NCT04022538

Evaluation of Vertical Height in Anterior Maxillary Sandwich Osteotomy: Simultaneous Versus Delayed Implant Placement

Evaluation of Vertical Bone Augmentation Using Anterior Maxillary Segmental Sandwich Osteotomy: Simultaneous Versus Delayed Implant Placement, A Randomized Controlled Trial

• Status: Unknown
• Phase: N/A
• Study type: Interventional
• Enrollment: 20 (estimated)
• Sponsor: Cairo University · Academic / Other
• Sex: All
• Age: 20 Years – 55 Years
• Healthy volunteers: Accepted

Summary

Vertical bone height has always presented challenge for the clinicians especially in the anterior aesthetic zone. Therefore, this trial will attempt to compare whether better vertical bone height and implant placement technique can be achieved using simultaneous implant placement with the sandwich osteotomy, which is a time saving procedure performed in a single stage surgery; when compared to using fixation plates to support the segment followed by delayed implant placement.

Detailed description

Fixation plates are usually used to support the segmentalized bone segment during vertical bone augmentation using sandwich osteotomy and inlay bone grafting; to minimize movement of the bone segment and allow for new bone formation. Therefore, the aim of this study is to evaluate vertical bone height achieved at the anterior maxilla in vertical segmental sandwich osteotomy with simultaneous implant placement versus the same technique using fixation plates. Description of Sandwich Osteotomy procedure to be done: * A full thickness pyramidal flap with buccal paracrestal incision and two vertical releasing incisions slightly divergent to each other will be made. Then the mucoperiosteal flap will be reflected exposing the whole buccal cortical plate without reflection of the palatal mucosa. * The palatal mucosa will not be reflected to avoid disturbance of blood supply to the mobilized segment for proper healing. * With a Tungsten carbide disc - 1 mm in thickness and 10 mm in diameter - the alveolar bone will be segmented using a horizontal cut 3 to 5 mm apical to the crest of the ridge, and two lateral vertically oblique cuts 1-2 mm away from adjacent teeth roots slightly converging toward the alveolar crest or almost parallel to each other; thus creating a trapezoid-shaped bone segment pedicled on the attached palatal tissues. * The horizontal and the two vertical cuts will then be revised using a set of graduated ridge splitting (fine chisels) osteotomes of sequential width and a light weight mallet to ensure that the surgical cuts are down to spongy bone. * The segment will then be mobilized crestally, pedicled on the non-reflected palatal tissue.

Conditions

• Alveolar Bone Resorption

Interventions

Type	Name	Description
PROCEDURE	Anterior maxillary vertical segmental sandwich osteotomy with simultaneous implant placement	Following the Sandwich Osteotomy procedure described in the study description, the following steps will be done: * The first implant osteotomy will be prepared and placed while a chisel is placed between the down fractured segment and the basal bone, and then the second implant will be installed. * The gap between the transported segment and the basal bone will be filled with xenograft particulate bone substitute. * Finally, periosteal scoring will be done to allow tension-free interrupted closure using 3-0 vicryl suturing material.
PROCEDURE	Anterior maxillary vertical segmental sandwich osteotomy using micro-plates fixation	Following the Sandwich Osteotomy procedure described in the study description, the following steps will be done: * The created gap between the transported segment and the basal bone will be filled with xenograft particulate bone substitute. * The mobilized segment is to be fixed to the basal bone using micro-plates and micro-screws. * Finally, periosteal scoring will be done to allow tension-free interrupted closure using 3-0 vicryl suturing material.

Timeline

• Start date: 2019-07-01
• Primary completion: 2020-07-01
• Completion: 2020-08-01
• First posted: 2019-07-17
• Last updated: 2019-07-17