measured by resonance frequency analysis (ISQ) at placement and before loading, and time to definitive loading. Early wound healing on the Landry index, the degree of bone corticalization before loading, implant survival, healing-abutment complications and analgesic requirement are also recorded.

Autogenous Dentin Graft for Alveolar Ridge Preservatio

When a tooth is extracted, the bone around the empty socket naturally shrinks over time, which can make it difficult to place a dental implant later without additional bone-building procedures. This study investigated whether grafting the socket with the patient's own extracted tooth material, processed into a graft (autogenous dentin graft), can help preserve this bone. The study also examined whether adding platelet-rich fibrin (PRF), a concentrate prepared from the patient's own blood that is rich in healing factors, could further improve outcomes. A total of 56 extraction sockets were randomly assigned to one of four treatment approaches: no grafting (natural healing), dentin graft alone, dentin graft combined with PRF, or a freeze-dried bone allograft, which is a commonly used bone substitute for comparison. Four months after treatment, small bone samples were taken from each site at the time of dental implant placement and examined under the microscope to measure how much new bone had formed, along with other markers of healing such as blood vessel formation and a bone-growth protein called BMP-2. The results showed that sockets treated with dentin graft healed at least as well as those treated with the standard bone substitute, and that combining dentin graft with PRF produced the best healing results of all groups tested. These findings suggest that a patient's own extracted tooth, which would otherwise be discarded, may serve as an effective and low-cost graft material for preserving bone after tooth extraction, particularly when combined with PRF.

VST vs Modified Periosteal Inhibition Technique

Losing a tooth in the upper front of the mouth is common, and many people choose a dental implant to replace it. When a tooth is removed, the thin layer of bone in front of the socket - the buccal, or front, bone - often shrinks as the area heals. If this bone shrinks, the final implant can look less natural and the gum can recede. The problem is greater when part of the front bone is already missing at the time the tooth is taken out; this type of socket is harder to treat. This study compares two surgical techniques that aim to protect the front bone and gum while a dental implant is placed on the same day the tooth is removed. In Vestibular Socket Therapy (VST), a thin bone membrane is inserted through a small incision high in the gum fold to cover the front bone, and bone graft material is packed into the socket. In Modified Periosteal Inhibition (MPI), a thin bone membrane is placed against the outside of the front bone and held in place with a tissue glue, and the socket is filled with a collagen sponge. Adults aged 20 to 50 with a non-restorable upper front tooth (canine to canine) and partial loss of the front bone can take part. Participants are randomly assigned to one of the two techniques and receive an implant immediately after the tooth is removed, then are followed for 12 months. Using cone-beam CT scans, intraoral scans, and an esthetic (appearance) score taken at the start and at 6 and 12 months, the investigators measure the thickness of the front bone, the level and thickness of the gum around the implant, and the overall appearance. The study tests whether one technique preserves or increases the thickness of the front bone and produces better gum and esthetic results than the other.

Simultaneous Implant Placement With Vertical and Horizontal Bone Augmentation

The purpose of this study was to report the clinical and radiographical outcomes of using autogenous cortical bone plates combined with sticky allogenic bone graft for augmenting maxillary anterior atrophic combined horizontal and vertical ridge defects with simultaneous versus staged implant placement.

THBC/CGF for Alveolar Bone Regeneration: A Real-World Study

This study aims to combine real-world research with relevant bone repair materials and techniques to improve alveolar bone resorption in extraction sockets following impacted wisdom tooth removal, while achieving effective bone preservation or promoting bone regeneration. All eligible cases within specified parameters will be included in the clinical study scope. Based on real-world clinical data, we will proactively collect postoperative clinical examination findings and imaging data. Statistical analysis will be performed on clinical outcomes and follow-up data from patients undergoing mandibular impacted M3 extraction. The study aims to clarify the therapeutic efficacy of the thermosensitive hydroxyethylchitosan-loaded concentrated growth factor group in repairing mesial bone defects of M2s following M3 extraction.

Alveolar Ridge Preservation (ARP) in the Posterior Maxilla After the Extraction of Maxillary Molars

Dental implants are a fixed replacement solution with reported long-term survival rates between 94-98% over 20-40 years. In order to ensure successful implant therapy, adequate bone and soft tissue as well as correct 3D positioning of the implant are required. Upon extraction of a tooth, socket width can decrease by up to 60% within six months post-extraction, with a 11-22% vertical reduction. Additionally, sinus pneumatization occurs post-extraction as the maxillary sinus expands into the empty socket due to disuse atrophy and intra-sinus air pressure, as explained by Wolff's law. This further reduces residual bone height (RBH), often resulting in posterior maxillary sites requiring supplemental procedures to prevent bone loss or to augment the bone height at the time of implant placement. However, if the bone height and width dimensions are sufficient before and after extraction - in that, even with the aforementioned loss in width and height percentages in the latter, a standard implant may still be placed in the surrounding bone, one can argue that grafting may not be necessarily done at the time of extraction. Rather, it can be tailored to the patients' needs; thus potentially reducing overall post-operative discomfort and pain.

Demineralized Dentin Allograft Versus Demineralized Dentin Autograft for Socket Preservation

This study is designed to evaluate and compare clinically and radiographically the effectiveness of Demineralized Dentin Allograft (DDA) versus Demineralized Dentin Autograft (Auto-DD) for preservation of alveolar ridge dimensions after surgical extraction of the impacted mandibular third molar.

Crestal Sinus Lifting in Periodontally-Compromised Patients Utilizing Autologous Dentin Graft

The integration of artificial intelligence and computer-guided technology offers the potential for improving surgical accuracy, reducing complications, and enhancing outcomes. Additionally, advancements such as electromagnetic mallets for bone manipulation and autologous dentin grafts provide promising alternatives for bone regeneration. This study aims to combine these technologies to assess the efficacy and clinical outcomes of AI-assisted, computer-guided crestal sinus lifting with immediate implant placement in periodontally compromised sites.