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24 patienta with non restorable anterior teeth underwent extraction with immediate implant installation using bone grafts either autogenous tooth bone graft or allogenic bone graft Autogenous tooth bone graft group (study group): 12 patients will have immediate implant placement with autogenous tooth bone graft.
• Allogeneic bone graft group (control group): 12 patients will have immediate implant placement with allogeneic bone graft (demineralized freeze dried bone allograft - cortico cancellous).
24 patienta with non restorable anterior teeth underwent extraction with immediate implant installation randomized to two groups Autogenous tooth bone graft group (study group): 12 patients will have immediate implant placement with autogenous tooth bone graft.
• Allogeneic bone graft group (control group): 12 patients will have immediate implant placement with allogeneic bone graft (demineralized freeze dried bone allograft - cortico cancellous).
preparation of autogenous tooth bone graft Any restorations, caries, cementum, periodontal ligament and pulp tissue will be removed .The tooth will be grinded using dental bone mill and bone crusher Tooth particles will be sieved to particles size 300 to 1200 microns. The sorted particles will be immersed in 70 % ethanol and 5% Peracetic acid* in a sterile container for 10 minutes to remove any soft tissue remnants, bacteria and smear layer (defatting and sterilization).
Tooth particles will be demineralized using 2% HNO3for 20 minutes to expose the dentine organic matrix.
The bacteria-free particulate dentin will be washed with phosphate buffered saline‡ twice for 5 minutes to restore the PH balance to 7.4. In the same setting, surgical procedure after atraumatic extraction immediate implant willbe inserted according to dimensions taken from CBCT and jumbing gap will be filled with bone graft according to randomization
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Autogenous tooth bone graft group | Experimental | Twelve patients receiving immediate implant placement with autogenous fresh partially demineralized dentin graft. |
|
| Allogeneic bone graft group (control group) | Active Comparator | Patients receiving immediate dental implant placement with allogeneic bone graft (DFDBA) for grafting of the jumping gap. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| immediate implant with allogenic bone graft | Procedure | after atraumatic extraction immediate implant will be inserted with allogenic bone graft |
|
| Measure | Description | Time Frame |
|---|---|---|
| labial bone thickness | measuring thickness of labial bone labial to the implant | 6 months |
| marginal bone loss | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| bone density around dental implant | bone density will be assessed using CBCT buccal to the implant fixtures 6 months after implant installation | 6 months |
| implant secondary stability | Implant stability will be assessed at the time of implant insertion and 6 months after the operation. Resonance frequency analysis (RFA) values expressed as implant stability quotient (ISQ) will be recorded by a transducer attached to the implant by a screw and a frequencyresponse analyzer (Osstell Mentor Device) with the average of 2measurements performed with the probe in 2 perpendiculardirections |
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Inclusion Criteria:
Patients with non restorable maxillary anterior teeth need to be extracted.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| diab abdelgaied diab, master | faculty of dentistry tanta university | Principal Investigator |
| Rafic ramadan bedir, professor | faculty of dentistry tanta university | Principal Investigator |
| Ibrahim mohammed nowair, professor | faculty of dentistry tanta university | Principal Investigator |
| Mona samy sheta, lecturer | faculty of dentistry tanta university | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of Dentistry | Tanta | 3111 | Egypt |
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non restorable anterior teeth with thin labial plate of bone
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| Allogeneic bone graft with immediate implant placement | Procedure | Immediate dental implant placement with grafting of the jumping gap using allogeneic bone graft (DFDBA). |
|
| 6 months |
| implant success | when the following clinical features arise: emerging of the fistula, the particle of the bone graft material flow out from the fistula or mucosal dehiscence, and the chronic inflammation ragarded as failure | 6 months |