- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03792113
AUTOLOGOUS FIBRIN GLUE VERSES 4-0 SILK SUTURES IN PERIODONTAL FLAP CLOSURE
EVALUATION AND COMPARISON OF THE EFFICACY OF AUTOLOGOUS FIBRIN GLUE WITH 4-0 SILK SUTURES IN PERIODONTAL FLAP CLOSURE AND WOUND HEALING - A SPLIT MOUTH RANDOMIZED CONTROLLED TRIAL.
The study is a split mouth study but the interventions for the two different arms will be spaced by a fixed duration in time. Verbal and written consent will be obtained from the patients fulfilling the inclusion and exclusion criteria after briefing them about the procedure. Following phase-1 periodontal therapy, randomisation for the test and control quadrants will be done. Surgical debridement will be done first for the control side to avoid the carry-across effect of fibrin glue. Control and test procedures will be performed with a wash out period of 15days.
Preparation of Autologous fibrin glue :
- 10 ml of blood will be withdrawn from healthy adult human donor by venous puncture into sodium citrate vials and will be centrifuged for 30 min at 1200 g to obtain platelet-poor plasma (PPP).
- To the solution, fibrinogen and protamine sulphate will be added and will be centrifuged at 1000 g for 5 min to sediment the precipitate and fibrin glue will be procured.
Prior to commencement of periodontal flap surgery GCF collection will be done. Following anaesthesia and elevation of full thickness muco periosteal flap, thorough debridement and root planning of the exposed root surfaces will be done. On the control site, the periodontal flap will be approximated using 4-0 black silk suture. Patients will be instructed to rinse twice daily with 0.12% chlorhexidine and recalled after 7 days for suture removal and post-surgical GCF collection from the control side. After a wash out period of 15 days presurgical GCF sampling along with the surgical procedure will be performed on the test side. The periodontal flap will be approximated on the test site using autologous fibrin glue on the under surface of the raised flap up to 2 mm from the coronal margin and repositioned back on to the root surface. Thereafter, the tissues will be kept in position with a gentle pressure using a wet gauze for 30 - 60 seconds. Persistence of bleeding, stability of tissues 5 minutes after repositioning will be recorded and the amount of fibrin sealant used in the procedure will be determined.Patients will be then recalled after 7 days for evaluation and post-surgical GCF collection from the test site. Clinical parameters will be assessed at 7, 14, 21 and 28 days.
Collection of GCF :
GCF will be collected immediately prior to surgery and on seventh day following surgery from both test and control sites for wound healing assessment. Samples of GCF will be collected from four sites from the surgical site following isolation. Colour - coded, 1-5 microlitre calibrated volumetric micro capillary pipettes will be kept extra-crevicularly for not more than five minutes or until 1 microlitre is collected. The fluid will be immediately transferred to a plastic vial and frozen at -20 degree Celsius for further analysis. Pipettes in sites which do not express any fluid or those contaminated with blood/saliva will be discarded.
Statistical analysis:
The data gathered from the study will be subjected to appropriate statistical analysis. The statistical analysis will be done using:
- Mann-Whitney test
- Wilcoxon signed rank test.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Anticipated)
Phase
- Phase 2
- Phase 3
Contacts and Locations
Study Contact
- Name: Neha Pradhan, BDS, Post graduate student
- Phone Number: +91 9620508212
- Email: pradhanneha92@yahoo.in
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients diagnosed with periodontitis, with good systemic health and presence of a minimum of 3 teeth with periodontal pocket depth (PPD) of ≥6mm and clinical attachment level (CAL) of ≥5mm (stage 3 periodontitis as described by the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Condition and published by the American Academy of Periodontology) in at least two quadrants will be selected.
Exclusion Criteria:
- Patients who have undergone periodontal therapy during the previous 6 months, or exhibit poor plaque control after phase I therapy.
- History of any systemic disease such as diabetes mellitus, hypertension,osteoporosis, unstable or life-threatening conditions, bleeding disorder, undergoing antibiotic or other antimicrobial therapy.
- Patients on drugs like aspirin, blood thinners and anticoagulant therapy
- Patients with history of allergy
- Current or former smokers.
- Mobility of selected teeth.
- Pregnant or lactating women.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Autologous fibrin glue
The periodontal flap will be approximated on the test site using autologous fibrin glue on the under surface of the raised flap up to 2 mm from the coronal margin and repositioned back on to the root surface.
Thereafter, the tissues will be kept in position with a gentle pressure using a wet gauze for 30 - 60 seconds.
|
Periodontal access flap surgery will be performed in both test site followed by control site in each subject
Autologous fibrin glue procured from the subject's own venous blood will be used to approximate periodontal flaps following access periodontal surgery
|
Active Comparator: 4-0 silk suture
The periodontal flap will be approximated using 4-0 black silk suture.
|
Periodontal access flap surgery will be performed in both test site followed by control site in each subject
Conventional 4-0 black silk suture will be used to approximate periodontal flaps following access flap surgery
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Cytokine parameter
Time Frame: Change from baseline to 7days
|
Interleukin 1-β will be assessed in GCF using a commercially available Enzyme-linked immunosorbent assay kit (ELISA), specific for human IL-1 β
|
Change from baseline to 7days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Oral Hygiene Index
Time Frame: Changes from baseline to 7day, 14day, 21day, 28day
|
by John C Greene & Jack Vermilion in 1964 OHI = DI + CI INTERPRETATION Good 0.0-1.2
Fair 1.3-3.0
Poor 3.1-6.0
|
Changes from baseline to 7day, 14day, 21day, 28day
|
Early Wound Healing Index
Time Frame: Changes from baseline to 7th day, 14th day, 21st day and 28th day
|
Index given by Watchel et al in 2005 SCORING CRITERIA: DEGREE 1-Complete flap closure No fibrin line in the interproximal area DEGREE 2- Complete flap closure Fine fibrin line in the interproximal area DEGREE 3- Complete flap closure Fibrin clot in the interproximal area DEGREE 4- Incomplete flap closure Partial necrosis of interproximal tissue DEGREE 5- Incomplete flap closure Complete necrosis of interproximal tissue |
Changes from baseline to 7th day, 14th day, 21st day and 28th day
|
Gingival Index
Time Frame: Changes from baseline to 7th day, 14th day, 21st day and 28th day
|
Index given by Loe and Silness in 1963 Scoring criteria 0 = Normal gingiva
Score 0.1-1.0-Mild gingivitis 1.1-2-Moderate gingivitis 2.1-3.0 Severe gingivitis |
Changes from baseline to 7th day, 14th day, 21st day and 28th day
|
VAS score
Time Frame: Changes from baseline to 7th day, 14th day, 21st day and 28th day
|
Index given by Freyd in 1923 Scale -1-10 Score Scale: 0-10 Score 0-No pain 1-3: Mild 4-6: Moderate 7-9: severe 10-worst
|
Changes from baseline to 7th day, 14th day, 21st day and 28th day
|
Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- nehafibringlue
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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