L-PRF versus sticky tooth versus sticky bone to fill the shield-implant gap during AI-guided socket-shield immediate front-tooth implants

L-PRF Versus Sticky Bone Grafting of the Jumping Gap in AI-assisted/Computer-Guided Socket Shield Immediate Dental Implantation: A Randomized Clinical Trial

This study will test whether L-PRF, sticky tooth (autogenous dentin + i-PRF), or sticky bone (particulate graft + i-PRF) best supports bone and gum healing for adults receiving AI-guided socket-shield immediate implants after a non-restorable front tooth.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 45 (estimated)
• Ages: 18 Years to 45 Years
• Sex: All
• Sponsor: Kafrelsheikh University (Academic / other)
• Locations: 2 sites (Kafr ash Shaykh, Kafrelsheikh and 1 other locations)
• Trial ID: NCT07433920 on ClinicalTrials.gov

What this trial studies

Adults with one non-restorable anterior tooth and sufficient apical/palatal bone will receive socket-shield immediate implant placement using an AI-assisted, patient-specific guide created from intraoral scan and CBCT superimposition. The shield-implant 'jumping gap' will be filled with one of three modalities: L-PRF alone, sticky tooth (autogenous dentin + i-PRF), or sticky bone (particulate graft + i-PRF). CBCT imaging will be obtained immediately, at three months, and at six months to quantify hard- and soft-tissue dimensional changes. The investigators hypothesize that cohesive biologic composites (sticky tooth and sticky bone) will provide superior space maintenance and early wound stability compared with PRF alone.

Who should consider this trial

Good fit: Adults over 18 who are medically ASA I or II, present with a single non-restorable anterior tooth, and have sufficient apical/palatal bone for primary implant stability are the intended candidates.

Not a fit: Patients with active periapical infection, large chronic periapical lesions, insufficient apical bone, ankylosed teeth, or who are ASA III-V are excluded and unlikely to benefit from the procedures tested here.

Why it matters

Potential benefit: If successful, the results could help clinicians choose a grafting approach that better preserves bone and gum contours and improves aesthetic outcomes and implant stability after immediate front-tooth implantation.

How similar studies have performed: Prior studies and recent reviews suggest PRF and autogenous dentin- or bone-based sticky composites can aid peri-implant gap fill and soft-tissue healing, but rigorous head-to-head comparisons in standardized, AI-guided workflows remain limited.

Eligibility criteria

Inclusion Criteria:

* Medically healthy patients according to the American Society of Anesthesiologists (ASA) physical status classification system; only patients belonging to ASA I and ASA II categories will be included in this study.
* Age \> 18 years.
* Patients presenting with one non-restorable hopeless anterior tooth due to extensive caries, cervical/root fracture, vertical or oblique root fracture, multiple failed endodontic treatments, or root resorption.
* Sufficient apical/palatal bone to obtain primary implant stability.

Exclusion Criteria:

* Patients belonging to ASA III, ASA IV and ASA V will be excluded.
* Vertical root fracture involving the labial aspect of the root planned to be retained as the facial shield.
* Horizontal root fracture that is too far apically located.
* Presence of acute (active) periapical infection.
* Large chronic periapical lesion.
* Lack of sufficient bone apical to the extraction socket to obtain primary stability. \* Ankylosed tooth positioned too apically in relation to adjacent teeth.

Where this trial is running

Kafr ash Shaykh, Kafrelsheikh and 1 other locations

• faculty of dentistry, kafrelsheikh University — Kafr ash Shaykh, Kafrelsheikh, Egypt (Recruiting)
• Walid Elamrousy — Kafr ash Shaykh, Egypt (Recruiting)

Study contacts

• Study coordinator: Walid Elamrousy, PhD

Conditions Dental Implant Failed