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.

Effect of Povidone Iodine on the Dental Implant Internal Surface Microbiome

We hope to learn if applying antiseptic to the inside of a dental implant will decrease or alter the types of bacteria inside it which may then decrease the incidence of implant failure associated with bone loss, infection, and other complications. During your implant placement appointment, an antiseptic (povidone iodine) will be applied to the inside one of your two new dental implants, no antiseptic will be applied to your other dental implant (this is what would occur if you choose not to participate in this study), before covering both of them with a cover screw or healing abutment. You will return to the Madigan Oral \& Maxillofacial Surgery Clinic 3-6 months later when your implant hardware is removed a swab of the implants internal cavities will be collected. Your participation in this research will last up to 6 months and require one additional minute during both your implant placement and hardware removal appointments.

Using Superimposition of Intra-Oral Scan and CBCT in Single Implant Restorations in Aesthetic Zone.

This study will be performed to evaluate patients'satisfaction and aesthetic outcomes of single implant restorations in aesthetic zone by using superimposition of intra-oral scan and CBCT.

Lactoferrin Nanohydrogel for Soft And Hard Tissue Healing and Implant Stability in Immediate Implant Placement

The goal of this randomized clinical trial is to evaluate whether local application of a 4% bovine lactoferrin nanohydrogel improves soft tissue healing, bone healing, and implant stability following immediate dental implant placement in mandibular molar sites. The main questions it aims to answer are: Does the use of a Lactoferrin Nano-Hydrogel in combination with healing abutments enhance bone and soft tissue regeneration, reduce peri-implant inflammation, and improve the success rate of immediate implant placement in mandibular molars compared to conventional healing methods? Researchers will compare immediate implant placement with local application of the 4% bovine lactoferrin nanohydrogel to the same surgical procedure without the nanohydrogel to evaluate differences in bone healing, marginal bone levels, implant stability, soft tissue healing, clinical inflammation, and postoperative pain.

Serum S1P Levels and Dental Implant Osseointegration in Patients

This retrospective study aims to investigate whether a specific substance in the blood, called Sphingosine-1-Phosphate (S1P), is related to the degree of osseointegration around dental implants. We will review the medical records of 20 patients who have already completed their dental implant surgery and standard follow-up. The S1P levels will be measured using leftover blood samples from their routine preoperative examinations. By analyzing their existing dental x-ray images (CBCT) taken before surgery and during their routine 3-month follow-up, we will evaluate the osseointegration and implant stability. Ultimately, we hope to find out if measuring S1P levels from routine blood tests can help predict the quality of osseointegration after getting dental implants.

Quality of Life, Nutritional Status and Aesthetics in Patients Rehabilitated With FP1 Full-Arch Reconstructions

The World Health Organization defines quality of life as "a state of physical, mental, and social well-being"; therefore, it is important to consider the patient holistically, taking into account social function and the ability to meet basic needs, such as the ability to eat and pain control. In this context, oral health plays a key role in patient well-being, as it is essential for communication, chewing, nutrition, and aesthetics. The loss of teeth-whether extracted due to periodontal disease or caries-can cause masticatory, phonetic, and aesthetic impairments, which are considered factors contributing to a decline in quality of life. The loss of natural teeth compromises masticatory function, making appropriate prosthetic rehabilitation essential to restore oral function and improve quality of life.

Multi-Evaluation of Dental Abutments With Different Surfaces

The placement of dental implants has been a routine procedure for the rehabilitation of fully or partially edentulous patients for nearly 40 years. Dental abutments are intermediary components that connect prosthetic teeth to the implants after healing. Depending on the properties of the abutment material, plaque accumulation and bacterial adhesion may lead to inflammation and bone loss in peri-implant tissues. Developed by Nobel Biocare, the Xeal™ abutment surface protects the underlying bone, supports stable soft tissue integration, and has been shown to reduce marginal bone loss and promote healthier mucosa compared to machined abutments. However, previous studies have mostly relied on clinical and radiographic evaluations, without three-dimensional evaluation or microbiological analysis. This study aimed to evaluate peri-implant marginal bone loss (MBL), digital evaluation of peri-implant soft tissue, and differences in the microbial composition of the oral microflora colonizing the soft tissue/abutment interface between Multi-unit Abutments Xeal™ and conventional titanium multi-unit abutments placed in the posterior region.

Clinical and Radiographic Comparison of Two Implant-Abutment Connections

The aim of this clinical study is to evaluate two different implant-abutment connection design on preserves gingiva and bone health in the long term. As part of this study, two different implant systems will be applied to the posterior edentulous areas on both sides of the mouth. Implants featuring a new macro-design and a special surface technology (TiUltra surface and N1 system), aimed at accelerating tissue healing, will be placed in one area; meanwhile, implants with a conical design and the same special surface technology, which are widely used in clinical practice (Nobel Active), will be placed in the other area. Procedure for Participants First, an intraoral examination will be performed, and CBCT will be taken to assess suitability for the procedure. Surgical Procedure: Implant placement. Prosthetic Phase: Once healing is complete, impressions will be taken, and porcelain teeth will be placed on the implants. Follow-up Appointments: Follow-ups will be conducted at 1, 3, 6, and 12 months following the placement of the teeth. During these check-ups, gingiva health will be assessed, and X-rays will be taken to observe changes in bone levels.

The General Aim is to Implement Clinical Assessment of Overload by Voluntary Bite Force Registration to Enable Future Simple But Precise Risk Assessment to Provide Individualized Treatment Plans.

The general aim of this clinical trial is to implement clinical assessment of overload by bite force registration to enable future simple but precise risk assessment to provide individualized treatment plans. The main questions it aims to answer are: * Can we risk-assess patients regarding overload based on bite force measurement before dental implant treatment? * Can we profile patients based on bite force to tailor precise dental implant treatment for individual patients? * Will this profiling lead to improved prognosis by reduced number of technical and/or biological complications? Participants with dental implant prostheses get their bite force measured and followed every year up to 10 years to see complications.

Immediate vs Conventional Loading With Different Crown Materials on Immediately Placed Single Implants

This randomized controlled trial compares immediate and conventional loading of single implants placed immediately into fresh extraction sockets in the upper front and premolar region. Eighty adults will be randomly assigned to four groups: immediate loading (within 48 hours) with a definitive zirconia crown, a permanent printed PMMA crown, or a temporary printed PMMA crown, or conventional loading with a definitive zirconia crown after 3 months. All implants are placed with a fully guided digital workflow.

Effect of Vitamin D3 Supplementation on Serum Sphingosine-1-Phosphate Levels and Dental Implant Osseointegration: A Prospective Study

This study aims to evaluate whether vitamin D3 supplementation can promote dental implant osseointegration by increasing serum sphingosine-1-phosphate (S1P) levels. Sixty patients scheduled for dental implant surgery between July 2025 and December 2026 will be enrolled. Before surgery, baseline clinical data, cone-beam computed tomography (CBCT) imaging data, and blood samples for serum S1P measurement by ELISA will be collected. Based on baseline S1P levels, 40 patients with low S1P levels will be selected and randomized into a control group and an intervention group, with the intervention group receiving daily vitamin D3 supplementation (800 IU) from immediately after surgery until 3 months postoperatively. At the 3-month follow-up, CBCT images will be acquired again and compared with baseline to assess osseointegration, implant stability will be evaluated by measuring implant stability quotient (ISQ) values, and serum S1P levels will be re-measured. Statistical analysis will be performed using R software. The primary endpoint is the effect of vitamin D3 supplementation on dental implant osseointegration, while secondary endpoints include changes in serum S1P levels, implant stability (ISQ), and safety.

Assessing Current Clinical Concepts in Dental Practice

This purpose of this database is to collect, store and use appropriately derived data from routine patient care in a specialist dental practice. Comprehensive observational data will be gathered, systematically organised and be continuously updated. This data will be used to evaluate treatment outcomes and identify areas for improvement. This will contribute to the existing evidence base to validate new and current clinical concepts in dentistry. Patient consent will be sought for this, and all data extracted from patient notes will be stored and used anonymously. Use of the Oral Health Impact Profile (OHIP) -14 questionnaire pre and post treatment will be used to assess patient satisfaction with outcomes.

Assessment of Early Healing Period of Dental Implants

This prospective cohort study aimed to evaluate, clinically, radiographically, and digitally, the volumetric changes occurring during the early healing period after implant treatment in patients with tooth loss in the posterior regions of the jaws, focusing on the processes of osseointegration and biological width formation.

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.

Do Immediate Digital Workflows Increase Patient Value?

This two-center randomized controlled trial will evaluate whether an immediate digital posterior implant workflow provides greater patient-defined value than a delayed digital workflow in adults requiring single posterior implant rehabilitation. Participants will be randomized 1:1 to immediate implant placement at the time of tooth extraction or to delayed implant placement after approximately 16 weeks of healing following extraction and ridge preservation as indicated. The primary endpoint is oral health-related quality of life assessed longitudinally using the OHIP-14 questionnaire and analyzed as the model-based mean score averaged across the active treatment phase from baseline through definitive crown delivery. Secondary outcomes include workflow-related patient experience, chairside time, number of visits, postoperative pain, buccal contour changes based on intraoral scan-derived volumetric analysis, radiographic marginal bone level changes, implant survival, clinical peri-implant parameters, technical complications, esthetic outcomes, accuracy of guided implant placement, and clinician-reported workflow outcomes.

Randomized Clinical Study Comparing Two Guided Surgery Techniques for Free-end Implant Placement

This is a randomized multicenter clinical study that compares two static guided surgery techniques in free-end partial edentulism. The aim is to compare the accuracy obtained between dento-osseous supported and dento-mucosal supported surgical splints to place dental implants in posterior osseous ridges.

Artificial Intelligence-Guided Versus Manual CBCT Planning for Immediate Implant Placement

This study evaluates whether artificial intelligence (AI)-based analysis of cone-beam computed tomography (CBCT) scans can support clinical decision-making for immediate dental implant placement in molar extraction sites. When a molar tooth is removed, placing a dental implant immediately may reduce treatment time and preserve surrounding bone. However, immediate implant placement is not always possible and depends on the anatomy of the extraction socket, particularly the interradicular septum (the bone between the roots). CBCT imaging is routinely used to assess this anatomy before surgery. Traditionally, radiologists manually evaluate these scans. Recently, AI-based tools have been developed to automatically analyze CBCT images. In this randomized controlled trial, patients requiring molar extraction and potential immediate implant placement will be assigned to one of two planning approaches: AI-guided CBCT assessment or conventional manual CBCT assessment. The operating surgeon will use the assigned planning report to guide treatment decisions. The primary outcome of the study is the feasibility of immediate implant placement, defined as successful implant placement with achievement of primary stability during surgery. Secondary outcomes include surgical time, need for changes to the treatment plan, and implant stability measurements. The goal of this study is to determine whether AI-assisted CBCT analysis performs similarly to, or improves upon, conventional manual radiologic assessment in supporting safe and effective immediate implant placement.

To Compare the Two Implant Placement Protocols to Evaluate Placement Accuracy and Post-operative Healing of the Implant

The goal of this study is to evaluate two commonly utilized surgical guide protocols to determine dental implant placement accuracy compared to pre-operative computerized planning, post-operative healing and bone levels to 12-months post-placement, and patient assessed post-operative discomfort and healing using a visual acuity scale (VAS).

Effect of Bone Graft Material ON Peri-Implant Phenotype .

This prospective three-arm controlled interventional clinical study evaluates the effects of NanoBone alone and NanoBone combined with platelet-rich fibrin (PRF) on peri-implant hard and soft tissue phenotype after dental implant placement. Thirty-nine adult participants requiring dental implant therapy will be assigned to three groups of 13 using a repeating sequential 1-2-3 allocation sequence: implant placement alone (control), implant placement with NanoBone, or implant placement with NanoBone and PRF/CGF membrane. Clinical and radiographic outcomes will be assessed at baseline, immediately after surgery, 8 weeks after surgery, and 4 months after surgery, with an early postoperative assessment of pain, swelling, medication use, and wound healing.

Clinical and Patient-reported Outcomes of Guided Versus Freehand Harvesting Of Positioning of Autogenous Bone Shells

When people lose teeth or have gum disease, the jawbone can shrink over time. This shrinkage makes it difficult for dentists to place dental implants because implants need a strong and stable base of bone. To solve this problem, surgeons often use bone grafting techniques. One of the most reliable ways to rebuild lost bone is called the autogenous shell technique. In this method, very thin plates of bone are taken from another part of the patient's mouth, shaped into a "shell," and fixed into place at the site where bone is missing. The empty space inside the shell is then filled with tiny bone chips, and the whole graft heals into strong new bone over time. Once healed, implants can be placed securely. This technique has been widely studied and is considered highly effective. However, it is not easy to perform. Traditionally, the shells are harvested and positioned by hand, relying heavily on the skill and experience of the surgeon. Even very experienced clinicians face challenges: the shells can break if cut too thin, positioning may take a long time, and results can vary from patient to patient. Patients also report significant discomfort after surgery, including swelling, pain, and difficulty eating and speaking during recovery. In recent years, digital technology has begun to transform oral surgery. Using 3D imaging and computer design, it is now possible to create custom surgical guides and positioning jigs. These guides are printed with 3D printers and act like templates, helping surgeons cut bone in exactly the right size and shape, and place it precisely in the planned position. In implant dentistry, such guides are already used for the accurate placement of dental implants, and studies show they can make surgery faster and safer. However, little is known about whether these guides also improve patient comfort and recovery when used in bone grafting procedures such as the shell technique. This clinical trial has been designed to answer that question. It compares two groups of patients who need vertical bone augmentation before implant placement: Guided group: Patients treated with 3D-printed surgical guides for harvesting and positioning bone shells. Freehand group: Patients treated with the conventional freehand shell technique without guides. By studying both groups, the trial aims to determine whether guided surgery reduces pain, swelling, and recovery problems, and whether it saves time in the operating room. Most importantly, it seeks to put patients' voices at the center by focusing on patient-reported outcome measures (PROMs)-direct feedback from patients about how they feel after the procedure.

Multicenter Clinical Study on the Efficacy and Esthetic Outcomes of Immediate Implant Placement Using the Socket-Shield Technique Versus Conventional Immediate Implantation in the Anterior Maxillary Esthetic Zone

This study plans to enroll no fewer than 48 adult patients who have non-restorable maxillary anterior teeth due to trauma or dental diseases and are candidates for immediate implant placement, meeting the inclusion and exclusion criteria.

Flapless Mini-incision Implant Surgery

evaluate the clinical efficacy of the flapless mini-incision method compared to conventional flap and flapless punch methods

Effect of Cover Screws and Healing Abutments on Marginal Bone Loss

This randomized clinical trial aims to compare the effects of using a cover screw or a healing abutment during dental implant placement on short-term marginal bone loss. Participants receiving dental implants will be randomly assigned to either the cover screw group or the healing abutment group. Marginal bone levels around the implants will be evaluated radiographically at baseline and at the 3-month follow-up. The study aims to determine whether the healing approach used at the time of implant placement affects marginal bone level changes during the early healing period.

Influence of Timing of Implant Placement on Early Healing Molecular Events

Dental implants have been on the market for several years and they are routinely used to replace single/multiple missing teeth with a high success rate. However, there is still a limited number of studies comparing the influence of timing of implant placement on wound healing. In addition, there is no data available on the signaling pathways and the expression of healing biomarkers involved in the early stages of osseointegration after immediate implant placement (IP) or delayed implant placement (DP). The primary objective of this study is to describe changes in the expression of inflammatory, angiogenesis and osseous biomarkers of saliva at 1, 3, 7, 15 and 30 days and of PICF at 3, 7, 15 and 30 days after immediate implant placement (IP) compared with delayed placement (DP).