- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04849663
Comparative Evaluation of Buccal Fat Pad and Subepithelial Connective Tissue Graft (RCT)
Comparative Evaluation of Buccal Fat Pad and Subepithelial Connective Tissue Graft in the Treatment of Localized Recession (Randomized Clinical Trial)
Compare between Buccal fat pad and subepithelial connective tissue graft in treatment of localized recession.
Primary objective: to evaluate root coverage in terms of gingival thickness and esthetic.
Secondary objective: to evaluate patient satisfaction and postoperative pain.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Material and Methods
16 patients from outpatient Oral Diagnosis dental clinic will participate in this study.
Patient selection and hospitalization
Prospective randomized clinical trial will be conducted on patients requiring correction of gingival recession. The research will be reviewed by the ethical committee of Faculty of Dentistry Ain Shams University.
Patient Grouping
Patient will be randomly allocated into one of the two groups:
control group (8 patients): will be treated with coronally advanced flap combined with subepithelial Connective tissue graft (SCTG).
Study group(8 patients): will be treated with coronally advanced flap combined with buccal fat pad (BFP).
Preoperative Assessment
For all patients routine radiographic investigations are required. The first phase of therapy formed of oral hygiene measures, scaling, subgingival debridement and correction of any disturbance in occlusion needed. A periodontal evaluation should be done two weeks after phase I therapy.
A stent will be made for each defect with vertical groove located at the mid-labial region to standardize the placement and angulation of probe while taking measurement. All measurements will be taken with a standardized Williams graduated periodontal probe (Hu-Friedy).
Surgical procedure:
Oral antiseptic mouthwash will be used before anaesthetizing the surgical area. A field block anesthesia at the surgical area is given with a lidocaine and epinephrine-containing solution.
a) Recipient site preparation
- A split-thickness flap will be reflected by a horizontal incision made at the papilla base, mesial and distal to the recession defects. Two slightly divergent incisions will be released from the end of the previous horizontal incisions with a full-thickness flap starting from margin of the gingiva reaching 3-4 mm after the exposed bone then continue with a split-thickness extending to the alveolar mucosa .
After flap elevation scaling, planing of the exposed root followed by root conditioning with a tetracycline solution (125 mg tetracycline/ml of saline). In the study group sites, previously prepared BFP or a subepihelial CT graft in control group will be applied over the exposed root a single sling suture will fix the flap just coronal to the Cemento-enamel junction (CEJ). Flaps will also be coronally positioned.
b) Donor site:
- In study group the buccal vestibule is anesthetized in vicinity of the first and second maxillary molar. The cheek will be retracted laterally and a mucosal incision will be made while leaving a cuff of non- attached mucosa for closure. The incision will be done throughout the mucosa and muscle meanwhile an external pressure will be applied on the skin in the area of the buccal fat pad. After the buccal fat pad exposure, the fascia is pierced with scissors. With a continuous external pressure on the cheeck a long hemostat is used to spread and manipulate the fat. With minimal delicate traction, the protruding portion of the fat pad is gently grasped and pulled outside of the incision then the fat is clamped at the base and the required amount is harvested and excised to be used in donor site. The incision is closed with suture .
- The control group will receive SCTG from the palate with a single incision technique .
Postoperatively patients will be covered by Augmentine 1 gm tablets every 12 hours and flagyl 500 mg every eight hours. Analgesics are given in a combined protocol; where ibuprofen 600mg and paracetamol 1gm are alternating. The patient is instructed to use 0.12% chlorhexidine mouthwash three times daily for two weeks.
Methods of assessment
The parameters which should be measured at baseline, 3 and 6 months after surgery:
- Plaque index (PI) will be recorded according to Silness and Loe .
- Gingival index (GI) will be recorded according to Loe and Silness .
- Probing depth (PD).
- Clinical attachment level (CAL).
- Recession depth (RD).
- Recession width (RW).
- Percentage of mean root coverage (MRC %) will be calculated as ([RD preoperative - RD postoperative]/RD preoperative) × 100%.
- Width of keratinized tissue (WKT).
- Gingival thickness (GTH).
- Root coverage esthetic score (RES).
- Pain level will be assessed by verbal, numeric scale and by recording amount of analgesic intake postoperatively.
Result presentation and statistics
Results will be tabulated and statistically analyzed.
Study Type
Enrollment (Actual)
Phase
- Early Phase 1
Contacts and Locations
Study Locations
-
-
-
Cairo, Egypt, 11757
- Ain Shams University
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients should be above 18 years.
- Patient included in the study will be with Miller class II recession defect.
- Patient having at least 1 mm of residual keratinized tissue.
Exclusion Criteria:
- Patient with Systemic Problem affecting the results of periodontal Therapy.
- Patients having allergy to drugs.
- Pregnant women.
- Patients with any smoking habits.
- Patients having bleeding problems or on anticoagulant therapy.
- Patients having caries or restorations in relation to the treated site.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: study group
Use of free fat graft to cover exposed root
|
fat harvested from patient will be used to cover exposed root
|
Active Comparator: control group
use of sub epithelial connective tissue graft to cover exposed root
|
subepitheial graft harvested from palate
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
evaluation of root coverage esthetic score
Time Frame: 6 months
|
evaluation of root gingival coverage after modified Coronally advanced flap the scale is from 1-4 ... based on degree of coverage the score will be given 1=1005, 2=75%, 3=50%, 4=25%
|
6 months
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: shehad wael, Ain Shams University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
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
- ASU689
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 Gingival Recession
-
British University In EgyptNot yet recruiting
-
SVS Institute of Dental SciencesCompleted
-
University of LouisvilleCompletedRecession, GingivalUnited States
-
Cairo UniversityUnknownRecession, Gingival
-
Botiss Medical AGCompletedRecession, GingivalSerbia
-
Case Western Reserve UniversityRecruitingRecession, GingivalUnited States
-
University of LouisvilleRecruitingRecession, GingivalUnited States
-
Krishnadevaraya College of Dental Sciences & HospitalUnknown
-
Universidade Estadual Paulista Júlio de Mesquita...Completed
-
Centre Hospitalier Universitaire de LiegeRecruitingGingival Recession | Gingival Recession, LocalizedBelgium
Clinical Trials on free fat graft
-
University of Sao PauloCompletedBreast Reconstruction | Contour Irregularities | Volume InsufficiencyBrazil
-
Royal Marsden NHS Foundation TrustNot yet recruiting
-
University of Sao PauloUniversidade Estadual de MaringáUnknown
-
University of PittsburghWithdrawnBreast Cancer | Mastectomy, Segmental | LumpectomyUnited States
-
Göteborg UniversityRecruitingGingiva AtrophyUnited Arab Emirates
-
Perio Health Professionals, PLLCCompleted
-
University of Alabama at BirminghamRecruitingGingival Recession | Thin Gingiva | Lack of Keratinized Attached Peri-implant MucosaUnited States
-
Odense University HospitalCompletedPost-Mastectomy Chronic Pain Syndrome (Disorder)Denmark
-
Berceste GulerRecruitingGingival Recession | Lack of Keratinized GingivaTurkey
-
University of PittsburghUnited States Department of DefenseTerminatedFacial Injuries | Adipose TissueUnited States