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Trial registered on ANZCTR
Registration number
ACTRN12623000206628
Ethics application status
Approved
Date submitted
13/02/2023
Date registered
27/02/2023
Date last updated
27/02/2023
Date data sharing statement initially provided
27/02/2023
Type of registration
Prospectively registered
Titles & IDs
Public title
The influence of increasing mucosal (gum) thickness around dental implants in reducing early bone loss, in patients with limited mucosal thickness
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Scientific title
The effect of vertical soft tissue augmentation with volume-stable collagen matrix on marginal bone levels around bone-level implants in thin mucosal tissue phenotype
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Secondary ID [1]
308532
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Dental implant early marginal bone loss
328383
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Condition category
Condition code
Oral and Gastrointestinal
325412
325412
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants with thin mucosa (thin mucosal phenotype) receiving dental implant therapy to replace missing molar or premolar teeth will be randomised to 1 of 2 groups. Group 2 will receive implant placement with the placement of a soft tissue substitute (Geistlich Fibro-Gide®) which is an addition to the standard of care with the aim to increase the mucosal thickness. The procedures will be performed by either specialist periodontists or dentists currently specialising in periodontics who will be under the supervision of specialist periodontists. This will occur within a public oral health centre and private practice. The placement of the soft tissue substitute is anticipated to be approximately 5 minutes with a similar appointment length to routine dental implant placement (approximately 90 minutes).
Implant restoration will occur ~10-14 weeks following implant placement which allows adequate time for integration of the implant. The implant will be restored following either a conventional impression or digital intra-oral scan of the implant (at the discretion of the treating clinician) to allow fabrication of a screw retained ceramic crown which will be inserted at a separate appointment following fabrication of the custom crown. These appointments are anticipated to be approximately 30-45 minutes in duration.
Participants will then be reviewed at ~6 months and ~12 months following placement of the implant restoration during routine follow-ups to assess changes in the bone level around these implants (appointment duration ~30 minutes). Radiographs and clinical notes from all appointments will be documented within the participants secure profile.
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Intervention code [1]
324983
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Treatment: Devices
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Intervention code [2]
324984
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Prevention
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Comparator / control treatment
The control arm includes those participants randomised to Group 1 who will receive implant placement as usual (standard care), without the additional placement of a soft tissue substitute material to augment the thickness of the mucosa
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Control group
Active
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Outcomes
Primary outcome [1]
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Assess differences in radiographic marginal bone level changes up to 12 months following restoration of bone level implants between augmented and non-augmented sites, measured in millimetres comparing parallel x-rays (periapical radiographs)
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Assessment method [1]
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Timepoint [1]
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Baseline- implant placement
10-14 weeks from baseline- implant restoration
37-41 weeks from baseline- ~6 months following restoration
63-67 weeks from baseline- ~12 months following restoration
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Secondary outcome [1]
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Assess differences in volumetric soft tissue changes using intra-oral scans up to 12 months following restoration of bone level implants between augmented and non-augmented sites
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Assessment method [1]
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Timepoint [1]
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Baseline- implant placement
10-14 weeks from baseline- implant restoration
37-41 weeks from baseline- ~6 months following restoration
63-67 weeks from baseline- ~12 months following restoration
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Eligibility
Key inclusion criteria
Inclusion Criteria
• 18 years or older
• Missing molar or premolar tooth in the lower or upper jaw with enough space for dental implant placement
• Gums less than or equal to 2mm thick at the potential implant site
• Sufficient volume of bone for implant placement without the need for bone grafting
• Placement of the implant at least 3 months after removal of the tooth (Type III-IV implant placement)
• Medically and periodontally (absence of uncontrolled gum disease) healthy
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Exclusion Criteria
• Poor oral hygiene (Plaque Index >30%)
• Untreated or poorly maintained gum disease (periodontitis)
• Systemic illness or medications which may compromise healing (e.g. uncontrolled diabetes)
• Current smokers (more than 10 cigarettes daily)
• Pregnancy and breast-feeding females
• Inability to give informed consent
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation will be concealed in opaque envelopes which will only be opened following placement of the dental implant
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomisation
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
A sample size of 34 participants has been calculated allowing for a 10% drop out rate using G power analysis with an effect size of 0.7 based on previous clinical studies, a error= 0.05 and power= 95% . The statistical analysis will be carried out using 2-way analysis of variance (ANOVA) with confidence at 95% and statistical significance set at p<0.05. The statistical unit will be mean values and standard deviations.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/03/2023
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Actual
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Date of last participant enrolment
Anticipated
30/09/2023
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Actual
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Date of last data collection
Anticipated
31/12/2024
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Actual
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Sample size
Target
34
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment postcode(s) [1]
39088
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4006 - Herston
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Recruitment postcode(s) [2]
39089
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4000 - Brisbane
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Recruitment postcode(s) [3]
39090
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4122 - Mount Gravatt
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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The University of Queensland
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Address [1]
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St Lucia Campus, St Lucia 4072 QLD
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Country [1]
312777
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Australia
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Primary sponsor type
University
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Name
The University of Queensland
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Address
St Lucia Campus, St Lucia 4072 QLD
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
314409
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Address [1]
314409
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Country [1]
314409
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
312070
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Metro South Human Research Ethics Committee
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Ethics committee address [1]
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Level 7, Translational Research Institute Building Princess Alexandra Hospital Ipswich Road, Woolloongabba Qld 4102
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Ethics committee country [1]
312070
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Australia
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Date submitted for ethics approval [1]
312070
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15/08/2022
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Approval date [1]
312070
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16/11/2022
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Ethics approval number [1]
312070
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HREC/2022/QMS/86844
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Summary
Brief summary
The primary purpose of this research is to evaluate potential benefits of thickening the soft tissue (gums) that surround dental implants, by placing a soft tissue substitute at the time of implant placement. The application of the soft tissue substitute may minimise the amount of bone loss that occurs following implant placement in the presence of thin soft tissue/gums (known as thin mucosal phenotype). Thin mucosal phenotype is observed when the thickness of the soft tissue (gums) at the planned implant site is 2mm or less. It has been demonstrated that a minimum thickness of the gums is required around dental implants, if this is not present loss of bone may occur around the shoulder/collar of the implant (the part of the implant closest to the surface), This occurs to accommodate an increase in thickness of the gums. This study is evaluating the differences in marginal bone level changes which occur in the first 12 months after the implant is restored (a crown is placed on the implant), in sites which receive a soft tissue substitute at the time of implant placement (group 2), compared to sites which receive implant placement alone (group 1- this is the usual treatment approach). Study participants will be randomised to one of these treatment groups.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Ryan Lee
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Address
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University of Queensland- School of Dentistry
288 Herston Rd, Herston QLD 4006
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Country
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Australia
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Phone
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+61 7 336 58013
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Daniel McKenzie
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Address
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University of Queensland- School of Dentistry
288 Herston Road, Herston QLD 4006
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Country
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Australia
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Phone
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+61 7 3365 8019
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Daniel McKenzie
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Address
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University of Queensland- School of Dentistry
288 Herston Road, Herston QLD 4006
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Country
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Australia
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Phone
123360
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+61 7 3365 8019
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Fax
123360
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Email
123360
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Raw data will not be published, only data for primary and secondary outcomes of the study will be published
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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