Clinical Trial: Plasma of Argon Cleaning on Implant Abutments: 5-year Results of a Randomized Clinical Trial

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Effect of Plasma of Argon Cleaning on Implant Abutments in Patients With a History of Periodontal Disease and Thin Biotype: Five Years Post-loading Results of a Randomized Controlled Trial

Brief Summary: Contamination of implant abutments could potentially influence the peri-implant tissue inflammatory response. The aim of the present study was to assess the radiographic bone changes around customized, platform switched, abutments placed according to the "one-abutment-one-time" protocol, with and without plasma of argon cleaning treatment.

Detailed Summary:

After technical procedures, presence of contaminants (mostly Titanium wear micro-particles, Carbon and Aluminum traces due to lubricant used during customization) on the whole abutment surface, the internal connection and the screw can be found, even after the usually cleaning steps (steaming).

Such debris, present at titanium/connective-bone tissues interface (gingival portion of the abutment), could directly or indirectly deleteriously influence the inflammatory response on the peri-implant tissues.

Plasma of Argon cleaning treatment was demonstrated to have a double effect on titanium abutments: removal of pollutions following customization and increase of cell adhesion. Additionally, Plasma of Argon demonstrated very potent anti-biofilm activity. This prospective, match paired, triple-blinded randomized controlled trial was aimed to test if plasma treatment of customized abutments can affect radiographic peri-implant marginal bone level changes after 5 years of prosthetic loading.


Sponsor: University of Valencia

Current Primary Outcome: Success Rate of the Implants and Prostheses (Participants). [ Time Frame: During all the follow-up (5 years) ]

An implant was considered a failure if it presented any mobility, assessed by tapping or rocking the implant head with the metallic handles of two instruments, and/or any signs of radiolucency, progressive marginal bone loss or infection, and any mechanical complications (e.g. implant fracture) rendering the implant unusable, though still mechanically stable in the bone. This was evaluated on an intraoral radiograph taken with a paralleling technique strictly perpendicular to the implant-bone interface. The implant stability was assessed at initial loading and following 3 years of application, with the prostheses removed.

A prosthesis was considered a failure if it needed to be replaced by an alternative prosthesis.



Original Primary Outcome: Success rate of the implants and prostheses (percentage). [ Time Frame: During all the follow-up (5 years) ]

Current Secondary Outcome:

  • Any Biological or Technical Complications. [ Time Frame: During all the follow-up (5 years) ]
    Complications: any biological (pain, swelling, suppuration, etc) and/or mechanical complications (fracture of the framework and/or the veneering material, screw loosening, etc) were considered.
  • Peri-implant Marginal Bone Level Changes (Express in mm). [ Time Frame: At 5 years. ]
    At the time of loading with the provisional crown (T0), periapical standardized digital or analogical radiographs were taken in order to control the perfect adaptation of the abutment on the implant and control peri-implant bone level. The customized film holder was made using an hard silicone on the bite of film holders (Rinn XCP; Dentsply Rinn, Elgin, IL, USA) and the parallel technique was used. Radiographs were also taken at 12 (T1), 24 (T2), 48 (T4), and 60 months (T5) after the final restoration delivery, to evaluate marginal bone level changes.
  • Esthetic Parameters Measured as the Changes in Mesial and Distal Papilla Height (PH) and Buccal Peri-implant Mucosa Changes at the Zenith (REC), Expressed in mm. [ Time Frame: At 5 years. ]

    A customized millimeter tubular support (stent) was placed temporarily around each dental implant. For each site, mesial and distal soft tissue dimensions (papilla height, PH), and buccal peri-implant mucosa dimension at the zenith (REC) were measured, and reported in millimeters. Two measurements were recorded. The first at definitive crown delivery (baseline), and the second at the 5 years follow-up examination. Changes in PH and REC were reported in millimeters as the difference between values recorded at the 5-year follow-up and the baseline.

    The full procedure was published in:

    Canullo L, Iurlaro G, Iannello G. Double-blind randomized controlled trial study on post-extraction immediately restored implants using the switching platform concept: soft tissue response. Preliminary report. Clinical Oral Implants Research [Internet]. 2009 Apr;20(4):414-20.

  • Percentage of Patients With Plaque Index [ Time Frame: At 5 years. ]
    Modified Plaque Index (mPI) was evaluated as the amount of plaque at the cervical part of the implant-supported crown, scored by running a probe along the implant-supported crown surface. Measured as Yes or Not.
  • Percentage of Patients With Bleeding on Probing [ Time Frame: At 5 years. ]
    Presence of bleeding within 10 seconds after probing. Measured as Yes or Not.


Original Secondary Outcome:

  • Any Biological or Technical Complications. [ Time Frame: During all the follow-up (5 years) ]
  • Peri-implant Marginal Bone Level Changes (Express in mm). [ Time Frame: At 1, 2 and 5 years. ]
  • Esthetic parameters (VAS score). [ Time Frame: At 5 years. ]
  • Probing depth [ Time Frame: At 5 years. ]
    Measured in mm from gingival contour to bone level.
  • Bleeding on probing [ Time Frame: At 5 years. ]
    Presence of bleeding within 10 seconds after probing. Measured as Yes or Not.


Information By: University of Valencia

Dates:
Date Received: September 14, 2015
Date Started: January 2010
Date Completion:
Last Updated: May 10, 2016
Last Verified: May 2016