Overview
The purpose of this study is to evaluate and compare the clinical and radiographic outcomes of using photofunctionalized (UV-treated) dental implants with or without the application of melatonin hormone in the posterior maxilla (upper back jaw).
The posterior maxilla is known to have lower bone quality, which can negatively affect the primary and secondary stability of dental implants,. UV photofunctionalization is a method that modifies the titanium surface of the implant, changing it from hydrophobic (water-repelling) to superhydrophilic (water-attracting). This enhancement aims to accelerate protein adsorption and promote bone-building cells (osteoblasts). On the other hand, melatonin acts as an anti-inflammatory and antioxidant agent that stimulates bone formation and reduces bone resorption.
A total of 21 dental implants will be placed in patients requiring tooth replacement in the posterior maxilla. The implants will be divided into three main approaches: one using UV-treated implants alone, and the other combining UV-treated implants with melatonin. and one using conventional implant Patients will be followed up clinically and radiographically to assess implant stability, bone healing, and overall implant success over time.
Description
This interventional study is designed to clinically and radiographically evaluate the potential synergistic effects of ultraviolet (UV) photofunctionalized dental implants combined with melatonin hormone in the posterior maxilla, bone density (D4 bone quality) and challenging primary implant stability.
Biological aging of titanium is an unavoidable phenomenon occurring within weeks of manufacturing, where hydrocarbon contamination covers the protective titanium dioxide layer, increasing surface hydrophobicity and reducing optimal osteoblast adhesion. To counteract this, UV photofunctionalization (UV irradiation) will be utilized immediately prior to implant insertion to restore superhydrophilic properties, reduce hydrocarbon content, and enhance early protein adsorption and osteoblastic differentiation.
Additionally, melatonin (N-acetyl-5-methoxytryptamine) will be investigated as an alternative graft or bioactive material. Melatonin exhibits potent anti-inflammatory and antioxidant capabilities, destroys reactive oxygen species, and stimulates human osteoblasts to synthesize type I collagen fibers. It also down-regulates RANKL-mediated osteoclast activation, thereby reducing bone resorption during the critical early healing phases.
Patients will be selected from the Outpatient Clinic of the Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Mansoura University, following ethical committee approval and obtaining informed written consents. A total of 21 implants will be placed in the posterior maxilla. The clinical and radiographic evaluation will monitor parameters such as primary and secondary implant stability, marginal bone level changes, and peri-implant tissue health to compare the outcomes of photofunctionalized implants alone against those combined with melatonin.
Eligibility
Inclusion Criteria:
- Patients aged between 18 and 60 years old.
- Patients seeking replacement of missed single or multiple teeth in the posterior maxilla.
- Sufficient bone volume (height and width) to accommodate dental implant placement without major bone grafting.
- Good oral hygiene and motivated patients.
- Systemically healthy patients with no contraindications for minor oral surgery.
Exclusion Criteria:
- Patients with uncontrolled systemic diseases
- Patients who received radiation therapy in the head and neck region within the last 5 years.
- Heavy smokers (more than 10 cigarettes per day).
- Patients with active periodontal disease or poor oral hygiene.
- Pregnant or lactating females.
- Parafunctional habits such as severe bruxism or clenching.
