Use of a Custom-Made Acrylic Palatal Stent to Minimize Donor Site Morbidity After Suture-Free Epithelialized Gingival Graft Harvesting: A Randomized Clinical Trial
Epithelialized gingival graft (EGG) harvesting from the palate is associated with postoperative morbidity, including pain and bleeding, due to healing by secondary intention. The effectiveness of palatal stents in reducing donor-site morbidity, particularly in suture-free techniques, remains unclear.
This randomized controlled clinical trial evaluates the effect of a custom-made acrylic palatal stent (APS) compared with no stent on postoperative outcomes following EGG harvesting.
The primary outcome is postoperative pain assessed using a visual analog scale (VAS). Secondary outcomes include other patient-reported measures, clinician-reported healing, and exploratory assessments of tissue healing.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Epithelialized gingival graft (EGG) harvesting is widely used in periodontal plastic surgery but is associated with postoperative discomfort at the palatal donor site. Healing occurs by secondary intention and may result in pain, bleeding, and delayed recovery.
Palatal stents have been proposed as a mechanical approach to protect the wound and reduce morbidity; however, evidence supporting their effectiveness, especially in suture-free techniques, is limited.
This randomized controlled, assessor-blind, parallel-arm clinical trial aims to evaluate the effect of a custom-made acrylic palatal stent (APS) on postoperative morbidity following EGG harvesting. Patients were randomly assigned to receive APS or no stent after surgery.
The primary outcome is postoperative pain. Secondary outcomes include patient-reported measures, clinical healing parameters, and exploratory assessments of tissue healing.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Torino
-
Torino, Torino, Italy, 10126
- C.I.R. Dental School
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Adults ≥18 years of age
- Patients requiring periodontal plastic surgery involving epithelialized gingival graft (EGG) harvesting from the palate
- Indications including keratinized tissue augmentation, soft tissue thickness augmentation, or root coverage procedures
- Adequate palatal tissue thickness to allow graft harvesting (≥2 mm)
- Full-mouth plaque score (FMPS) and full-mouth bleeding score (FMBS) ≤20%
- Ability to understand and complete patient-reported outcome questionnaires
- Signed informed consent
- Willingness to comply with study procedures and follow-up visits
Exclusion Criteria:
- compromised general health contraindicating the procedures (ASA III-VI)
- heavy smokers (≥ 10 cigarettes/day),
- systemic diseases or medications affecting treatment outcomes,
- known allergies or hypersensitivity to ibuprofen.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Custom-Made Acrylic Palatal Stent
A custom-made acrylic palatal stent (APS) will be fabricated prior to surgery based on an impression of the maxillary arch. The device will be thermoformed, trimmed, polished, and adjusted for proper fit and retention. Following epithelialized gingival graft (EGG) harvesting, the APS will be positioned over the palatal donor site to provide mechanical protection and stabilization of the blood clot. The stent will be worn continuously during the early healing phase according to the study protocol. |
A custom-made acrylic palatal stent (APS) will be fabricated prior to surgery based on an impression of the maxillary arch. The device will be thermoformed, trimmed, polished, and adjusted for proper fit and retention. Following epithelialized gingival graft (EGG) harvesting, the APS will be positioned over the palatal donor site to provide mechanical protection and stabilization of the blood clot. The stent will be worn continuously during the early healing phase according to the study protocol. |
|
Active Comparator: No palatal stent
Following epithelialized gingival graft (EGG) harvesting, no protective device will be applied to the palatal donor site.
Hemostasis will be achieved through local anesthesia only, without the use of sutures, pressure, or additional hemostatic agents.
Healing will occur by secondary intention
|
Following epithelialized gingival graft (EGG) harvesting, no protective device will be applied to the palatal donor site.
Hemostasis will be achieved through local anesthesia only, without the use of sutures, pressure, or additional hemostatic agents.
Healing will occur by secondary intention
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Postoperative pain at the palatal donor site
Time Frame: 7 days after surgery
|
Postoperative pain assessed using a 100-mm visual analog scale (VAS), where 0 indicates no pain and 100 indicates worst imaginable pain.
Patients will record pain daily using standardized questionnaires
|
7 days after surgery
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Postoperative bleeding
Time Frame: Daily from Day 1 to Day 7, Day 14, 21, 28
|
Patient-reported bleeding at the palatal donor site assessed using a 100-mm VAS
|
Daily from Day 1 to Day 7, Day 14, 21, 28
|
|
Postoperative swelling
Time Frame: Daily from Day 1 to Day 7, day 14, 21, 28
|
Patient-reported swelling assessed using a 100-mm VAS.
|
Daily from Day 1 to Day 7, day 14, 21, 28
|
|
Analgesic consumption
Time Frame: 7 days after surgery
|
Total intake of ibuprofen (mg) recorded by patients during the postoperative period.
|
7 days after surgery
|
|
Oral health-related quality of life (OHIP-14)
Time Frame: Baseline, 7 days, 14 days, 21 days, 28 days
|
Oral health-related quality of life assessed using the OHIP-14 questionnaire
|
Baseline, 7 days, 14 days, 21 days, 28 days
|
|
Willingness to undergo retreatment
Time Frame: 28 days after surgery
|
Patient willingness to undergo a similar procedure in the future (yes/no)
|
28 days after surgery
|
|
Epithelialization
Time Frame: 7 and 14 days after surgery
|
Wound epithelialization assessed using hydrogen peroxide (H₂O₂) test and classified as none, partial, or complete.
|
7 and 14 days after surgery
|
|
Clinical wound healing
Time Frame: 7, 14 days
|
Healing assessed from standardized photographs evaluating color match, tissue contour, and scar appearance using visual analog scales.
|
7, 14 days
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Optical Coherence Tomography (OCT) parameters
Time Frame: Baseline, 7, 14, 21, 28 days after surgery
|
Quantitative assessment of palatal tissue healing using OCT, including measurements of epithelial layer, keratin layer, and lamina propria thickness.
|
Baseline, 7, 14, 21, 28 days after surgery
|
|
Inflammatory biomarkers in wound exudate
Time Frame: 4 days post surgery
|
Levels of inflammatory and healing-related biomarkers (e.g., IL-1β, IL-6, TGF-β1, VEGF-A) measured from palatal wound exudate using multiplex assay.
|
4 days post surgery
|
|
Postoperative complications
Time Frame: up to 28 days
|
Incidence of complications including infection, delayed healing, excessive bleeding, or other adverse events.
|
up to 28 days
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- FGFTurin
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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 Pain Management
-
NCT06849648CompletedPain Management | Nonpharmalogical Pain Management | Children Pain Management
-
NCT06719726CompletedPain Management | Breast Augmentation | Pain Management After Surgery | Pain Management in Postoperative Care
-
NCT06155825Not yet recruitingPain Management | Neonates Pain Management
-
NCT07016386Active, not recruitingPain | Pain Management | Pain Management in Postoperative Care
-
NCT04341194CompletedInfant Pain Management | Parent-driven Pain Management
-
NCT02506348UnknownPain Management | Post Surgical Management | Inflamation Management
-
NCT02654860CompletedPhase 1: Pain Management | Phase 2: Pain Management
-
NCT07355166Not yet recruitingPostoperative Pain Management
-
NCT07242339Completed
-
NCT07417319CompletedPostoperative Pain Management
Clinical Trials on Custom-Made Acrylic Palatal Stent
-
NCT07523802RecruitingPostoperative Pain | Gingival Recessions | Mucogingival Defects
-
NCT06972823Not yet recruitingMouthguard Use | Orofacial Injuries Prevention | 3D Printed Mouthguard | Traditional Custom-made Mouthguard | Speech and Oral Functions
-
NCT04054076CompletedDiabetes | Diabetic Foot | Foot Ulcer | Foot Deformities | Neuropathy | Gait Disorder, Sensorimotor | Plantar Ulcer | Motor Neuropathy
-
NCT07643259CompletedTMJ Disorder | Mandibular Deficiency | TMJ Ankylosis
-
NCT05411224Recruiting
-
NCT07493200Active, not recruiting
-
NCT02581605Active, not recruitingArthritis of Knee
-
NCT01663519CompletedQuality of Life | Diabetic Foot | Neuropathy