Advanced X-Ray Technology for Dental Implants

Overseen By Charles Powell, DDS, MS

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: The University of Texas Health Science Center at San Antonio

Must not be taking: Bone metabolism drugs

Disqualifiers: Maxillary sinus disease, Diabetes, Pregnancy, others

No Placebo Group

Approved in 3 Jurisdictions

Trial Summary

What is the purpose of this trial?

The goal of this clinical study is to learn if cone beam computed tomography (CBCT) or 3-dimensional x-ray can help to let the investigator know if dental implant placement can be done after performing closed sinus surgery. The study will look at the structure of your gum where the implant will be placed after performing the surgery using 3-D x-ray and compare that to how the structure of your gum looks 6 months later. The 3-D imaging will happen after standard of care surgery to prepare your gum for an implant and then 6 months later to verify that the site is ready for the implant.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but you cannot participate if you use medications that affect bone metabolism.

What data supports the effectiveness of the treatment Advanced X-Ray Technology for Dental Implants?

Research shows that transcrestal sinus lift procedures, which are part of this treatment, are well established and can provide advantages such as predictable bone augmentation and implant stability. Studies also report successful outcomes with minimal complications and good implant survival rates over several years. ^{1 2 3 4 5}

Is the Advanced X-Ray Technology for Dental Implants safe for humans?

The procedures related to transcrestal sinus floor elevation, which are similar to the Advanced X-Ray Technology for Dental Implants, have been shown to be safe with no complications reported during or after surgery in studies. Additionally, preventive measures can help avoid complications in high-risk patients. ^{1 5 6 7 8}

What makes the Closed Sinus Augmentation treatment unique for dental implants?

Closed Sinus Augmentation, also known as transcrestal sinus lift, is unique because it is a less invasive technique compared to the lateral approach, using methods like the sinus balloon technique to elevate the sinus floor and increase bone height. This approach can be performed simultaneously with dental implant placement, reducing the overall treatment time and minimizing complications such as sinus membrane perforation. ^{1 5 7 9 10}

Research Team

Charles Powell, DDS, MS

Principal Investigator

The University of Texas Health Science Center at San Antonio

Eligibility Criteria

This trial is for individuals needing dental implants who require closed sinus surgery to prepare the gum. Participants must be suitable for standard of care surgery and willing to undergo 3-D x-rays immediately after surgery and six months later.

Inclusion Criteria

Individuals who are normal healthy or have a diabetes diagnosis with a current HbA1c (glycated glucose) < 7.0

I need a sinus lift for dental implants and I'm between 18-85.

I have at least 5mm of bone below the sinus in my upper jaw.

Exclusion Criteria

My condition affects how my bones use nutrients.

I am taking medication that affects bone health.

Alcoholism or other recreational drugs

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Surgical Procedure

Participants undergo sinus grafting and dental implant placement, followed by a three-dimensional x-ray

1 day

1 visit (in-person)

Follow-up

Participants are monitored for changes in bone volume and undergo a three-dimensional x-ray at six months post-surgery

6 months

1 visit (in-person)

Treatment Details

Interventions

• Closed Sinus Augmentation (Procedure)

Trial Overview The study tests if a low volume CBCT, or 3-dimensional x-ray, can accurately assess the readiness of the gum structure for dental implant placement after closed sinus augmentation, both immediately post-surgery and at a six-month follow-up.

Participant Groups

Group I: Closed sinus augmentation with Calcium Phosphosilicate Putty Experimental Treatment 1 Intervention

Use of CBCT immediately post-operatively after placement of Calcium Phosphosilicate Putty used as standard of care for closed sinus augmentation and at 6 months after surgery.

Closed Sinus Augmentation is already approved in Canada for the following indications:

Approved in Canada as Closed Sinus Augmentation for:

• Vertical bone augmentation in the posterior segment of the edentulous maxilla for dental implant placement

Who Is Running the Clinical Trial?

The University of Texas Health Science Center at San Antonio

Lead Sponsor

Trials

486

Recruited

92,500+

Findings from Research

The flapless Localised Management of Sinus Floor (LMSF) technique for maxillary sinus elevation and simultaneous dental implant placement showed a high cumulative success rate of 95% across 71 procedures performed on 52 patients, indicating its efficacy.

This technique is safe with minimal postoperative complications and avoids the need for additional grafting, using only native bone for augmentation, which reduces patient morbidity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Flapless Localised Management of Sinus Floor (LMSF) for trans-crestal sinus floor augmentation and simultaneous implant placement. A retrospective non-randomized study: 5-year of follow-up. Bruschi, GB., Bruschi, E., Papetti, L.[2022]

In a study involving 37 patients, immediate implant insertion combined with transcrestal sinus augmentation showed no implant failures, indicating a high safety and efficacy of this technique for maxillary molar replacement.

The study found that the relationship between maxillary molar roots and the sinus floor can influence bone height, but there were no significant differences in marginal bone loss or other clinical parameters among different root-sinus relationships after one year.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Transcrestal sinus floor augmentation with immediate implant placement applied in three types of fresh extraction sockets: A clinical prospective study with 1-year follow-up. Chen, Y., Yuan, S., Zhou, N., et al.[2018]

The Smart Lift technique for transcrestal sinus floor elevation is a minimally invasive method that effectively uses existing bone to augment the sinus cavity, reducing the risk of complications such as membrane perforation.

In a case study, the Smart Lift procedure demonstrated successful implant stability and no complications for up to 1 year post-surgery, with clear radiographic evidence of bone augmentation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Minimally invasive technique for transcrestal sinus floor elevation: a case report. Trombelli, L., Minenna, P., Franceschetti, G., et al.[2021]

In a case involving a 48-year-old male with severe anatomical issues in the maxillary sinus, a collaborative approach between an otorhinolaryngologist and a dentist successfully prevented postsinus lift maxillary sinusitis through noninvasive methods.

The patient received preoperative topical steroids, a leukotriene receptor antagonist, and perioperative antibiotic prophylaxis, highlighting the importance of addressing underlying sinus conditions before dental procedures to enhance safety and efficacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Successful Treatment Regimen for the Prevention of Sinusitis after Maxillary Sinus Floor Elevation Surgery in a High-Risk Case. Suzuki-Yamazaki, M., Takahashi, K., Takada, S., et al.[2020]

The transcrestal sinus lift using the sinus balloon technique resulted in an average bone height gain of 8.7 mm, allowing for successful dental implant placement even with only 3 mm of residual bone.

One year after the procedure, the implant success rate was 100% in the five patients studied, indicating the efficacy and safety of this minimally invasive technique.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Transcrestal sinus lift and implant placement using the sinus balloon technique. Peñarrocha-Diago, M., Galán-Gil, S., Carrillo-García, C., et al.[2021]

In a study of 25 implant sites, the use of synthetic biphasic calcium phosphate for transcrestal sinus floor elevation resulted in an average graft height reduction of 0.57 mm after 6-8 months, indicating some degree of remodeling of the grafted bone.

The reduction in graft height was positively correlated with factors such as the vertical amount of implant protrusion and the vertical elevation height, suggesting that these factors may influence the stability of the grafted bone.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Grafted bone remodeling following transcrestal sinus floor elevation: A cone-beam computed tomography study. Kuo, PY., Lin, CY., Chang, CC., et al.[2021]

Transalveolar sinus elevation is a less invasive and time-efficient technique for addressing bone height deficiencies in the posterior maxilla, making it a favorable option for dental implant placement.

The review analyzed 26 articles on various modifications of this technique, highlighting that the choice of method should depend on the clinician's expertise, available equipment, and the specific bone conditions of the patient.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Different techniques in transalveolar maxillary sinus elevation: A literature review. Lafzi, A., Atarbashi-Moghadam, F., Amid, R., et al.[2022]

In a study using 20 human cadaver heads, no significant differences in sinus membrane perforation rates were found among three different transcrestal sinus floor elevation techniques, indicating that the risk of perforation is similar regardless of the method used.

Real-time endoscopy revealed that perforations were more frequently noted during implant placement compared to graft insertion, although this difference was not statistically significant, highlighting the importance of careful monitoring throughout the procedure.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The incidence of maxillary sinus membrane perforation during endoscopically assessed crestal sinus floor elevation: a pilot study. Garbacea, A., Lozada, JL., Church, CA., et al.[2022]

References

1. England pubmed.ncbi.nlm.nih.gov

Flapless Localised Management of Sinus Floor (LMSF) for trans-crestal sinus floor augmentation and simultaneous implant placement. A retrospective non-randomized study: 5-year of follow-up. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Transcrestal sinus floor augmentation with immediate implant placement applied in three types of fresh extraction sockets: A clinical prospective study with 1-year follow-up. [2018]

3. United States pubmed.ncbi.nlm.nih.gov

Transcrestal Sinus Floor Augmentation by Sequential Drilling and the Use of Plasma Rich in Growth Factors. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Radiographic analysis of a transalveolar sinus-lift technique: a multipractice retrospective study with a mean follow-up of 5 years. [2014]

5. Germany pubmed.ncbi.nlm.nih.gov

Minimally invasive technique for transcrestal sinus floor elevation: a case report. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

A Successful Treatment Regimen for the Prevention of Sinusitis after Maxillary Sinus Floor Elevation Surgery in a High-Risk Case. [2020]

7. Spain pubmed.ncbi.nlm.nih.gov

Transcrestal sinus lift and implant placement using the sinus balloon technique. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

Grafted bone remodeling following transcrestal sinus floor elevation: A cone-beam computed tomography study. [2021]

9. Iran pubmed.ncbi.nlm.nih.gov

Different techniques in transalveolar maxillary sinus elevation: A literature review. [2022]

10. United States pubmed.ncbi.nlm.nih.gov

The incidence of maxillary sinus membrane perforation during endoscopically assessed crestal sinus floor elevation: a pilot study. [2022]