Association of Implant Position and Crown Contour With Tissue Health
Study Details
Study Description
Brief Summary
Emergence profile and crown contour of implant supported rehabilitation, which is influenced by implant position, is associated with peri-implant health and esthetic outcomes. However, there is no study prospectively explore the association between implant position, emergence profile/crown contour, and dental implant outcomes. Thus, the present study aims to (1) assess the multivariate association between local factors and peri-implant soft-tissue health, inflammation, and microbiome; and (2) to identify patterns/clusters of implant characteristics significantly associated with health or inflammation.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Detailed Description
This will be a prospective study aimed at associating the development of peri-implant mucosal inflammation (mucositis) and deeper inflammation (peri-implantitis with marginal bone loss) with features associated with implant position (three-dimensional position of the implant platform) and the consequent shape of the crown contour and emergence profile. The hypothesis is that implant position determines the shape of the crown, which in turn determines the persistence of a local microbial biofilm as unfavourable crown contours hamper oral hygiene efforts aimed at biofilm control/removal. The persistence of a biofilm will cause soft tissue inflammation, which may lead to microbial dysbiosis and disease.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Dental implant rehabilitation Patients having undergone dental implant treatment, with a single implant-supported restoration in anterior jaws (premolars to premolars), will be included. |
Outcome Measures
Primary Outcome Measures
- Changes in bleeding on probing [Changes over six months, 1, 2, and 3 years after final crown insertion.]
Peri-implant probing will be performed with light (∼25 g) force using UNC-15 periodontal probe, at six sites (mesio- buccal, buccal, disto-buccal, mesio-lingual, lingual, disto-lingual) per implant. At each site, presence of bleeding will be recorded.
Secondary Outcome Measures
- Changes in cytokine level in peri-implant crevicular fluid [Changes over six months, 1, 2, and 3 years after final crown insertion.]
Peri-implant crevicular fluid will be collected and level of inflammatory cytokines will be analyzed using commercial enzyme-linked immunosorbent assays (ELISAs) kits.
- Changes in composition of microbiome in sub-gingival plaque sample [Changes over six months, 1, 2, and 3 years after final crown insertion.]
Sub-gingival plaque sample will be collected. Composition of microbiome in sub-gingival plaque samples will be assessed by 16sRNA technique.
- Marginal bone level change [Chenges over Six months, 1, 2, and 3 years after final crown insertion.]
Marginal bone level change will be measured on periapical radiograph using parallel technique. The uppermost end of bone-to-implant contact will be recorded as marginal bone level. Implant will be used as reference.
- Buccal soft tissue level change [Changes over six months, 1, 2, and 3 years after final crown insertion.]
Intra-oral scan taken at different follow-up time points will be superimposed. Buccal soft tissue level will be recorded and the change will be measured.
- Papilla height change [Changes over six months, 1, 2, and 3 years after final crown insertion.]
Intra-oral scan taken at different follow-up time points will be superimposed. Papilla height will be recorded and the change will be measured.
Eligibility Criteria
Criteria
Inclusion Criteria:
Patients with a single implant-supported restoration in anterior jaws (premolars to premolars), with adjacent natural teeth, with pre-surgery CBCT and intra-oral scans, and willing to comply with research appointments/schedule.
Exclusion Criteria:
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Pregnancy or intention to become pregnant at any point during the study duration;
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With any systematic diseases/conditions that are contradictions to dental implant treatment;
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Inability or unwillingness of individual to give written informed consent.
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Inability of follow-up according to the protocol.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University | Shanghai | Shanghai | China | 200011 |
Sponsors and Collaborators
- Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University
Investigators
- Principal Investigator: Maurizio Tonetti, DMD, Shanghai Ninth People Hospital
Study Documents (Full-Text)
None provided.More Information
Publications
- Chan D, Pelekos G, Ho D, Cortellini P, Tonetti MS. The depth of the implant mucosal tunnel modifies the development and resolution of experimental peri-implant mucositis: A case-control study. J Clin Periodontol. 2019 Feb;46(2):248-255. doi: 10.1111/jcpe.13066. Epub 2019 Feb 7.
- Katafuchi M, Weinstein BF, Leroux BG, Chen YW, Daubert DM. Restoration contour is a risk indicator for peri-implantitis: A cross-sectional radiographic analysis. J Clin Periodontol. 2018 Feb;45(2):225-232. doi: 10.1111/jcpe.12829. Epub 2017 Dec 5.
- Tonetti MS, Jung RE, Avila-Ortiz G, Blanco J, Cosyn J, Fickl S, Figuero E, Goldstein M, Graziani F, Madianos P, Molina A, Nart J, Salvi GE, Sanz-Martin I, Thoma D, Van Assche N, Vignoletti F. Management of the extraction socket and timing of implant placement: Consensus report and clinical recommendations of group 3 of the XV European Workshop in Periodontology. J Clin Periodontol. 2019 Jun;46 Suppl 21:183-194. doi: 10.1111/jcpe.13131.
- Yi Y, Koo KT, Schwarz F, Ben Amara H, Heo SJ. Association of prosthetic features and peri-implantitis: A cross-sectional study. J Clin Periodontol. 2020 Mar;47(3):392-403. doi: 10.1111/jcpe.13251. Epub 2020 Jan 21.
- SH9H-2022-T296