Gingival RecessionNCT06118177
Ultrasonographic Assessment of Palatal Wound Healing
An observational study of Gingival Recession and Palate; Wound, run by Pamukkale University at 1 site in Turkey (Türkiye).
Trial summary
Palatal-tissue harvesting is a routinely performed procedure in periodontal plastic surgery. Subepithelial connective tissue graft (sCTG) is considered the gold standard in root coverage. Read more about this study
- Who is it for?
- Ages 20 to 65 yearsHealthy volunteers can take part
- Conditions the study is for
- Gingival Recession, Palate; Wound
- What is being tested?
- connective tissue harvesting, ultrasonography and autolog platelet rich fibrin application
- Type of treatment
- Surgery or procedure
- How many people
- 20 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 5 Sep 2022to 8 Aug 2023
- How long will I take part?
- 3 Months
- Phase
- Observational
- 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 20 to 65 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Study population: Patients with Miller 1 and 2 gingival recession who need root coverage treatment
Who may be able to join
- Need connective tissue for tunnel operation or coronally flap operation for the treatment of gingival recession
- Non-smoking
- Good oral hygiene
- No gag reflex
- No periodontal surgery before at operation site
Who cannot join
- Systemic disorders (immunologic diseases, uncontrolled diabetes mellitus, ongoing chemotherapy or radiotherapy)
- Pregnancy/lactation/menstruation
- Inability or unwillingness to provide informed consent
Trial locations and contacts
1 site in 1 country.
Turkey (Türkiye)1 site
Pamukkale University Faculty of Dentistry
Denizli, 20160
About this study
Official title: Ultrasonographic Assessment of the Effects of Platelet Rich Fibrin on Wound Healing Following Palatal Connective Tissue Harvesting.
Palatal-tissue harvesting is a routinely performed procedure in periodontal plastic surgery. Subepithelial connective tissue graft (sCTG) is considered the gold standard in root coverage. However, over the years, several materials have been attempted to accelerate wound healing and to decrease the post-operative patient discomfort and pain, which are considered the most common disadvantages of tissue harvesting from the palate. Reharvesting from the same region could be necessary in some complicated gingical recessions. For this reason, patients may face long treatment times due to recovery periods of the palate between surgeries.
Platelet-rich fibrin (PRF) which has 3-dimensional fibrin matrix structure contributes to regeneration of surgical wounds by releasing growth factors for 10-14 days and showing angiogenic properties.
Read more
In medicine and dentistry, ultrasonography (USG) method can be used to measure tissue thickness, vascularization, elasticity and blood flow. USG, as a non-invasive method, can provide objective data in evaluating the effects of surgical techniques and biomaterials used on soft tissue healing dynamics and tissue perfusion.
The investigators hypothesised that leukocyte rich PRF (L-PRF) application to the palatal area after sCTG harvesting could increase palatal tissue thickness and vascularity throughout 3-month follow-up period compared to the controls. Therefore, in this study, the investigators aimed to evaluate the effects of the L-PRF membrane on soft tissue donor site healing after harvesting sCTG in terms of wound healing dynamics using USG method.
Read the detailed description
This study was planned as a randomized prospective controlled study. Patients with Miller class 1 or 2 gingival recession who needs root coverage surgery in the Department of Periodontology were included in the study. The subepithelial connective tissue graft was obtained in each patient using the single incision technique from the region between the mesial of canine and the mesial of first molar in the palate. Connective tissue dimensions were approximately 10 × 5 × 2 mm. Finally, the incision line was sutured with 5/0 synthetic, nonabsorbable, sterile monofilament suture in the control group while L-PRF membrane was placed to the donor site in the test group before the suturing. Patients were evaluated using an ultrasonography device (MyLab™ Seven, Esaote, Genoa, Italy) at the Department of Oral and Maxillofacial Radiology. USG measurements were performed on days 0, 3, 7, 14, 21, 30 and 90 for palatal tissue thickness and tissue vascularization by an oral and maxillofacial radiologist with at least six years of experience. A 6-18 MHz intraoral probe was used in intraoral USG examinations. Sterile gel was applied to the intraoral probe and covered with a stretch film. Then, it was placed directly on the mucosal surface of the donor site in the palatal area. Mucosal thickness was evaluated using the B-mode of the device, and vascularization was evaluated using the color doppler and pulsed wave doppler modes of the device. The mean pulsatility index (PI) values of each patient were calculated and considered for statistical analysis.
The power analyse of the study was performed for sample size calculation. Sample size was calculated using a statistical program (G*Power; Universitat, Dusseldorf, Germany) for α = 0.05 and effect size = 0.26. The analyses revealed that 10 subjects per group achieved a power of 80 % with 95% confidence.
The data were analysed with the SPSS 21 program (SPSS Inc., Chicago, IL). Continuous variables were presented as mean ± standard deviation and categorical variables as numbers and percentages. Shapiro-Wilk test was used to detect data's normality. For the comparison of the parameters of the study groups, independent samples T-test test was used for normally distributed data while Mann Whitney U test test was performed as non-parametric test. Within-group comparisons between the different time periods were tested with repeated measures of ANOVA. Bonferroni correction was performed for multiple variations. The statistical significance value was accepted as p < 0.05.
- Conditions
- Gingival Recession, Palate; Wound
- Being tested
- connective tissue harvesting, ultrasonography, autolog platelet rich fibrin application
- Keywords
- platelet-rich fibrin, wound healing, ultrasonography, blood-flow velocity
- Medical subject headings
- Gingival Recession, Wounds and Injuries
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
connective tissue harvestingProcedure or surgery
The subepithelial connective tissue graft was obtained in each patient using the single incision technique from the region between the mesial of canine and the mesial of first molar in the palate. Connective tissue dimensions were approximately 10 × 5 × 2 mm. Finally, the incision line was sutured with 5/0 synthetic, nonabsorbable, sterile monofilament suture
ultrasonographyDiagnostic test
A 6-18 MHz intraoral probe was used in intraoral USG examinations. Sterile gel was applied to the intraoral probe and covered with a stretch film. Then, it was placed directly on the mucosal surface of the donor site in the palatal area. Mucosal thickness was evaluated using the B-mode of the device, and vascularization was evaluated using the color doppler and pulsed wave doppler modes of the device. The following equation is used and calculated by US unit: Pulsality index (PI) = (Vmax-Vmin)/(Vmean) (Vmax is peak systolic flow velocity, Vmin is diastolic flow velocity and Vmean is mean flow velocity). The mean PI values of each patient were measured.
autolog platelet rich fibrin applicationOther
Leukocyte rich PRF (L-PRF) was obtained with the centrifugation of the two tubes at 2800 rpm for 12 minutes. After centrifugation, L-PRF clots were taken from the tubes using sterile tweezers, separated from the red blood cell base using scissors. Then L-PRF membrane was placed into the donor site.
| Study group | Role | What they receive |
|---|---|---|
| Test group | 20-ml blood samples were taken from the antecubital vein of the patient's right or left arm in one attempt. The blood was gently transferred to glass-coated plastic tubes free from anticoagulant agents without wasting time. The tubes were immediately centrifuged at 2800 rpm for 12 min with a centrifuge device.
After the subepithelial connective tissue graft harvesting from in the palate, obtained L-PRF was placed into donor site at the palate then incision line was suturedwith 5/0 synthetic, non-absorbable, sterile monofilament suture. Receives: Procedure: connective tissue harvesting; Diagnostic Test: ultrasonography; Other: autolog platelet rich fibrin application | |
| Control group | After the subepithelial connective tissue graft harvesting from in the palate, the incision line was sutured with 5/0 synthetic, nonabsorbable, sterile monofilament suture. No additional material was performed into the donör area. Receives: Procedure: connective tissue harvesting; Diagnostic Test: ultrasonography |
What is being measured
The primary outcome is the main question the study is designed to answer.
tissue thickness
tissue thickness was measured with B-Mod mod of ultrasonography device
Measured: at baseline before operation, on days 3, 7, 14, 21, 30, 90
Secondary outcomes (1)
pulsatility index
pulsatility index was measured with Doppler-mode of ultrasonography device
Measured: at baseline immediately after the operation, on days 3, 7, 14, 30, 90
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted7 Nov 2023
- Study start5 Sep 2022
- Primary completion8 Aug 2023
- Study completion8 Aug 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Gingival RecessionStudies of the same condition, open and under way.
- More trials run by Pamukkale UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Case-control
- Time perspective
- Prospective
- Enrolment
- 20 participants (actual)
- Target duration
- 3 Months
Sponsor and investigators
- Lead sponsor
- Pamukkale University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Gizem Torumtay Cin, Pamukkale University
- Investigators
- Gizem Torumtay Cin, asist.prof., Principal investigator, Pamukkale University Faculty of Dentistry
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06118177
- Sponsor's protocol ID
- 16.08.2022/12
- Status last verified
- Nov 2023
- First submitted
- 31 Oct 2023
- Last updated
- 8 Nov 2023
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 8 Nov 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Ultrasonographic Assessment of the Effects of Platelet Rich Fibrin on Wound Healing Following Palatal Connective Tissue Harvesting.
- ClinicalTrials.gov ID
- NCT06118177
- Acronym / sponsor ID
- 16.08.2022/12
- Conditions
- Gingival Recession, Palate; Wound
- Keywords
- platelet-rich fibrin, wound healing, ultrasonography, blood-flow velocity
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 20 participants (actual)
- Lead sponsor
- Pamukkale UniversityUniversity, hospital or other
- Study start
- 5 Sep 2022 (actual)
- Primary completion
- 8 Aug 2023 (actual)
- Study completion
- 8 Aug 2023 (actual)
- First posted
- 7 Nov 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Palatal-tissue harvesting is a routinely performed procedure in periodontal plastic surgery. Subepithelial connective tissue graft (sCTG) is considered the gold standard in root coverage. However, over the years, several materials have been attempted to accelerate wound healing and to decrease the post-operative patient discomfort and pain, which are considered the most common disadvantages of tissue harvesting from the palate. Reharvesting from the same region could be necessary in some complicated gingical recessions. For this reason, patients may face long treatment times due to recovery periods of the palate between surgeries.
Platelet-rich fibrin (PRF) which has 3-dimensional fibrin matrix structure contributes to regeneration of surgical wounds by releasing growth factors for 10-14 days and showing angiogenic properties.
In medicine and dentistry, ultrasonography (USG) method can be used to measure tissue thickness, vascularization, elasticity and blood flow. USG, as a non-invasive method, can provide objective data in evaluating the effects of surgical techniques and biomaterials used on soft tissue healing dynamics and tissue perfusion.
The investigators hypothesised that leukocyte rich PRF (L-PRF) application to the palatal area after sCTG harvesting could increase palatal tissue thickness and vascularity throughout 3-month follow-up period compared to the controls. Therefore, in this study, the investigators aimed to evaluate the effects of the L-PRF membrane on soft tissue donor site healing after harvesting sCTG in terms of wound healing dynamics using USG method.
Detailed description
This study was planned as a randomized prospective controlled study. Patients with Miller class 1 or 2 gingival recession who needs root coverage surgery in the Department of Periodontology were included in the study. The subepithelial connective tissue graft was obtained in each patient using the single incision technique from the region between the mesial of canine and the mesial of first molar in the palate. Connective tissue dimensions were approximately 10 × 5 × 2 mm. Finally, the incision line was sutured with 5/0 synthetic, nonabsorbable, sterile monofilament suture in the control group while L-PRF membrane was placed to the donor site in the test group before the suturing. Patients were evaluated using an ultrasonography device (MyLab™ Seven, Esaote, Genoa, Italy) at the Department of Oral and Maxillofacial Radiology. USG measurements were performed on days 0, 3, 7, 14, 21, 30 and 90 for palatal tissue thickness and tissue vascularization by an oral and maxillofacial radiologist with at least six years of experience. A 6-18 MHz intraoral probe was used in intraoral USG examinations. Sterile gel was applied to the intraoral probe and covered with a stretch film. Then, it was placed directly on the mucosal surface of the donor site in the palatal area. Mucosal thickness was evaluated using the B-mode of the device, and vascularization was evaluated using the color doppler and pulsed wave doppler modes of the device. The mean pulsatility index (PI) values of each patient were calculated and considered for statistical analysis.
The power analyse of the study was performed for sample size calculation. Sample size was calculated using a statistical program (G*Power; Universitat, Dusseldorf, Germany) for α = 0.05 and effect size = 0.26. The analyses revealed that 10 subjects per group achieved a power of 80 % with 95% confidence.
The data were analysed with the SPSS 21 program (SPSS Inc., Chicago, IL). Continuous variables were presented as mean ± standard deviation and categorical variables as numbers and percentages. Shapiro-Wilk test was used to detect data's normality. For the comparison of the parameters of the study groups, independent samples T-test test was used for normally distributed data while Mann Whitney U test test was performed as non-parametric test. Within-group comparisons between the different time periods were tested with repeated measures of ANOVA. Bonferroni correction was performed for multiple variations. The statistical significance value was accepted as p < 0.05.
Study design
- Observational model
- Case-control
- Time perspective
- Prospective
- Target follow-up
- 3 Months
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Test group | – | Procedure: connective tissue harvesting, Diagnostic Test: ultrasonography, Other: autolog platelet rich fibrin application20-ml blood samples were taken from the antecubital vein of the patient's right or left arm in one attempt. The blood was gently transferred to glass-coated plastic tubes free from anticoagulant agents without wasting time. The tubes were immediately centrifuged at 2800 rpm for 12 min with a centrifuge device. After the subepithelial connective tissue graft harvesting from in the palate, obtained L-PRF was placed into donor site at the palate then incision line was suturedwith 5/0 synthetic, non-absorbable, sterile monofilament suture. |
| Control group | – | Procedure: connective tissue harvesting, Diagnostic Test: ultrasonographyAfter the subepithelial connective tissue graft harvesting from in the palate, the incision line was sutured with 5/0 synthetic, nonabsorbable, sterile monofilament suture. No additional material was performed into the donör area. |
Who may qualify
- Ages
- 20 to 65 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
- Study population
- Patients with Miller 1 and 2 gingival recession who need root coverage treatment
Key inclusion criteria (5 listed)
- Need connective tissue for tunnel operation or coronally flap operation for the treatment of gingival recession
- Non-smoking
- Good oral hygiene
- No gag reflex
- No periodontal surgery before at operation site
Key exclusion criteria (3 listed)
- Systemic disorders (immunologic diseases, uncontrolled diabetes mellitus, ongoing chemotherapy or radiotherapy)
- Pregnancy/lactation/menstruation
- Inability or unwillingness to provide informed consent
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| connective tissue harvestingThe subepithelial connective tissue graft was obtained in each patient using the single incision technique from the region between the mesial of canine and the mesial of first molar in the palate. Connective tissue dimensions were approximately 10 × 5 × 2 mm. Finally, the incision line was sutured with 5/0 synthetic, nonabsorbable, sterile monofilament suture | Procedure or surgery | Control group, Test group |
| ultrasonographyA 6-18 MHz intraoral probe was used in intraoral USG examinations. Sterile gel was applied to the intraoral probe and covered with a stretch film. Then, it was placed directly on the mucosal surface of the donor site in the palatal area. Mucosal thickness was evaluated using the B-mode of the device, and vascularization was evaluated using the color doppler and pulsed wave doppler modes of the device. The following equation is used and calculated by US unit: Pulsality index (PI) = (Vmax-Vmin)/(Vmean) (Vmax is peak systolic flow velocity, Vmin is diastolic flow velocity and Vmean is mean flow velocity). The mean PI values of each patient were measured. | Diagnostic test | Control group, Test group |
| autolog platelet rich fibrin applicationLeukocyte rich PRF (L-PRF) was obtained with the centrifugation of the two tubes at 2800 rpm for 12 minutes. After centrifugation, L-PRF clots were taken from the tubes using sterile tweezers, separated from the red blood cell base using scissors. Then L-PRF membrane was placed into the donor site. | Other | Test group |
Primary outcome
tissue thickness
Time frame: at baseline before operation, on days 3, 7, 14, 21, 30, 90
tissue thickness was measured with B-Mod mod of ultrasonography device
1 secondary outcome
pulsatility index
Time frame: at baseline immediately after the operation, on days 3, 7, 14, 30, 90
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Nov 2023.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Gizem Torumtay Cin, asist.prof. principal investigator
Pamukkale University Faculty of Dentistry
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Gingival Recession and Palate; Wound, run by Pamukkale 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 5 inclusion and 3 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 8 Nov 2023. 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?
tissue thickness (time frame: at baseline before operation, on days 3, 7, 14, 21, 30, 90). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 8 Nov 2023.