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This randomized clinical trial compares three peri-implant jumping gap management approaches following fully guided immediate implant placement in the maxillary esthetic zone. Clinical and digital outcomes will be evaluated after immediate provisionalization and final restoration.
Seventy two patients will be randomly assigned to receive no graft, silicate-added β-TCP putty, or extended sticky bone for jumping gap management around immediately placed implants. A CAD/CAM provisional crown will be delivered immediately, and the final prosthesis will be placed after 3 months.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control group | Experimental | Fully guided immediate implant placement with an ungrafted peri-implant jumping gap and immediate CAD/CAM provisionalization. |
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| Study Group 1 (Si-β-TCP Putty Group) | Experimental | Fully guided immediate implant placement with a peri-implant jumping gap filled using silicate-added β-TCP putty and immediate CAD/CAM provisionalization. |
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| Study Group 2 (Extended Sticky Bone Group) | Experimental | Fully guided immediate implant placement with a peri-implant jumping gap filled using extended sticky bone and immediate CAD/CAM provisionalization. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| No Grafting | Procedure | The peri-implant jumping gap was managed without grafting. |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Implant Stability | Implant stability will be evaluated using Osstell device based on resonance frequency analysis (ISQ values). | Immediate post-operative, 3 months, and 6 months. |
| Hard Tissue (Peri-implant bone) | Marginal bone loss will be assessed using CBCT measured in mm. | - Immediately after implant placement - 6 months after implant placement. |
| Measure | Description | Time Frame |
|---|---|---|
| Soft Tissue | Soft tissue contour and peri-implant tissue condition will be assessed using digital intraoral scanning (STL files) using superimposition and modified sulcus bleeding index (mSBI). | Baseline, 1 month, 3 months, and 6 months. |
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Inclusion Criteria:
1) Patients with non-restorable teeth in maxillary esthetic zone requiring dental extraction.
2) Age range: from18 to 50 years. 3) Adequate inter-arch relation and inter-occlusal space to accommodate the prosthetic restoration.
4) Jumping gap more than 2mm. 5) Patients with good oral hygiene. 6) Patients willing to participate in the study's follow-up intervals.
Exclusion Criteria:
1) Patients with any pathological lesion or aggressive periodontal disease at the planned surgical site impaired the immediate implant placement.
2) Alcohol or drug abuse. 3) Smokers. 4) Patients with systemic diseases that absolutely contraindicate implant placement (bleeding disorders, immunosuppression,…etc.) 5) Pregnancy. 6) Patients with para-functional habits (bruxism and clenching). 7) Lack of motivation or inability to maintain good oral hygiene.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of Dentistry Mansoura University | Al Mansurah | Dakahlia Governorate | Egypt |
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| Silicate-Added β-TCP Putty |
| Procedure |
The peri-implant jumping gap was managed using silicate-added β-TCP putty. |
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| Extended Sticky Bone | Procedure | The peri-implant jumping gap was managed using extended sticky bone. |
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