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Singapore, 3 July 2019 – The National Dental Centre Singapore (NDCS) has developed a second-generation bioresorbable 3D-printed dental plug that aims to improve the experience of patients who require dental implants. Patients can benefit from having one less surgery procedure, and a shorter treatment process. In partnership with Singapore Clinical Research Institute (SCRI) and local medical technology company and dental plug manufacturer Osteopore, a randomised controlled clinical trial to evaluate the use of these dental plugs is now open for participant recruitment.

Features of second generation dental plug

When a tooth is lost, resorption or shrinkage occurs in the alveolar ridge bone that supports it. The dental plug is designed to be inserted in the tooth socket immediately after a tooth extraction to prevent resorption and to promote bone growth so that a dental implant may be placed. The plug degrades gradually, allowing the patient’s own bone to fill in over time.

The first-generation dental plug was made from polycaprolactone (PCL), a material with mechanical properties similar to that of bone. It was tested in 13 NDCS patients in 2016 and found to promote better maintenance of alveolar ridge height, compared to tooth sockets without a dental plug.

The second-generation plug’s composite material has been enhanced with tricalcium phosphate (TCP) to increase its bioactivity and shorten the time for it to degrade, allowing patients to have implants placed earlier. The clinical trial will evaluate differences in alveolar ridge resorption after insertion of the dental plug as opposed to tooth sockets without a dental plug. The research team will also assess healing and inflammatory responses, and whether the enhanced plug improves bone density, which may increase the stability of dental implants.

Benefits of the 3D printed dental plug

Currently, many patients requiring dental implants must wait for three months for bone to grow in the tooth socket after an extraction because the alveolar ridge must be of adequate height and width to anchor an implant. If too much resorption has occurred, a bone graft is needed. Patients requiring a large graft have bone surgically harvested from their own chin, jaw, skull, or hip (autograft). Those needing a small graft receive commercially-produced animal-derived bone from bovine or porcine sources. These are expensive and not acceptable to patients with religious restrictions.

Recovery time after a bone graft ranges from five to 14 days, and there are potential post-operative complications such as pain, swelling, infection, graft non-take and resorption. Patients must also wait about six months for the graft to heal before an implant can be placed.

If the enhanced dental plugs prove successful, patients needing dental implants can benefit from a shorter and less painful treatment process, as the plugs are placed immediately after extraction, and an additional bone graft surgery may be obviated. They are likely to also experience cost saving compared to an autograft or animal-derived graft, as the dental plugs are 3D-printed in bulk using synthetic materials.

"We are continually looking for ways to collaborate with bioengineers and the medtech industry to co-develop innovative and value-based solutions that can be translated to better treatments and outcomes. If successful, the bioresorbable 3D-printed dental plug will significantly improve the experience of patients who need dental implants," commented Clinical Associate Professor Goh Bee Tin, Director, Research and Education, NDCS, who is leading the trial.

"Osteopore International is pleased to collaborate with the strong clinical research teams of NDCS and SCRI to validate the clinical efficacy of our second generation regenerative technologies in dental socket preservation. These easy to use implants could save significant operative time for dental surgeons and deliver quality bone regeneration," said Mr Goh Khoon Seng, Chief Executive Officer, Osteopore International.

"In this landmark research project where we are studying this new treatment option to our patients, the SCRI team is proud to work hand in hand with the clinical team from NDCS and the product manufacturing team from Osteopore to enable this study to be done at the highest quality and we hope this project will eventually translate to a better treatment option for our patients in the future," said Associate Professor Teoh Yee Leong, Public Health Physician and CEO, Singapore Clinical Research Institute.

The clinical trial is recruiting 138 patients till January 2020. For enquiries to participate, members of the public can contact the NDCS clinical research office at +65 6324 8754 / +65 6435 2068 or email: research@ndcs.com.sg