Modified Periosteal Inhibition with Simultaneous Implant Placement in Aesthetic Zone
Trial Parameters
Brief Summary
A randomized controlled clinical and radiographic trial. Twenty sites with remaining roots or non-restorable teeth in the maxillary anterior region that fulfill the inclusion criteria will be selected from the Periodontology Clinic, Faculty of Dentistry, Tanta University. These sites will be divided into two groups; each of which has ten surgical sites. After phase I therapy, a traumatic extraction of the hopeless tooth will be made trying as much as possible to preserve the labial plate of bone and overlying soft tissue. * Once the tooth is extracted, the socket is gently debrided and irrigated using sterile saline solution. Then the dental implant is placed in the best prosthetic driven position, following the guidelines for immediate implants using prefabricated computer guided surgical template. * After accurate implant placement, a full-thickness flap will be elevated at mesial and distal papilla making a buccal envelope. A bone lamina 0.5 mm thickness will be trimmed and hydrated in sterile saline solution for 30 s to soften it; it should be 1-2 mm larger and deeper than the vestibular bone.
Eligibility Criteria
Inclusion Criteria: 1. Intact labial plate of bone with thickness ≤1 mm (Socket type I). 2. Moderate to thick gingival phenotype. 3. Bone quality ranges from D2-D3 as gained from preoperative cone beam computed tomography. 4. Presence of at least 3 mm of keratinized gingiva. 5. Optimal compliance as evidenced by no missing treatment appointments and positive attitude towards oral hygiene. Exclusion Criteria: 1. Medically compromised patients and systemic conditions precluding implant and periodontal surgery. 2. Pregnant or lactating women. 3. Smoking 4. Absence of buccal plate of bone. 5. History of chemotherapy, radiotherapy in head and/or neck region. 6. Bisphosphonate therapy.