Palatal Wound Healing After Free Gingival Graft Harvest in Diabetic Patients: A Clinical Trial
Oral Mucosa Wound Healing in Diabetic Patients. A Clinical Study on Open and Closed Wounds
The goal of this clinical trial is to evaluate local and systemic factors involved in palatal mucosal healing after Free Gingival Graft harvest in diabetic patients and to compare them with those in non-diabetic patients.
Diabetic and non-diabetic volunteers of both sexes aged ≥ 18 years with gingival recession may participate. The main questions it aims to answer are:
- If the palatal wound healing (area of the wound) and percentage of wound epithelialization are different in diabetics compared to non-diabetics.
- If different factors, such as the oral microbiome, inflammatory markers, and others, are associated with the clinical outcome.
Participants will be asked:
- Receive the procedure to treat their gingival recession defects
- To attend follow-up visits at 7, 14, 30, and 90 days after treatment.
- To provide different biological samples
- To answer different questionnaires.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Dawn G Dawson
- Phone Number: 8593235409
- Email: dawn.dawson@uky.edu
Study Locations
-
-
Kentucky
-
Lexington, Kentucky, United States, 40536
- College of Dentistry - University of Kentucky
-
Contact:
- Mauro Pedrine Santamaria, DDS, Ms, PhD
- Phone Number: 859 323 6297
- Email: maurosantamaria@uky.edu
-
Contact:
- Dawn Dawson
- Phone Number: 859 323-5409
- Email: dawn.dawson@uky.edu
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- aged ≥ 18 years;
- non-diabetic and diabetic patients (HbA1c>7% (American Diabetes Association 2025) managed with oral hypoglycemic agents or insulin;
- in the need of gingival recession treatment (RT1) in upper or lower arches with identifiable or restored cement-enamel junction (CEJ);
- periodontal stable (BoP ≤25%)(Lang et al. 2003);
- no morphological or pathological conditions in the palatal mucosa.
Exclusion Criteria:
- patients with cardiovascular, blood dyscrasias, and immunodeficiency that contraindicate surgical procedures;
- taking medications known to interfere with the wound healing process or that contraindicate the surgical procedure;
- Pregnancy/lactation (assessed via self-report);
- current opportunistic oral lesions that mainly colonize the palate region;
- subjects that have taken antibiotics within the last 3 months or need for antibiotic prophylaxis;
- prisoners;
- signs or symptoms of active extra-oral head and neck infection (swelling) as determined by a dentist at the time of evaluation;
- subjects who cannot read or speak English or Spanish, and do not agree to having the assistance of an interpreter
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Basic Science
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Diabetes group
Diabetic volunteers with gingival recession will be treated with coronally advanced flap and connective tissue graft (CTG).
The CTG will be obtained by harvesting a 2-mm thick free gingival graft (FGG), measuring 15 × 5 mm from the palatal area between the distal of the canine and the mesial aspect of the first molar.
The palatal wound will be evaluated.
|
Volunteers with gingival recession will be treated with coronally advanced flap and connective tissue graft (CTG).
The CTG will be obtained by harvesting a 2-mm thick free gingival graft (FGG), measuring 15 × 5 mm from the palatal area between the distal of the canine and the mesial aspect of the first molar.
The palatal wound will be evaluated.
|
|
Active Comparator: Non-diabetes group
Non-diabetic volunteers with gingival recession will be treated with coronally advanced flap and connective tissue graft (CTG).
The CTG will be obtained by harvesting a 2-mm thick free gingival graft (FGG), measuring 15 × 5 mm from the palatal area between the distal of the canine and the mesial aspect of the first molar.
The palatal wound will be evaluated.
|
Volunteers with gingival recession will be treated with coronally advanced flap and connective tissue graft (CTG).
The CTG will be obtained by harvesting a 2-mm thick free gingival graft (FGG), measuring 15 × 5 mm from the palatal area between the distal of the canine and the mesial aspect of the first molar.
The palatal wound will be evaluated.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Remaining wound area (RWA)
Time Frame: 3 months
|
The RWA will be measured in square millimeters using software (Image J- NIH, Bethesda, Maryland, USA) at baseline (trans-operative) and 1, 2, 4, and 12 weeks after the surgery
|
3 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Insomnia Severity Index Survey
Time Frame: Baseline and up to 4 weeks
|
The insomnia survey scores range from 0 to 28 with a higher score indicating greater insomnia.
|
Baseline and up to 4 weeks
|
|
Epithelialization - EPT
Time Frame: 3 months
|
Standardized photographs will be taken after a disclosure solution (Disclosing Agent, Dentsply, Charlotte, NC, USA) application in the wound area at 1,2, 4, and 12 weeks postoperatively.
The epithelialized area was calculated as the percentage of the original wound area using software (Image J- NIH, Bethesda, Maryland, USA) calibrated with a measuring scale in the palate.
|
3 months
|
|
Tissue thickness - TT
Time Frame: 3 months
|
An endodontic spreader with a stop rubber will be inserted at the center of the wound area until reaching the bone.
The distance between the instrument tip and the rubber stopper will be measured with a digital caliper
|
3 months
|
|
Inflammatory markers
Time Frame: 2 weeks
|
The wound exudate may be collected 1 week after the procedure.
Two paper strips (periopaper, Oraflow, Inc.) per wound will be individually placed and left in position for 40-60 s each.
Before sampling, the wound will be gently rinsed and dried using water and an air spray.
Relative isolation will then be performed immediately.
If contamination with blood or saliva occurs, the paper strip will be discarded, and a new sample will be collected.
In sequence, both paper strips will be placed into Eppendorf tubes and stored at -80º Celsius for further processing of inflammatory markers by Multiplex assay
|
2 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Mauro Pedrine Santamaria, DDS, Ms, PhD, University Of Kentucky
Publications and helpful links
General Publications
- Miguel MMV, Mathias-Santamaria IF, Rossato A, Ferraz LFF, Rangel TP, Casarin RCV, Tatakis DN, Santamaria MP. Enamel matrix derivative effects on palatal mucosa wound healing: Randomized clinical trial. J Periodontal Res. 2021 Dec;56(6):1213-1222. doi: 10.1111/jre.12934. Epub 2021 Sep 19.
- Santamaria MP, Mathias-Santamaria IF, Ferreira Bonafe AC, Gonzalez OA, Kirakodu S, Monteiro MF, Casarin RCV, Shaddox LM, Miguel MMV. Microbiome and Inflammatory Biomarkers Associated With Palatal Wound Healing. J Periodontal Res. 2025 Jul;60(7):664-675. doi: 10.1111/jre.13373. Epub 2025 Jan 13.
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- IRB-109004
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Diabetes Mellitus
-
NCT03811470RecruitingType 2 Diabetes Mellitus | Type1 Diabetes Mellitus | Monogenetic Diabetes | Pancreatogenic Diabetes | Drug-Induced Diabetes Mellitus | Other Forms of Diabetes Mellitus
-
NCT05168657CompletedDiabetes Mellitus, Type 1 | Type 1 Diabetes | Diabetes type1 | Type 1 Diabetes Mellitus | Autoimmune Diabetes | Diabetes Mellitus, Insulin-Dependent | Juvenile-Onset Diabetes | Diabetes, Autoimmune | Insulin-Dependent Diabetes Mellitus 1 | Diabetes Mellitus, Insulin-Dependent, 1
-
NCT00563004CompletedDiabetes Mellitus Type 2 | Diabetes Mellitus, Non-insulin Dependant | Diabetes Mellitus, on Oral Hypoglycemic Treatment | Adult Type Diabetes Mellitus
-
NCT04129424UnknownType 2 Diabetes Mellitus | Type 1 Diabetes Mellitus | Gestational Diabetes Mellitus | Pancreatogenic Diabetes Mellitus | Pregestational Diabetes Mellitus | Diabetes Patients in Perioperative Period
-
NCT02088658CompletedDiabetes Mellitus, Type 2 | Diabetes Mellitus, Type II | Diabetes Mellitus, Adult-Onset | Diabetes Mellitus, Non-Insulin-Dependent | Diabetes Mellitus, Noninsulin Dependent
-
NCT00929838CompletedDiabetes Mellitus, Type 2 | Diabetes Mellitus, Type II | Diabetes Mellitus, Adult-Onset | Diabetes Mellitus, Non-Insulin-Dependent | Diabetes Mellitus, Noninsulin Dependent
-
NCT02722499CompletedDiabetes Mellitus | Type 2 Diabetes Mellitus | Adult-Onset Diabetes Mellitus | Non-Insulin-Dependent Diabetes Mellitus | Noninsulin Dependent Diabetes Mellitus, Type II
-
NCT03332849UnknownType2 Diabetes Mellitus | Type1 Diabetes Mellitus
-
NCT07228117RecruitingType 2 Diabetes Mellitus | Type 1 Diabetes Mellitus
-
NCT07011147RecruitingDiabetes Mellitus | Diabetes | Type 2 Diabetes | Diabetes Mellitus Type 2 | Diabetes Mellitus, Type I | Diabetes Mellitus Type II | Diabetes Mellitus, Insulin-Dependent | Diabetes, Autoimmune | Type 1 Diabetes (T1D) | Diabetes Type 2 on Insulin
Clinical Trials on Free gingival graft
-
NCT02613702Active, not recruiting
-
NCT07617987Not yet recruitingInsufficient Keratinized Gingiva
-
NCT06037694Recruiting
-
NCT06615687Not yet recruiting
-
NCT05604391RecruitingGingival Recession | Lack of Keratinized Gingiva
-
NCT07409558RecruitingGingival Recession, Localized | Soft Tissue Volume Changes | Keratinized Tissue Deficiency
-
NCT04920136RecruitingGingival Recession | Thin Gingiva | Lack of Keratinized Attached Peri-implant Mucosa
-
NCT04970524Completed
-
NCT07365865Active, not recruitingHealthy | Deficient Keratinized Mucosa