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审核状态: Project audit state: |
通过审核 Successful |
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注册号: Registration number: |
ChiCTR2600123355 |
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最近更新日期: Date of Last Refreshed on: |
2026-04-24 23:05:51 |
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注册时间: Date of Registration: |
2026-04-24 00:00:00 |
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注册号状态: |
预注册 |
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Registration Status: |
Prospective registration |
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注册题目: |
种植机器人技术联合拔牙前种植窝洞制备技术在后牙区即刻种植中的精度、安全性、适应症及临床疗效研究 |
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Public title: |
A Multicenter Randomized Controlled Clinical Trial Comparing the Accuracy, Stability, and Safety of Four Implantation Protocols in Immediate Implant Placement for Maxillary and Mandibular Molars: Pre-extractive vs. Post-extractive Drilling with Handheld vs. Robotic Assistance |
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注册题目简写: |
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English Acronym: |
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研究课题的正式科学名称: |
种植机器人技术联合拔牙前种植窝洞制备技术在后牙区即刻种植中的精度、安全性、适应症及临床疗效研究 |
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Scientific title: |
A Multicenter Randomized Controlled Clinical Trial Comparing the Accuracy, Stability, and Safety of Four Implantation Protocols in Immediate Implant Placement for Maxillary and Mandibular Molars: Pre-extractive vs. Post-extractive Drilling with Handheld vs. Robotic Assistance |
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研究课题代号(代码): Study subject ID: |
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在二级注册机构或其它机构的注册号: The registration number of the Partner Registry or other register: |
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申请注册联系人: |
田茹晖 |
研究负责人: |
孙健 |
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Applicant: |
Tian Ruhui |
Study leader: |
Sun Jian |
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申请注册联系人电话: Applicant telephone: |
+86 21 6404 1990 |
研究负责人电话: Study leader's telephone: |
+86 21 6404 1990 |
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申请注册联系人传真 : Applicant Fax: |
研究负责人传真: Study leader's fax: |
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申请注册联系人电子邮件: Applicant E-mail: |
16608692569@163.com |
研究负责人电子邮件: Study leader's E-mail: |
sun.jian@zs-hospital.sh.cn |
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申请单位网址(自愿提供): Applicant website(voluntary supply): |
研究负责人网址(自愿提供): Study leader's website(voluntary supply): |
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申请注册联系人通讯地址: |
上海市徐汇区枫林路180号 |
研究负责人通讯地址: |
上海市徐汇区枫林路180号 |
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Applicant address: |
No. 180 Fenglin Road, Xuhui District, Shanghai |
Study leader's address: |
No. 180 Fenglin Road, Xuhui District, Shanghai |
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申请注册联系人邮政编码: Applicant postcode: |
研究负责人邮政编码: Study leader's postcode: |
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申请人所在单位: |
复旦大学附属中山医院 |
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Applicant's institution: |
Zhongshan Hospital Affiliated to Fudan University |
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研究负责人所在单位: |
复旦大学附属中山医院 |
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Affiliation of the Leader: |
Zhongshan Hospital Affiliated to Fudan University |
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是否获伦理委员会批准: |
是/Yes |
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Approved by ethic committee: |
Yes |
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伦理委员会批件文号: Approved No. of ethic committee: |
B2026-143R |
伦理委员会批件附件: Approved file of Ethical Committee: |
查看附件View |
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批准本研究的伦理委员会名称: |
复旦大学附属中山医院伦理委员会 |
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Name of the ethic committee: |
Ethics Committee of Zhongshan Hospital Affiliated to Fudan University |
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伦理委员会批准日期: Date of approved by ethic committee: |
2026-03-19 00:00:00 |
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伦理委员会联系人: |
复旦大学附属中山医院伦理委员会 |
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Contact Name of the ethic committee: |
Ethics Committee of Zhongshan Hospital Affiliated to Fudan University |
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伦理委员会联系地址: |
上海市徐汇区枫林路180号 |
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Contact Address of the ethic committee: |
No. 180 Fenglin Road, Xuhui District, Shanghai |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 21 3158 7871 |
伦理委员会联系人邮箱: Contact email of the ethic committee: |
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研究实施负责(组长)单位: |
复旦大学附属中山医院 |
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Primary sponsor: |
Zhongshan Hospital Affiliated to Fudan University |
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研究实施负责(组长)单位地址: |
上海市徐汇区枫林路180号 |
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Primary sponsor's address: |
No. 180 Fenglin Road, Xuhui District, Shanghai |
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试验主办单位(项目批准或申办者): Secondary sponsor: |
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经费或物资来源: |
院级临床专项课题基金 |
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Source(s) of funding: |
Hospital-level Clinical Special Project Research Fund |
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Target disease: |
Dentition defect |
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Target disease code: |
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研究类型: |
干预性研究 |
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Study type: |
Interventional study |
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研究所处阶段: |
其它 | ||||||||||||||||||||||
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Study phase: |
N/A |
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研究设计: |
随机平行对照 |
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Study design: |
Parallel |
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研究目的: |
多中心层面对比联合技术(试验组)与传统技术(对照组)在磨牙 / 前磨牙区即刻种植的种植体植入精度(冠部偏差、根尖偏差、角度偏差),明确 “拔牙前扩孔钻制备 + 机器人辅助种植” 方案的优势。评估四组方案在不同中心的安全性一致性(并发症发生率、伤口愈合、初期稳定性)。比较四种方案患者的中长期临床疗效(骨整合率、软组织健康、生活质量)及多中心术者操作体验差异,为临床个性化方案选择提供依据。 |
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Objectives of Study: |
Multi-center comparison of the implant placement accuracy (coronal deviation, apical deviation, angular deviation) between the combined technology (experimental group) and traditional technology (control group) in immediate implantation in the molar/premolar region, to clarify the advantages of the "pre-extraction hole preparation with reamer + robot-assisted implantation" scheme. Evaluate the consistency of safety (complication rate, wound healing, initial stability) of the four groups of schemes across different centers. Compare the medium- and long-term clinical efficacy (osseointegration rate, soft tissue health, quality of life) of patients with the four schemes and the differences in operator experience across multiple centers, so as to provide a basis for the selection of personalized clinical schemes. |
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药物成份或治疗方案详述: |
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Description for medicine or protocol of treatment in detail: |
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纳入标准: |
1: ? 年龄 18-70 岁,男女不限,全身状况良好,无种植手术绝对禁忌证(如未控制的糖尿病、凝血功能障碍、免疫功能低下等) 2: ? 上颌或下颌第一 / 第二磨牙因牙齿折断、不可治愈牙髓病或严重龋坏需拔除,符合即刻种植适应证 3: ? 牙槽窝类型为 SI/SII/SIII 型(按 Bleyan et al. 2021 分类):下颌磨牙需满足根分叉至下颌管距离≥10mm,根尖至下牙槽管上缘距离≥5mm;上颌磨牙需满足根尖至上颌窦底距离≥5mm,无严重上颌窦炎 4: ? 开口度≥30mm,能配合跨中心随访与影像学检查 5: ? 签署知情同意书,愿意完成 12 个月全程随访 |
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Inclusion criteria |
1. Aged 18-70 years, male or female, in good general condition, with no absolute contraindications to implant surgery (such as uncontrolled diabetes, coagulation disorders, immunocompromised status, etc.) 2. Maxillary or mandibular first/second molars that need to be extracted due to tooth fracture, untreatable pulp disease, or severe caries are eligible for immediate implantation. 3. The alveolar socket types are SI/SII/SIII (classified according to Bleyan et al. 2021): Mandibular molars must satisfy that the distance from the root bifurcation to the mandibular canal is >= 10 mm, and the distance from the root apex to the upper edge of the inferior alveolar canal is >= 5 mm; Maxillary molars must satisfy that the distance from the root apex to the floor of the maxillary sinus is >= 5 mm, without severe maxillary sinusitis. 4. The opening degree is >= 30 mm, and can cooperate with cross-center follow-up and imaging examinations. 5. Sign the informed consent form and be willing to complete the 12-month full follow-up. |
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排除标准: |
1: ? 牙根聚合畸形、活动性根尖周炎、颌骨囊肿或种植位点急性感染 2: ? 慢性吸烟(每日≥10 支)、夜磨牙症、重度牙周病(全口牙周袋深度≥6mm) 3: ? 孕期、哺乳期女性,或正在服用影响骨代谢的药物 4: ? 种植位点曾接受颌骨手术、放疗或化疗 5: ? 精神疾病、认知障碍或语言沟通障碍,无法配合治疗与随访 6: ? 参与其他同期口腔临床试验者 |
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Exclusion criteria: |
1. Root fusion deformity, active periapical periodontitis, jaw cysts, or acute infection at the implant site 2. Chronic smoking (>=10 cigarettes per day), bruxism, severe periodontal disease (full-mouth periodontal pocket depth >=6 mm) 3. Pregnant or lactating women, or those taking drugs that affect bone metabolism 4. The implant site has undergone jawbone surgery, radiotherapy, or chemotherapy 5. Mental illness, cognitive impairment, or language communication disorder, unable to cooperate with treatment and follow-up 6. Participants in other concurrent oral clinical trials |
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研究实施时间: Study execute time: |
从 From 2026-04-01 00:00:00至 To 2028-11-30 00:00:00 |
征募观察对象时间: Recruiting time: |
从From 2026-05-01 00:00:00 至 To 2028-03-31 00:00:00 |
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干预措施: Interventions: |
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研究实施地点: Countries of recruitment and research settings: |
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测量指标: Outcomes: |
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采集人体标本:
Collecting sample(s)
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征募研究对象情况: Recruiting status: |
尚未开始 Not yet recruiting |
年龄范围: Participant age: |
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性别: |
男女均可 |
Gender: |
Both |
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随机方法(请说明由何人用什么方法产生随机序列): |
由第三方统计师采用 SAS 9.4 软件,按中心 - 颌位分层、区组长度为 8、1:1:1:1 分配比例生成随机序列 |
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Randomization Procedure (please state who generates the random number sequence and by what method): |
SAS 9.4 software, stratified by study center and jaw position (maxilla/mandible), with a block size of 8 and a 1:1:1:1 allocation ratio |
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是否公开试验完成后的统计结果: Calculated Results after the Study Completed public access: |
公开/Public |
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盲法: |
开放标签,对评估者隐藏分组 |
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Blinding: |
Open the tags and hide the groups from the evaluators |
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试验完成后的统计结果(上传文件): |
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Calculated Results after
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是否共享原始数据: IPD sharing |
No |
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共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址): |
无 |
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The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
None |
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数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC: |
统一使用标准化纸质病例报告表(CRF),所有数据(基线资料、手术记录、随访结果、不良事件)均现场手写记录,确保信息实时准确。 原始资料(血常规 / 凝血报告、CBCT 影像报告、知情同意书)按患者识别码整理,与纸质 CRF 装订成册,形成 “一人一档”。 数据录入 各中心数据管理员在患者完成随访后 72 小时内,将纸质 CRF 数据录入统一格式的 Excel 电子表格(设置数据验证规则:如 ISQ 值范围 0-100、年龄范围 18-70 岁,避免录入错误)。 关键数据(种植体偏差、ISQ 值、骨丧失量)实行 双人双录入:由两名录入人员分别录入,对比一致性,差异值需溯源纸质 CRF 修正。 电子表格命名规则:中心-分组-患者识别码-随访时间.xlsx,确保文件可快速检索。 【数据核查与质控(人工分级核查)】 ?一级核查(中心内自查) 数据管理员每周核查本中心本周录入数据,重点检查:① 关键字段无缺失(如入组日期、种植体规格、随访结果);② 逻辑一致性(如 “机器人辅助组” 需有导航偏差记录,“徒手组” 无相关记录);③ 数据合理性(如手术时长不会出现极端值)。 核查发现问题标注 “待修正”,联系主治医生确认后修改,并填写 《数据修改记录表》(记录修改前值、修改后值、修改原因、修改人、修改日期)。 二级核查(跨中心交叉核查) 两中心交叉核查员每月抽查对方中心 25% 的病例,涵盖各组别、各随访节点,核查纸质 CRF 与电子表格的一致性,核查结果填写 《交叉核查报告》,反馈至对方数据管理员整改。 缺失值与异常值处理 缺失值:结局指标缺失率 <5%,采用完整病例分析;缺失率 5%-20%,由主治医生根据临床记录补充,无法补充则标注 “缺失原因”(如患者失访、检查设备故障);缺失率 > 20%,该病例排除统计分析。 异常值:发现如 “ISQ 值 = 0”“骨丧失量 > 5mm” 等异常数据,立即溯源原始检查报告,确认是录入错误则修正,是真实数据则由 PI 组织专家评估是否纳入分析,并记录评估意见。 【数据存储与备份(双重备份防丢失)】 纸质资料存储:各中心 “一人一档” 纸质资料存放于带锁档案柜,档案柜由数据管理员专人保管,借阅需填写《资料借阅登记表》,严禁带出研究中心。 电子数据存储 本地备份:电子表格同时存储于 两台独立电脑硬盘(数据管理员电脑 + 科室公用服务器); 离线备份:每月将电子数据刻录成只读光盘,与纸质资料一同归档,避免电子数据被篡改。 备份验证:每季度随机抽取 10% 备份数据,核对与原始数据的一致性,确保备份有效。 无edc |
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Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
Unified standard paper Case Report Forms (CRFs) shall be used. All data, including baseline characteristics, operative records, follow-up outcomes, and adverse events, shall be **handwritten on-site** to ensure real-time and accurate documentation. Source documents, including complete blood count (CBC) reports, coagulation test reports, CBCT imaging reports, and informed consent forms, shall be organized by **patient identification code**, bound together with the paper CRFs, and filed as **one file per patient**. ## Data Entry Data managers at each center shall enter data from paper CRFs into a standardized Excel spreadsheet **within 72 hours** after patient follow-up completion. Data validation rules shall be applied (e.g., ISQ value range: 0–100; age range: 18–70 years) to prevent entry errors. Critical data, including implant deviation, ISQ values, and bone loss, shall undergo **double entry by two independent personnel**. Entries shall be compared for consistency; discrepancies shall be verified against the original paper CRFs and corrected. Spreadsheets shall be named according to the rule: **Center-Group-Patient ID-Follow-up Time.xlsx** to enable rapid file retrieval. # Data Monitoring and Quality Control (Manual Hierarchical Verification) ## Level 1 Monitoring (Intra-Center Self-Monitoring) Data managers shall review data entered in the current week **every week**, focusing on: 1. No missing key fields (e.g., enrollment date, implant specifications, follow-up outcomes); 2. Logical consistency (e.g., robot-assisted group must have navigation deviation records; freehand group has no such records); 3. Data plausibility (e.g., no extreme values for operative duration). Identified issues shall be marked "To be corrected", confirmed with the attending physician, revised, and documented in a **Data Modification Log** (recording pre-modification value, post-modification value, reason for modification, person in charge, and date). ## Level 2 Monitoring (Inter-Center Cross-Monitoring) Cross-monitors from the two centers shall **randomly audit 25% of cases** from the counterpart center every month, covering all groups and follow-up time points. Consistency between paper CRFs and electronic spreadsheets shall be verified. Results shall be documented in a **Cross-Monitoring Report** and sent to the counterpart data manager for rectification. ## Handling of Missing Values and Outliers - **Missing values**: - Missing rate of outcome measures < 5%: analyzed as complete cases; - Missing rate 5%–20%: supplemented by the attending physician based on clinical records; if unavailable, mark "reason for missing" (e.g., patient lost to follow-up, equipment failure); - Missing rate > 20%: the case shall be excluded from statistical analysis. - **Outliers**: Abnormal data (e.g., ISQ = 0, bone loss > 5 mm) shall be immediately verified against source documents. If confirmed as entry error, correct the data; if confirmed as true value, the PI shall convene an expert panel to evaluate eligibility for analysis and document the assessment. # Data Storage and Backup (Dual Backup to Prevent Loss) ## Paper Data Storage "One file per patient" paper documents shall be stored in **locked filing cabinets** under the exclusive custody of data managers. Borrowing requires completion of a **Document Borrowing Log**; removal from the research center is strictly prohibited. ## Electronic Data Storage - **Local backup**: Electronic spreadsheets shall be stored simultaneously on **two independent hard drives** (data manager’s computer + departmental public server); - **Offline backup**: Electronic data shall be burned to **read-only optical discs** every month and archived together with paper documents to prevent tampering. - **Backup verification**: Randomly check 10% of backup data every quarter to confirm consistency with original data and ensure backup integrity. Note: No Electronic Data Capture (EDC) system is used in this study. |
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数据与安全监察委员会: Data and Safety Monitoring Committee: |
暂未确定/Not yet |