Clinical Research Directory

Computer Guided Simultaneous Implant Placement With Tri-cortical Ridge Augmentation Using Chin Cortical Bone Struts in Anterior Atrophic Maxilla: A Case Series

10 patients having deficient anterior maxilla will be recruited and a preoperative CBCT will be done to evaluate the vertical and horizontal dimensions of the intended alveolar ridge. pre-operative manufacturing of the digital surgical guides performed for Harvesting of the chin cortical bone struts from the symphysial area in the donor site and for Placement of the grafted cortical bone struts and the implant in the recipient site. Intra operatively the donor site (Chin) will be prepared to harvest autogenous bone from the chin aided by the patient's prefabricated bone harvesting guide. The recipient site (Maxillary anterior defect) will be prepared to receive the chin grafts. Grafts will be screwed in position and implants will be screwed in its preparation until it gains primary stability from basal bone, using the prefabricated bone fixation-implant placement guide. Any gaps will be filled with autogenous bone particulates from the chin. A healing tie base Abutment will be screwed into the implant through the third cortex. Primary stability will be assessed using Osstell device. An immediate postoperative CBCT will be done and superimposed on the preoperative CBCT to measure accuracy of plan transfer to make sure the planning was followed accurately. Follow up after 6 months and CBCT will be done for bone formation and density assessment and implant exposure for implant stability measurement-using osstell and removal Healing abutment and consecutive prosthetic loading.

Shell Technique for Implant Site Development

The goal of this clinical trial is to learn if shell technique is useful for implant placement site preparation in adults. The main questions it aims to answer are: Does using xenograft in this technique can reduce the amount of bone harvested from intra oral sites and reduce postoperative complications while offering enough bone to support endosseous implants with long term success? Researchers will compare autogenous bone blocks to xenograft bone blocks in the shell technique ridge augmentation. Participants will undergo ridge augmentation surgery, then have implants placed in the augmented area, then receive implant supported restorations afterwards.

Autogenous Sticky Bone Plus Platelet-rich Fibrin Membrane Versus Xenograft With Collagen Membrane for Posterior Atrophic Mandible

Background: Teeth loss in the posterior mandible initiates residual ridge resorption, this causes difficulty in implant placement so ridge augmentation must be done either simultaneous with implant placement or in a staged approach Aim: To evaluate the effect of autogenous sticky bone with PRF membrane and xenograft with collagen membrane with simultaneous implant placement clinically on primary and secondary implant stability, and radiographically on bucco-lingual width gain, bone density and crestal bone loss

Evaluation of Free Gingival Graft Timing

This clinical trial aims to compare and evaluate the clinical outcomes between two distinct treatment sequences: free gingival graft surgery preceding guided bone regeneration and guided bone regeneration followed by free gingival graft.

Magnesium NOVAMag® Membrane vs. Collagen Jason® Membrane in Patients Requiring Guided Bone Regeneration

The NOVAMag® membrane is a medical device approved in the EU, and is a completely resorbable and biodegradable metal membrane. This medical device is used in the treatment of bone defects in the oral cavity. The membrane ensures sufficient stability of the bone augmentation material and provides a barrier to the soft tissue. This enables new bone to form in the defect space and for the subsequent placement of dental implants. In this clinical trial, the NOVAMag® membrane is compared with the Jason® collagen membrane, another medical device for supporting bone regeneration, with the aim of demonstrating the non-inferiority in terms of radiographically measured volumetric bone gain of the NOVAMag® membrane to the comparator membrane.

Safety and Performance, and Dose, of OsteoAdapt DE in Localized Alveolar Ridge Augmentations

This study's objective is to evaluate OsteoAdapt DE's safety and performance in comparison to Xenograft particulate bone graft for alveolar ridge augmentation. Additionally, the study aims to optimize OsteoAdapt DE dosing for future studies by assessing two concentrations: a low dose (0.8 mg/cc) and a high dose (2.0 mg/cc).

One Stage Ridge Splitting Using 2 Different Techniques in Maxilla

* The selected patients will be informed of the nature of the research work and informed consent will be obtained. * Patients of both groups will be subjected to CBCT. * Intra operative procedures (for both groups) followed by CBCT will be taken for every patient after 4 months. * Infiltration local anesthesia will be given to the patient (Articaine 4% 1:100 000 epinephrine) Both the study and control group will receive: * In Recipient site, full thickness mucoperiosteal flap pyramidal flap, reflection using mucoperiosteal elevator. * The defective site is reevaluated. * Flap advancement inorder to allow tension free flap closure. * In the Study group: Piezo surgery bone inserts is used to cut crestal osteotomies. * In the Control group: Bone discs diameter is used. * Followed by, the use of bone chisels. * The point and pilot implant drills are used followed by bone expanders. Based on the preexisting bone, the defect morphology and bone quality. The implant is submerged below the alveolar crest to compensate for crestal bone resorption. * Following partial immobilization of the buccal bone segment either book or island pattern. The fixture is inserted submerged below the alveolar bone crest. Followed by bone smoothening and roundation under external saline irrigation at recommended speed of 38000rpm and gear ratio 1:1 calibrated on fesiodespenser. * Xenogenic bone particle size of 0.5 mm to 1mm is going to be condensed into the dead space. * Recheck adequate flap advancement to allow tension free closure. * Double line closure using horizontal mattress followed by interrupted sutures to allow contact area and wound edge eversion.

One Stage Ridge Splitting Using 2 Different Techniques in the Posterior Mandible

The selected patients will be informed of the nature of the research work and informed consent will be obtained. The control group ridge splitting with simultaneous implants using the conventional technique and study group ridge splitting with simultaneous implants using the piezo surgery. * Pre operative procedures Patients of both groups will be subjected to CBCT. * Intra operative procedures (for both groups) followed by CBCT will be taken for every patient after 4 months. * Infiltration local anesthesia will be given to the patient (Articaine 4% 1:100 000 epinephrine). Both the study and control group will receive: * In Recipient site, incision of full thickness mucoperiosteal flap inorder to obtain, three-line pyramidal flap, followed by flap reflection. * The defective site is reevaluated. * Flap advancement using periosteal releasing incision. * In the Study group: Piezo surgery bone inserts are used. * In the Control group: Bone discs diameter are used. * Followed by bone chisels. * The point and pilot implant drills are used followed by the sequential use of bone expanders. Based on the preexisting bone, the defect morphology and bone quality. The implant is submerged below the alveolar crest. * The fixture is inserted submerged below the alveolar bone crest followed by bone smoothening and roundation under external saline irrigation at recommended speed of 38000rpm and gear ratio 1:1 calibrated on fesiodespenser. * Xenogenic bone particle size of 0.5 mm to 1mm is going to be condensed into the dead space. * Recheck adequate flap advancement. * Double line closure using horizontal mattress sutures followed by interrupted sutures on top to allow contact area and wound edge eversion.

Reconstruction of Deficient Atrophic Ridges Using Guide Bone Regeneration Technique

patients will be informed of the nature of the research work and informed consent will be obtained then randomized in 2 groups. Mixture 1:1 autogenous and xenogenic bone covered with Polytetrafluoroethylene membrane control group and study group p covered with native collagen membrane. * Patients of both groups will be subjected to CBCT (diagnostic for upper arch), diagnostic wax-up and stent fabrication. * Intra operative procedures (for both groups) followed by CBCT will be taken for every patient after 4 months. Both the study and control group will receive: * In Recipient site, using 15C blade on Bard Parker handle incision of full thickness mucoperiosteal flap inorder to obtain, three-line pyramidal flap, reflection using mucoperiosteal elevator molt 9. * The defective site is reevaluated after its primary evaluation on CBCT using UNC (University of North Carolina) periodontal probe and a template is cut using sterile suture pack, prior to donor site preparation. * Flap advancement using periosteal releasing incision inorder to allow later tension free flap closure. * In Donor site, mucoperiosteal flap is done, auto chip maker (ACM) is used for autogenous bone harvesting. * Autogenous particulate bone graft is obtained using auto chip maker bur (ACM), in implant contra 20:1 using surgical motor recommended drilling speed 100 rpm and maximum torque 50 Ncm. as well as, using bone scrapper in push direction. * Xenogenic bone graft particles (De-proteinized bovine bone mineral small granules (0.25-1 mm). is added to the autogenous bone particles to obtain homogenous mixture ratio 1:1. * The gold standard is a mixture of autogenous bone containing viable cells and xenogenic bone which has slower rate of resorption is to be placed in recipient decorticated site and covered by PTFE membrane. * The assemble is to be fixed by titanium bone tacks of diameter 2.5 mm and length 3.5 mm, to avoid micro movements of particulate bone assembly. * In the Study group: The assemble is going to be covered by resorbable collagen membrane and fixed by tacks. * Recheck adequate flap advancement by visualizing passive flap approximation, to allow tension free closure. * Double line closure using horizontal mattress placed 5mm away from flap margins followed by interrupted sutures on top to allow contact area which is preferred to point contact and wound edge eversion.

Ridge Augmentation Treatment Using OSSIX® BREEZE vs Jason®

This is a prospective randomized controlled parallel trial. The aim of this study is to evaluate bone formation and soft tissue healing after 4 and 8 months in patients with ridge deficiencies in simultaneous implantation approach. The trial will compare a (sugar cross linked) - SCL pericardium membrane OSSIX® Breeze vs native pericardium membrane (Jason®).

Guided Bone Regeneration With and Without the Use of Intra-marrow Penetrations

The primary aims of this study are to compare, after 6 months, the clinical and histologic results of intra-marrow penetrations vs no intra-marrow penetrations when performing guided bone regeneration procedures.