AzTrials
AzTrials

Connective Tissue Graft HarvestingNCT05494294

Comparison of Different De-epithelialization Techniques of Soft Tissue Grafts.

A study testing Intraorally de-epithelialization and Extraorally de-epithelialization in people with Connective Tissue Graft Harvesting, run by Hacettepe University at 1 site in Turkey (Türkiye).

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

In this randomized comparative controlled clinical trial, 50 patients with single recession defects with thin phenotype were treated with coronally advanced flap. The connective tissue graft was obtained by removing the keratinized layer of the tissue. Removal of the epithelium was achieved by to different approach. Read more about this study

Who is it for?
Ages 18 to 60 yearsHealthy volunteers can take part
Conditions the study is for
Connective Tissue Graft Harvesting
What is being tested?
Intraorally de-epithelialization and Extraorally de-epithelialization
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
50 participants
Where
1 siteTurkey (Türkiye)
Study dates
4 Jul 2021to 5 Aug 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 60 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Single tooth recession more than 2mm
  • Gingival thickness less than 1mm

Who cannot join

  • unstable endodontic conditions or presence of any restoration/abrasion,
  • tooth mobility, any surgical history or gingival enlargement in the area,
  • smoking
  • uncontrolled systemic disease, pregnancy or use of drugs known to affect gingival conditions

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • Hacettepe University

    Ankara, 06100

Other trials in Turkey (Türkiye)

About this study

Official title: Does the De-epithelialization Procedure Affect the Epithelial Remnants and Recession Coverage Outcomes?

In this randomized comparative controlled clinical trial, 50 patients with single recession defects with thin phenotype were treated with coronally advanced flap. The connective tissue graft was obtained by removing the keratinized layer of the tissue. Removal of the epithelium was achieved by to different approach. At first group epithelium and remnants were removed extraorally whereas others were intraorally. After the removal, obtained graft laid on a lamella, and residual keratinocytes were observed under the microscope. Amount of recession reduction recorded at the 6th week, 6th month, 12th month, and keratinized tissue height, gingival thickness, recession depth, recession width, probing depth, and clinical attachment level, were also evaluated. Keratinized tissue change, Gingival thickness change, root coverage, clinical attachment gain, and complete root coverage were calculated. Wound healing index, tissue appearance, patient expectations, aesthetics, and dentine hypersensitivity were assessed at baseline and 6th week.

Being tested
Intraorally de-epithelialization, Extraorally de-epithelialization

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Intraorally de-epithelializationProcedure or surgery

    In this group, the grafts were de-epithelialized at the donor site before harvesting. The calibrated surgeon removed the epithelium with a sharp Kirkland knife under magnification. To be sure of the elimination whole epithelial layer, bleeding was observed. Recipient site was prepared as follows; A after sulculer incision had done (blade 15c) two vertical incions were made from the gingival margin to 3 mm beyond the mucogingival junction A partial-thickness flap was elevated under the recession area and full thickness flap elevated adjacent flap portions. then relasing incisions were made apically from the mucogingival junction. After the preparation of the recipient site, obtained graft was sutured 1 mm apically to the cemento-enamel junction. Finally flap was positioned without tension and stabilized at least 2mm coronally from the cemento-enamel margin with the single interrupted sutures.

  • Extraorally de-epithelializationProcedure or surgery

    In this group, the grafts were de-epithelialized after graft harvesting. The calibrated surgeon removed the epithelium with 15 c knife under magnification. all remnants were removed under magnification. Same recipient site procedure was conducted in this group.

Study groups in NCT05494294
Study groupRoleWhat they receive
IntraoralActive comparatorIn this group, the grafts were de-epithelialized at the donor site before harvesting. The calibrated surgeon removed the epithelium with a sharp Kirkland knife under magnification. To be sure of the elimination whole epithelial layer, bleeding was observed. Recipient site was prepared as follows; A after sulculer incision had done (blade 15c) two vertical incions were made from the gingival margin to 3 mm beyond the mucogingival junction A partial-thickness flap was elevated under the recession area and full thickness flap elevated adjacent flap portions. then relasing incisions were made apically from the mucogingival junction. After the preparation of the recipient site, obtained graft was sutured 1 mm apically to the cemento-enamel junction. Finally flap was positioned without tension and stabilized at least 2mm coronally from the cemento-enamel margin with the single interrupted sutures.
Receives: Procedure: Intraorally de-epithelialization
ExtraoralActive comparatorIn this group, the grafts were de-epithelialized after graft harvesting. The calibrated surgeon removed the epithelium with 15 c knife under magnification. all remnants were removed under magnification. Same recipient site procedure was conducted in this group.
Receives: Procedure: Extraorally de-epithelialization

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Recession reduction

    RD, measured from the cemento-enamel junction (CEJ) to the most apical extension of the gingival margin.

    Measured: 3rd month

  2. Recession reduction

    RD, measured from the cemento-enamel junction (CEJ) to the most apical extension of the gingival margin.

    Measured: 6th month

  3. Recession reduction

    RD, measured from the cemento-enamel junction (CEJ) to the most apical extension of the gingival margin.

    Measured: 12th month

Secondary outcomes (45)
  1. amount of deciduous cells

    Amount of deciduous cells was measured with computerized microscope via histomorfometric methods.

    Measured: at the day of the surgery.

  2. percentage of deciduous cells

    amount of deciduous cells Amount of deciduous cells was measured with computerized microscope via histomorfometric methods.

    Measured: at the day of the surgery

  3. Recession Depth (RD)

    RD, was measured from the cemento-enamel junction (CEJ) to the most apical extension of the gingival margin.

    Measured: Baseline.

  4. Recession Depth (RD)

    RD, was measured from the cemento-enamel junction (CEJ) to the most apical extension of the gingival margin.

    Measured: 3rd month

  5. Recession Depth (RD)

    RD, was measured from the cemento-enamel junction (CEJ) to the most apical extension of the gingival margin.

    Measured: 6th month

  6. Recession Depth (RD)

    RD, was measured from the cemento-enamel junction (CEJ) to the most apical extension of the gingival margin.

    Measured: 12th month

  7. Keratinized Tissue Height (KTH)

    TH, was measured from gingival margin to the mucogingival junction (MGJ).

    Measured: baseline

  8. Keratinized Tissue Height (KTH)

    TH, was measured from gingival margin to the mucogingival junction (MGJ).

    Measured: 3rd month

  9. Keratinized Tissue Height (KTH)

    TH, was measured from gingival margin to the mucogingival junction (MGJ).

    Measured: 6th month

  10. Keratinized Tissue Height (KTH)

    TH, was measured from gingival margin to the mucogingival junction (MGJ).

    Measured: 12th month

  11. Gingival Thickness (GT)

    GT, was measured at the midpoint location between the gingival margin and mucogingival junction, using an endodontic spreader (#25 endodontic spreader, 25 mm; D-perfect, Shenzhen, China).

    Measured: baseline

  12. Gingival Thickness (GT)

    GT, was measured at the midpoint location between the gingival margin and mucogingival junction, using an endodontic spreader (#25 endodontic spreader, 25 mm; D-perfect, Shenzhen, China).

    Measured: 3rd month

  13. Gingival Thickness (GT)

    GT, was measured at the midpoint location between the gingival margin and mucogingival junction, using an endodontic spreader (#25 endodontic spreader, 25 mm; D-perfect, Shenzhen, China).

    Measured: 6th month

  14. Gingival Thickness (GT)

    GT, was measured at the midpoint location between the gingival margin and mucogingival junction, using an endodontic spreader (#25 endodontic spreader, 25 mm; D-perfect, Shenzhen, China).

    Measured: 12th month

  15. Recession width (RW)

    Recession width (RW), the distance between the mesial gingival margin and the distal gingival margin of the tooth measured from the widest point of the recession.

    Measured: baseline

  16. Recession width (RW)

    Recession width (RW), the distance between the mesial gingival margin and the distal gingival margin of the tooth measured from the widest point of the recession.

    Measured: 3rd month

  17. Recession width (RW)

    Recession width (RW), the distance between the mesial gingival margin and the distal gingival margin of the tooth measured from the widest point of the recession.

    Measured: 6th month

  18. Recession width (RW)

    Recession width (RW), the distance between the mesial gingival margin and the distal gingival margin of the tooth measured from the widest point of the recession.

    Measured: 12th month

  19. Probing pocket depth (PD)

    Probing pocket depth (PD), measured from the gingival margin to the bottom of the gingival sulcus.

    Measured: baseline

  20. Probing pocket depth (PD)

    Probing pocket depth (PD), measured from the gingival margin to the bottom of the gingival sulcus.

    Measured: 3rd month

  21. Probing pocket depth (PD)

    Probing pocket depth (PD), measured from the gingival margin to the bottom of the gingival sulcus.

    Measured: 6th month

  22. Probing pocket depth (PD)

    Probing pocket depth (PD), measured from the gingival margin to the bottom of the gingival sulcus.

    Measured: 12th month

  23. Clinical attachment level (CAL)

    Clinical attachment level (CAL), measured from the cementoenamel junction to the bottom of the gingival sulcus.

    Measured: Baseline

  24. Clinical attachment level (CAL)

    Clinical attachment level (CAL), measured from the cementoenamel junction to the bottom of the gingival sulcus.

    Measured: 3rd month

  25. Clinical attachment level (CAL)

    Clinical attachment level (CAL), measured from the cementoenamel junction to the bottom of the gingival sulcus.

    Measured: 6th month

  26. Clinical attachment level (CAL)

    Clinical attachment level (CAL), measured from the cementoenamel junction to the bottom of the gingival sulcus.

    Measured: 12th month

  27. Keratinized tissue change (KTC)

    Keratinized tissue change (KTC), GT change (GTC), root coverage, clinical attachment gain (CAG) were calculated in millimeters and percentages.

    Measured: 3rd month

  28. Keratinized tissue change (KTC)

    Keratinized tissue change (KTC), GT change (GTC), root coverage, clinical attachment gain (CAG) were calculated in millimeters and percentages.

    Measured: 6th month

  29. Keratinized tissue change (KTC)

    Keratinized tissue change (KTC), GT change (GTC), root coverage, clinical attachment gain (CAG) were calculated in millimeters and percentages.

    Measured: 12th month

  30. Wound healing index (WHI)

    Wound healing index (WHI) was recorded two-weeks after surgery. The wound surface was visually inspected and the soft tissue healing was defined as 'uneventful' (score 1), 'slightly disturbed' (score 2) or 'poor' (score 3) based on the presence and severity of the items including patient discomfort, erythema, edema, suppuration and flap dehiscence.

    Measured: 3rd month

  31. Wound healing index (WHI)

    Wound healing index (WHI) was recorded two-weeks after surgery. The wound surface was visually inspected and the soft tissue healing was defined as 'uneventful' (score 1), 'slightly disturbed' (score 2) or 'poor' (score 3) based on the presence and severity of the items including patient discomfort, erythema, edema, suppuration and flap dehiscence.

    Measured: 6th month

  32. Wound healing index (WHI)

    Wound healing index (WHI) was recorded two-weeks after surgery. The wound surface was visually inspected and the soft tissue healing was defined as 'uneventful' (score 1), 'slightly disturbed' (score 2) or 'poor' (score 3) based on the presence and severity of the items including patient discomfort, erythema, edema, suppuration and flap dehiscence.

    Measured: 12th month

  33. Tissue appearance (TA)

    Tissue appearance (TA) was evaluated by asking the patients to score the consistency, contour, color match, keloid formation degree and contiguity of their treated sites at T2. The scores were collected as points, shown in parentheses, by asking the consistency as firm (1p) or spongy (0p); contour as presence (2p) or absence (0p) of knife-edged and scalloped gingival margin; color match as excellent (3p), good (2p), adequate (1p) or unsatisfactory (0p); keloid formation degree as absent (1p) or present (0p); contiguity as the presence (-1p) or absence (0p) of each perceptible incision mark.

    Measured: 3rd month

  34. Tissue appearance (TA)

    Tissue appearance (TA) was evaluated by asking the patients to score the consistency, contour, color match, keloid formation degree and contiguity of their treated sites at T2. The scores were collected as points, shown in parentheses, by asking the consistency as firm (1p) or spongy (0p); contour as presence (2p) or absence (0p) of knife-edged and scalloped gingival margin; color match as excellent (3p), good (2p), adequate (1p) or unsatisfactory (0p); keloid formation degree as absent (1p) or present (0p); contiguity as the presence (-1p) or absence (0p) of each perceptible incision mark.

    Measured: 6th month

  35. Tissue appearance (TA)

    Tissue appearance (TA) was evaluated by asking the patients to score the consistency, contour, color match, keloid formation degree and contiguity of their treated sites at T2. The scores were collected as points, shown in parentheses, by asking the consistency as firm (1p) or spongy (0p); contour as presence (2p) or absence (0p) of knife-edged and scalloped gingival margin; color match as excellent (3p), good (2p), adequate (1p) or unsatisfactory (0p); keloid formation degree as absent (1p) or present (0p); contiguity as the presence (-1p) or absence (0p) of each perceptible incision mark.

    Measured: 12th month

  36. Dentine hypersensitivity (DH)

    Dentine hypersensitivity (DH) was evaluated with air evaporative stimulus method at baseline and T2. After placement of finger(s) for preserving the nearby teeth, the recession sites were subjected to evaporative stimulus comprised of 1-second air blast from 1 to 3 mm distance by using the air spray at 40-65 psi pressure and 19±50C. After application, the patients were requested to give a score to their DH between 0 (=no pain) and 10 (=extreme pain).

    Measured: 3rd month

  37. Dentine hypersensitivity (DH)

    Dentine hypersensitivity (DH) was evaluated with air evaporative stimulus method at baseline and T2. After placement of finger(s) for preserving the nearby teeth, the recession sites were subjected to evaporative stimulus comprised of 1-second air blast from 1 to 3 mm distance by using the air spray at 40-65 psi pressure and 19±50C. After application, the patients were requested to give a score to their DH between 0 (=no pain) and 10 (=extreme pain).

    Measured: 6th month

  38. Dentine hypersensitivity (DH)

    Dentine hypersensitivity (DH) was evaluated with air evaporative stimulus method at baseline and T2. After placement of finger(s) for preserving the nearby teeth, the recession sites were subjected to evaporative stimulus comprised of 1-second air blast from 1 to 3 mm distance by using the air spray at 40-65 psi pressure and 19±50C. After application, the patients were requested to give a score to their DH between 0 (=no pain) and 10 (=extreme pain).

    Measured: 12th month

  39. Aesthetics (A)

    Aesthetics (A) was evaluated by the patient at T1 by rating its level as excellent, good, fair or poor.

    Measured: 3rd month

  40. Aesthetics (A)

    Aesthetics (A) was evaluated by the patient at T1 by rating its level as excellent, good, fair or poor.

    Measured: 6th month

  41. Aesthetics (A)

    Aesthetics (A) was evaluated by the patient at T1 by rating its level as excellent, good, fair or poor.

    Measured: 12th month

  42. Vestibuler Depth

    VD was measured from the gingival margin to the deepest point of to vestibule sulcus.

    Measured: baseline

  43. Vestibuler Depth

    VD was measured from the gingival margin to the deepest point of to vestibule sulcus.

    Measured: 3rd month

  44. Vestibuler Depth

    VD was measured from the gingival margin to the deepest point of to vestibule sulcus.

    Measured: 6th month

  45. Vestibuler Depth

    VD was measured from the gingival margin to the deepest point of to vestibule sulcus.

    Measured: 12th month

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 Aug 2022
  2. Study start4 Jul 2021
  3. Primary completion30 Jul 2022
  4. Study completion5 Aug 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
50 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05494294
Sponsor's protocol ID
quality of graft
Status last verified
Aug 2022
First submitted
7 Aug 2022
Last updated
11 Aug 2022
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Din F, Kabalak MO, Yilmaz BT, Baris E, Avci H, Caglayan F, Keceli HG. Efficacy of different gingival graft de-epithelialization methods: A parallel-group randomized clinical trial. Clin Oral Investig. 2025 May 7;29(6):289. doi: 10.1007/s00784-025-06365-7.

    PubMed 40332625

Questions about this trial

What is this clinical trial studying?

A study testing Intraorally de-epithelialization and Extraorally de-epithelialization in people with Connective Tissue Graft Harvesting, run by Hacettepe University at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 11 Aug 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Recession reduction (time frame: 3rd month). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05494294, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Aug 2022.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in