Vestibular Versus Trapezoid Flap in Immediate Implants

Condition(s) studied

Investigational drug(s) / intervention(s)

control GBR: will have a full thickness papilla preservation FLAP, followed by an immediate implant placement using a surgical guide. Then a guided bone regeneration will be achieved by bone graft (autogenous bone chips and xenograft particles and a membrane barrier 1 mm thickness will be applied. The membrane shield then will be stabilized to the apical bone using 2 membrane tacks, customized healing abutment will be connected , then, the elevated flap will be sutured to its original position.

VST: Pre extraction procedure: Prior to tooth extraction, cone beam computed tomography (CBCT) images will be taken to inspect the overall socket condition. All patients will be scanned pre-operatively using an intra-oral scanner (IOS). Extraction protocol: incisal extraction technique, where atraumatic tooth extraction to the hopeless tooth will be performed using periotomes followed by conventional forceps.

Study summary

The vestibular socket therapy was introduced by Elaskary et al that allowed immediate implant placement and total socket rehabilitation at the same time in class 2 compromised sockets , that showed supreme esthetic and functional predictability over 1,2,3 years of follow up, and showed minimal or no post restorative mid facial recession . The Vestibular socket therapy (VST) entails socket augmentation through a minimally invasive vestibular access incision to allow the delivery of the grafting components thus bypass the deleterious effect of the classic mucoperiosteal flap reflection as well as the deleterious effect of the delay approach, regardless of the degree of socket compromise \[6-8\].

Eligibility

Primary outcome measure(s)

• Changes in mid facial recession — 6 months after final restoration
  soft tissue stability measured in mm as difference In mid facial recession between pre operative and six months post operative

Trial sites (3)

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