AzTrials
AzTrials

CavitationPiezocleanNCT06866431

Effect Of Cavitation In Post-Extractive Socket Healing

An observational study of Cavitation and Healing of Extraction Socket, run by International Piezosurgery Academy at 1 site in Italy.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

In everyday clinical practice, the proper management of the post-extraction socket is crucial in order to enable an optimal healing of the wound and a close post-surgical monitoring is critical to prevent possible complications. Read more about this study

Who is it for?
Ages 18 to 100 years
Conditions the study is for
Cavitation, Healing of Extraction Socket
What is being tested?
Piezoclean
Type of treatment
Surgery or procedure
How many people
84 participants
Where
1 siteItaly
Study dates
1 Apr 2025to 31 Mar 2026
Phase
Observational
Are there results?
Not yet: the study is under way

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 100 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: people with two single rooted hopeless teeth of the same arch to be extracted

Who may be able to join

  • Age between 18 and 100 years
  • Two single rooted hopeless teeth of the same arch to be extracted
  • ASA scale value equal or less than 3
  • Signed informed consent

Who cannot join

  • General contraindications for dental and/or surgical treatments
  • Inflammatory and autoimmune disease of the oral cavity
  • Uncontrolled diabetes (HbA1c > 7.5%)
  • History of malignancy requiring chemotherapy or radiotherapy within the past five years
  • Previous immunosuppressant bisphosphonate or high dose corticosteroid therapy
  • Heavy smokers (> 20 cigarettes /day)
Show all 9Show fewer
  • Pregnancy or lactating women
  • No compliance
  • Extraction performed after raising a flap and/or with osteotomy

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Claudio Stacchi, Dott. contact

+39 0403992254

claudio@stacchi.it

Italy1 site, 1 recruiting
  • University of Trieste

    Trieste, TS, 34127

    Claudio Stacchi, DDS, MSc, +39 0403992254, claudio@stacchi.it

    Recruiting

Other trials in Italy

About this study

In everyday clinical practice, the proper management of the post-extraction socket is crucial in order to enable an optimal healing of the wound and a close post-surgical monitoring is critical to prevent possible complications. After an injury, the cellular reaction starts early, presenting significant changes as soon as 12 to 24 hours later. Favourable wound healing begins with the timely formation, organization, stabilization, and attachment of the blood clot. The stability of the clot is influenced by various factors including the host response, local anatomical characteristics, presence of bacteria and severity of surgical trauma. Delayed healing can lead to increased complications, patient discomfort, and potential procedure failures. In the light of these considerations, the proven effectiveness of piezoelectric devices to facilitate healing mechanisms is known in literature. Inverse piezoelectric effect, as used in current devices, creates mechanical shock waves that oscillate linearly at sonic and ultrasonic frequencies (from 30 to 30.000 Hz). In addition, mechanical micro-movements with a frequency between approximately 24 and 30 kHz create a cavitation effect in the irrigation solution, limiting intraoperative bleeding, thereby increasing the visibility and safety of the procedure.

The purpose of the present study is to evaluate if the application of cavitation effect of post-extractive socket is capable of reducing healing time and Numeric Pain Rating Scale (NPRS) values.

Read the detailed description

Methods: Subjects referring to the clinical centers with the clinical indication of extraction of two contralateral single-rooted teeth of the same arch are suitable for enrollment. Teeth to be extracted should be characterized by the following condition: deep unrecoverable decay; untreatable endodontic issue; untreatable crow-root fracture.

The same surgical extractive protocol will be performed in both sites. Following local anesthesia and periotomy, flapless extraction will be performed using forceps and elevators. After socket debridement with Lucas surgical curette, the extraction sockets will be randomly divided into test and control group. Test group sites will receive 90 seconds of ultrasonic cavitation treatment with 0.9% sodium chloride via a specific insert (Piezoclean, Esacrom, Imola, Italy) driven by a piezoelectric device with the following modalities: i) piezo settings: SURGERY 1 U 040 V 080 P 100; ii) no pressure should be applied to prevent the steel insert from coming into contact with the bone; iii) do not create a complete seal to avoid heating the liquid, which could cause potential discomfort or harm to the patient.

In control group, a simple 0.9% sodium chloride irrigation (control group) will be performed.

An "X" suture will be then applied using non-resorbable synthetic monofilament. All patients will be instructed in post-extractive domiciliary care. Paracetamol 1g every 8 hours in case of pain will be prescribed.

Patients will be given a questionnaire to fill out daily, entering a score on the NPRS (from 1 to 10) for 7 days, where a score of 0 indicates "no pain" and a score of 10 indicates "very severe pain", along with the number of paracetamol intakes per day. Follow-ups will be scheduled for day-3, day-7 for suture removal, day-14, day 21 for final check.

On day 3, day 7, day 14 and day 21 the maturation and quality of tissues will be evaluated using a modified version of the Healing Index (HI) that involves 3 scoring levels for each of the 4 parameters considered:

  • tissue color (1 = 100% of gingiva pink; 2 ≤ 50% of gingiva red, hyperemic, movable; 3 ≥ 50% of gingiva red, hyperemic, movable);
  • color and consistency of the healing tissue (1 = close grained, pink; 2 = soft, red; 3 = fragile, greenish or grayish);
  • suppuration (1 = absent; 2 = absent but pronounced amount of plaque around socket walls; 3 = pronounced);
  • bleeding (1 = absent; 2 = induced by palpation; 3 = spontaneous). The total score ranged from 4 (excellent healing) to 12 (severely impaired healing).

Study design: Prospective randomized clinical trial.

Study population: The study will be conducted in an outpatient hospital setting.

Subject numerosity: The outcome of the study involves the evaluation of the application of cavitation effect via piezoelectric device on post-extractive sockets.

To date, there are no studies in the literature reporting results regarding the application of cavitation that may be used for an adequate sample size calculation.

Therefore, a minimal clinically important difference (MCID) was considered to be a difference between the means of the group 1 and the group 2 of 0.5 points on NPRS at T1 (3gg), with a standard deviation of 1 point. With alpha set at 0.05 and power set at 0.8, a sample size of 62 statistical units per group was calculated.

Each center will treat 12 patients with bilateral extractions (7 centers = 84 patients), to compensate possible drop-outs during the study.

Enrollment procedure: all patients who meet the inclusion and exclusion criteria will be enrolled in the study following the administration of the Information Sheet and the acquisition of informed consent.

Data collection: Data will be entered in an Excel database, which can be accessed using specific usernames and passwords in the possession of the staff involved in the study. The data will be entered anonymously by associating a numeric ID to each patient.

Data analysis: Statistical analysis will be performed by means of a computerized statistical package (SigmaStat 3.5, SPSS Inc., Germany). Data will be expressed as mean ± SD and median (interquartile range), respectively, for parametric and nonparametric values. Data will be normalized and difference in NPRS between the treatments at the various timepoints will be analyzed with descriptive statistics to assess whether they have a normal distribution; both equal variance and normality tests will be used. Hypotheses will be tested using unpaired t-test in case of normally distributed data, while Mann-Whitney U-test will be performed to compare nonparametric values.

Being tested
Piezoclean, Control

What participants receive

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

  • PiezocleanProcedure or surgery

    Following local anesthesia and periotomy, flapless extraction will be performed using forceps and elevators. After socket debridement with Lucas surgical curette, the extraction sockets will be randomly divided into test and control group.Test group sites will receive 90 seconds of ultrasonic cavitation treatment with 0.9% sodium chloride via a specific insert (Piezoclean, Esacrom, Imola, Italy) driven by a piezoelectric device with the following modalities: i) piezo settings: SURGERY 1 U 040 V 080 P 100; ii) no pressure should be applied to prevent the steel insert from coming into contact with the bone; iii) do not create a complete seal to avoid heating the liquid, which could cause potential discomfort or harm to the patient.

    An "X" suture will be then applied using non-resorbable synthetic monofilament.

  • ControlProcedure or surgery

    Following local anesthesia and periotomy, flapless extraction will be performed using forceps and elevators. After socket debridement with Lucas surgical curette, the extraction sockets will be randomly divided into test and control group. In control group, a simple 0.9% sodium chloride irrigation (control group) will be performed.

    An "X" suture will be then applied using non-resorbable synthetic monofilament.

Study groups in NCT06866431
Study groupRoleWhat they receive
PiezocleanUltrasonic cavitation treatment with 0.9% sodium chloride via a specific insert (Piezoclean, Esacrom, Imola, Italy) driven by a piezoelectric device in post extractive socket
Receives: Procedure: Piezoclean
ControlSimple 0.9% sodium chloride irrigation in post extractive socket
Receives: Procedure: Control

What is being measured

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

  1. Maturation and quality of tissues in post extractive socket

    The maturation and quality of tissues will be evaluated using a modified version of the Healing Index (HI) that involves 3 scoring levels for each of the 4 parameters considered:

    • tissue color (1 = 100% of gingiva pink; 2 ≤ 50% of gingiva red, hyperemic, movable; 3 ≥ 50% of gingiva red, hyperemic, movable);
    • color and consistency of the healing tissue (1 = close grained, pink; 2 = soft, red; 3 = fragile, greenish or grayish);
    • suppuration (1 = absent; 2 = absent but pronounced amount of plaque around socket walls; 3 = pronounced);
    • bleeding (1 = absent; 2 = induced by palpation; 3 = spontaneous). The total score ranged from 4 (excellent healing) to 12 (severely impaired healing).

    Measured: 3 days after tooth extraction

  2. Maturation and quality of tissues in post extractive socket

    The maturation and quality of tissues will be evaluated using a modified version of the Healing Index (HI) that involves 3 scoring levels for each of the 4 parameters considered:

    • tissue color (1 = 100% of gingiva pink; 2 ≤ 50% of gingiva red, hyperemic, movable; 3 ≥ 50% of gingiva red, hyperemic, movable);
    • color and consistency of the healing tissue (1 = close grained, pink; 2 = soft, red; 3 = fragile, greenish or grayish);
    • suppuration (1 = absent; 2 = absent but pronounced amount of plaque around socket walls; 3 = pronounced);
    • bleeding (1 = absent; 2 = induced by palpation; 3 = spontaneous). The total score ranged from 4 (excellent healing) to 12 (severely impaired healing).

    Measured: 7 days after tooth extraction

  3. Maturation and quality of tissues in post extractive socket

    The maturation and quality of tissues will be evaluated using a modified version of the Healing Index (HI) that involves 3 scoring levels for each of the 4 parameters considered:

    • tissue color (1 = 100% of gingiva pink; 2 ≤ 50% of gingiva red, hyperemic, movable; 3 ≥ 50% of gingiva red, hyperemic, movable);
    • color and consistency of the healing tissue (1 = close grained, pink; 2 = soft, red; 3 = fragile, greenish or grayish);
    • suppuration (1 = absent; 2 = absent but pronounced amount of plaque around socket walls; 3 = pronounced);
    • bleeding (1 = absent; 2 = induced by palpation; 3 = spontaneous). The total score ranged from 4 (excellent healing) to 12 (severely impaired healing).

    Measured: 14 days after tooth extraction

  4. Maturation and quality of tissues in post extractive socket

    The maturation and quality of tissues will be evaluated using a modified version of the Healing Index (HI) that involves 3 scoring levels for each of the 4 parameters considered:

    • tissue color (1 = 100% of gingiva pink; 2 ≤ 50% of gingiva red, hyperemic, movable; 3 ≥ 50% of gingiva red, hyperemic, movable);
    • color and consistency of the healing tissue (1 = close grained, pink; 2 = soft, red; 3 = fragile, greenish or grayish);
    • suppuration (1 = absent; 2 = absent but pronounced amount of plaque around socket walls; 3 = pronounced);
    • bleeding (1 = absent; 2 = induced by palpation; 3 = spontaneous). The total score ranged from 4 (excellent healing) to 12 (severely impaired healing).

    Measured: 21 days after tooth extraction

Secondary outcomes (7)
  1. NPRS

    The Numeric Pain Rating Scale (NPRS) is an 11-point numeric scale, ranging from 0 indicating no pain to 10 indicating worst pain imaginable.

    Measured: on the day of extraction

  2. NPRS

    The Numeric Pain Rating Scale (NPRS) is an 11-point numeric scale, ranging from 0 indicating no pain to 10 indicating worst pain imaginable.

    Measured: on the first day after extraction

  3. NPRS

    The Numeric Pain Rating Scale (NPRS) is an 11-point numeric scale, ranging from 0 indicating no pain to 10 indicating worst pain imaginable.

    Measured: on the second day after extraction

  4. NPRS

    The Numeric Pain Rating Scale (NPRS) is an 11-point numeric scale, ranging from 0 indicating no pain to 10 indicating worst pain imaginable.

    Measured: on the third day after extraction

  5. NPRS

    The Numeric Pain Rating Scale (NPRS) is an 11-point numeric scale, ranging from 0 indicating no pain to 10 indicating worst pain imaginable.

    Measured: on the fourth day after extraction

  6. NPRS

    The Numeric Pain Rating Scale (NPRS) is an 11-point numeric scale, ranging from 0 indicating no pain to 10 indicating worst pain imaginable.

    Measured: on the fifth day after extraction

  7. NPRS

    The Numeric Pain Rating Scale (NPRS) is an 11-point numeric scale, ranging from 0 indicating no pain to 10 indicating worst pain imaginable.

    Measured: on the sixth day after extraction

Timeline

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

  1. First posted10 Mar 2025
  2. Study start1 Apr 2025
  3. Primary completion31 Mar 2026 (estimated)
  4. Study completion31 Mar 2026 (estimated)

Resources

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
84 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06866431
Sponsor's protocol ID
PIEZOCLEAN
Acronym
Piezoclean
Status last verified
May 2025
First submitted
4 Mar 2025
Last updated
28 May 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

An observational study of Cavitation and Healing of Extraction Socket, run by International Piezosurgery Academy at 1 site in Italy.

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 4 inclusion and 9 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: looking for participants now, as of the sponsor's last update on 28 May 2025. 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 Italy. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Claudio Stacchi, Dott. (+39 0403992254, claudio@stacchi.it), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Maturation and quality of tissues in post extractive socket (time frame: 3 days after tooth extraction). The study lists 4 primary outcomes in all. 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 28 May 2025.

Free account

Keep searching with a free account

You’ve used your 3 free searches for this session. Log in or create a free AzTrials account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in