RecruitingNot ApplicableNCT07080710

State of the Art Immediate Implant Placement in the Premaxilla

A Clinical Study on Immediate Implant Placement in the Premaxilla With Flapless Guided Surgery, Hard and Soft Tissue Augmentation and Immediate Provisionalization

Sponsor

University Ghent

Enrollment

50 participants

Start Date

Jul 1, 2025

Study Type

INTERVENTIONAL

Conditions

Bone Resorption

Summary

The goal of this clinical study is to learn how well immediate implant placement works in the front upper jaw (premaxilla) when using flapless guided surgery, hard and soft tissue augmentation, and immediate provisional crowns. It will also learn about the safety and esthetic results of this treatment approach. The main questions it aims to answer are: Primary: How much buccal bone thickness remains one year after implant placement 1mm below the implant shoulder? Secondary: * How do patients rate pain, healing, and esthetics after treatment? * Are there any complications over the course of five years? * How much buccal bone thickness remains one year after implant placement 3mm and 5mm below the implant shoulder? * Marginal bone loss at one-year and five-year follow-up? * Peri-implant health at one-year and five-year follow-up? * Soft tissue changes at one-year and five-year follow-up? Researchers will compare treatment results in patients with intact bone sockets to those with damaged (non-intact) sockets. Participants will: * Receive a dental implant and temporary crown on the same day as the tooth extraction * Undergo guided, flapless surgery with bone and soft tissue grafting * Take antibiotics and anti-inflammatories for 4 days after surgery * Visit the clinic at 1 week, 3 months, 1 year, and 5 years for follow-up exams * Have X-rays, digital scans, and photos taken to measure bone and soft tissue changes * Answer questions about pain and esthetic satisfaction

Eligibility

Min Age: 20 Years

Inclusion Criteria5

At least 20 years old
Good oral hygiene defined as full-mouth plaque score ≤ 25%
Presence of one or more incisors, cuspids or premolars in the maxilla that need to be extracted for any reason with at least one neighboring tooth present
At least 3 mm bone available at the apical or palatal aspect of the alveoli as assessed on a three-dimensional radiograph to ensure primary implant stability
Written informed consent.

Exclusion Criteria6

Pregnancy (will be explicitly asked)
Systemic diseases
Smoking; suppuration
\> 1 mm gingival asymmetry between the failing teeth and contralateral teeth
Failing teeth outside the bone envelop as assessed on a three-dimensional radiograph
Untreated periodontal disease; untreated caries lesions.

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Interventions

PROCEDUREImmediate implant placement

Immediate implant placement with socket grafting and soft tissue augmentation. In cases with a buccal dehiscence \>3mm only this technique is applied. In cases with a buccal dehiscence between 4-6mm a collagen membrane is applied prior to socket grafting. In cases with a buccal dehiscence \> 6 mm, a collagen membrane is also applied and a mixture of C-DBBM and autogenous bone chips (1:1 ratio) is used as grafting material.