Comparison of Synthetic Bone Substitute and a Bovine-derived Xenograft in Horizontal Bone Augmentation

A Randomised Controlled Spilt-mouth Clinical Study Comparing a Synthetic Bone Substitute and a Bovine-derived Xenograft in Primarily Horizontal Bone Augmentation Procedure During Placement of Straumann Oral Implants

The objective of the study is to test the efficacy on bone formation of Straumann Bone Ceramic as a grafting material applied in buccal bone dehiscences on simultaneously placed oral implants.

This is a randomized, controlled, split mouth, prospective, single centre study. The total study duration for each patient should be 76 weeks +/-18 months.

In total 8 visits per patient are scheduled in this study.

The study devices Straumann Bone Ceramic and Bio-Oss are CE-marked, and approved by the FDA. The products are used within the indication.

One center in Beligum will participate.

Inclusion Criteria:

• Males and females, 18 years to 80 years of age
• At least two missing teeth up to full edentulous arches.
• Desiring implant supported restorations.
• Both study implants should have a self-containing (2-wall) buccal dehiscence defect after oral implant placement (at least 3.0 mm / max. 5.0 mm defect in apico-coronal aspect to be measured from the boarder of the rough surface of the oral implant to the bottom of the defect).
• At least 4mm of the implant, measured from the apical end to the lowest margin of the bone level, should be covered with bone.
• Sufficient bone volume such that both oral implants will not encroach on vital structures and primary stability of the oral implant can be achieved;
• Patients must be committed to the study and must sign informed consent.
• Patient in good general health as documented by self assessment;
• Full mouth plaque score of <20%;

Exclusion Criteria:

• Any systemic medical condition that could interfere with the surgical procedure or planned treatment;
• Current pregnancy or breast feeding/ lactating at the time of recruitment;
• Physical handicaps that would interfere with the ability to perform adequate oral hygiene;
• Alcoholism or chronically drug abuse causing systemic compromise.
• Patients who smoke more than 20 cigarettes per day.
• Conditions or circumstances, in the opinion of the investigator, which could represent a general contra-indication for surgical procedure or would prevent completion of study participation or interfere with analysis of study results, such as history of non-compliance, or unreliability
• Lack of primary stability of 1 or both implant(s) at surgery, measured by hand testing. In this instance the patient must be withdrawn and treated accordingly.
• Mucosal diseases such as erosive lichen planus
• History of local radiation therapy.
• Presence of osseous pathologies.
• Presence of oral lesions (such as ulceration, malignancy)
• Severe bruxing or clenching habits.
• Local inflammation, including untreated periodontitis.
• Bone surgery at the implant site(s) (bone grafts, guided tissue regeneration techniques for bone enhancement) prior to implant placement unless performed more than 6 months prior to implant placement.
• Patients presenting clinical and radiological signs and symptoms of maxillary sinus disease.
• Existing teeth in the residual dentition with untreated endodontic pathologies.
• Patients with inadequate oral hygiene or unmotivated for adequate home care