Nano Silver Effect in Rapid Wound Healing

April 7, 2026 updated by: Damascus University

Evaluation of the Efficacy of Applying the Nano-crystalline Silver Membrane After Surgical Gingival Depigmentation

Silver compounds have demonstrated a positive effect in most medical fields, including periodontal therapy, particularly in their nano-formulations. These nanoparticles have exhibited a significant capacity to accelerate healing and possess antibacterial and anti-inflammatory properties, in addition to their ability to mitigate pain and postoperative complications.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The objective of the current study was to evaluate tissue healing, epithelialization, postoperative pain, degree of pigmentation, and patient satisfaction following the application of a nano-silver crystal membrane compared to conventional dressing after the surgical removal of gingival melanin pigmentation.

Study Type

Interventional

Enrollment (Actual)

12

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Syria
      • Damascus, Syria
        • Damascus University, Faculty of Dentistry, Department of periodontology.

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  1. Gingival Hyperpigmentation: Presence of physiological melanin pigmentation in the maxillary anterior region, categorized as Grade 3 or 4 according to the Heden Gingival Pigmentation Index.
  2. Age Demographic: Patients aged 20 years or older.
  3. Periodontal Health: Absence of active periodontal disease (e.g., periodontitis or gingivitis).
  4. Gingival Biotype: Presence of a medium-to-thick gingival biotype.
  5. Attached Gingiva: An adequate width of attached gingiva to ensure surgical stability.
  6. Oral Hygiene: Demonstration of good oral hygiene with a proven ability to maintain effective plaque control throughout the study period.

Exclusion Criteria:

  1. Systemic Pigmentation: Presence of gingival discoloration secondary to systemic conditions or metabolic disorders.
  2. Drug-Induced Pigmentation: Hyperpigmentation resulting from the administration of specific pharmacological agents.
  3. Poor Oral Hygiene: Inadequate plaque control or a lack of compliance with oral self-care instructions.
  4. Smoking Status: Current smokers or individuals with a recent history of tobacco use, due to its confounding effect on gingival pigmentation and wound healing.
  5. Physiological Status: Pregnant or lactating women.
  6. Systemic Health & Medication: Patients with underlying systemic diseases or those receiving medications known to influence periodontal tissue integrity or inflammatory response (e.g., immunosuppressants or calcium channel blockers).
  7. Periodontal Disease: Presence of active periodontitis or attachment loss.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

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
Active Comparator: Standard Coe-PAK dressing
De-epithelialization of the melanin-pigmented gingiva was executed with a surgical blade, and the site was covered with the Coe-Pak dressing.
Procedure: Non eugenol zinc oxide Dressing
A standard Non eugenol zinc oxide Dressing "Coe-PAK®" was applied after the surgical removal of gingival melanin pigmentation
Experimental: Nano Silver dressing
De-epithelialization of the melanin-pigmented gingiva was executed with a surgical blade, and the site was covered with the Nano Silver dressing.
Procedure: Nano Silver Dressing
A Nano Silver Dressing was Applied After the surgical removal of gingival melanin pigmentation

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Wound Healing: Clinical Tissue Healing Index
Time Frame: Measured weekly, one week postoperatively until week 4 (measured 4 times).

The Tissue Healing Index was evaluated weekly for a total of four weeks postoperatively, according to the following five grades:

  • Grade 1 (Very Poor): Redness (>50%), granulation, bleeding, and pus present.
  • Grade 2 (Poor): Redness (>50%), granulation, and bleeding present; no pus.
  • Grade 3 (Good): Redness (<50%), no granulation, no bleeding, and no exposed connective tissue.
  • Grade 4 (Very Good): Redness (<25%), no granulation, no bleeding, and no exposed connective tissue.
  • Grade 5 (Excellent): Healthy pink tissue, no bleeding, and complete marginal closure.
Measured weekly, one week postoperatively until week 4 (measured 4 times).
Epithelization: Clinical epithelialization Index
Time Frame: Measured weekly, one week postoperatively until week 4 (measured 4 times).

Re-epithelialization was assessed weekly for a total of four weeks postoperatively using 1% Toluidine Blue. Deep blue staining identifies denuded connective tissue, while pale blue indicates complete healing. The clinical scale is as follows:

  • Grade 1: No epithelial formation.
  • Grade 2: Partial coverage (less than 50%).
  • Grade 3: Substantial coverage (more than 50%).
  • Grade 4: Complete re-epithelialization.
Measured weekly, one week postoperatively until week 4 (measured 4 times).

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain Assessment and Analgesic Consumption
Time Frame: Measured daily from day 1 till day 7 postoperatively.

Daily postoperative pain was recorded for one week using a 100-mm Visual Analogue Scale (VAS), ranging from 0 (no pain) to 100 (unbearable). Scores were categorized as:

  • 1-30 mm: Mild pain.
  • 31-60 mm: Moderate pain.
  • 61-100 mm: Severe pain. Daily analgesic intake was also documented to supplement these subjective findings.
Measured daily from day 1 till day 7 postoperatively.
Patient Satisfaction Index (PSI)
Time Frame: recorded for one time one week after the procedure was done
This qualitative metric categorizes the patient's subjective perception of the surgical outcome into four distinct grades. For analytical purposes, scores were dichotomized into 'Satisfied' (Grades 1-2) and 'Dissatisfied' (Grades 3-4).
recorded for one time one week after the procedure was done

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Damascus University

Investigators

  • Study Chair: Tarek A Qasim, DDS MSc PhD, Damascus University, Faculty of Dentistry, Department of Periodontology
  • Principal Investigator: Ara V Seferian, DDS, Damascus University, Faculty of Dentistry, Department of Periodontology

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 2, 2024

Primary Completion (Actual)

August 4, 2025

Study Completion (Actual)

December 22, 2025

Study Registration Dates

First Submitted

March 31, 2026

First Submitted That Met QC Criteria

April 7, 2026

First Posted (Actual)

April 9, 2026

Study Record Updates

Last Update Posted (Actual)

April 9, 2026

Last Update Submitted That Met QC Criteria

April 7, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • UDDS-2026-Perio-01

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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.

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