Diode Laser Versus Conventional Frenectomy in Children
Clinical Outcomes and Local Molecular Biomarker Changes in Gingival Crevicular Fluid Following Diode Laser Versus Conventional Frenectomy in Children: A Randomized Clinical Trial
This prospective, randomized, open-label, parallel-group clinical trial aims to compare diode laser frenectomy with conventional scalpel frenectomy in children aged 8-12 years with a clinical indication for maxillary labial frenectomy. Participants will be randomly allocated in a 1:1 ratio to undergo either diode laser or conventional scalpel frenectomy. Postoperative pain, wound healing, analgesic requirement, feeding difficulty, and daily comfort will be evaluated during follow-up. Gingival crevicular fluid samples will be collected at baseline and on postoperative Days 3, 7, and 14 to assess local molecular changes associated with inflammation, tissue injury, wound healing, and periodontal-alveolar remodeling using RT-qPCR.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Descrizione dettagliata
This study is a prospective, randomized, open-label, two-arm, parallel-group clinical trial designed to compare the postoperative clinical and local molecular responses following diode laser and conventional scalpel frenectomy in children.
Children aged 8-12 years with a clinical indication for maxillary labial frenectomy who meet the eligibility criteria will be randomly allocated in a 1:1 ratio to either the diode laser frenectomy group or the conventional scalpel frenectomy group using computer-generated randomization. Because the two surgical procedures are visibly and technically different, masking of the treating clinician and participants is not feasible.
Clinical evaluations will be performed at baseline and during postoperative follow-up. Postoperative pain will be assessed using a 0-10 Visual Analog Scale (VAS), and wound healing will be evaluated using the Landry, Turnbull and Howley Wound Healing Index. Analgesic requirement, feeding difficulty, daily comfort, and other clinical healing findings will also be recorded. Standardized intraoral photographs obtained during follow-up will provide supportive assessment of postoperative wound healing.
Gingival crevicular fluid samples will be collected from the gingival sulcus adjacent to the maxillary central incisors at baseline (Day 0) and on postoperative Days 3, 7, and 14. Two sterile paper points will be used at each sampling time point. Samples will be transferred to RNase-free tubes, transported under cold-chain conditions, and stored at -80°C until molecular analysis.
RNA isolation, complementary DNA synthesis, and RT-qPCR analyses will be performed to evaluate gene expression changes related to inflammation, tissue injury, wound healing, and local periodontal-alveolar remodeling. Planned molecular targets include IL1B, TNF, IL8, FGF2, TGFB1, an LDH metabolism-related target gene, and SOST. GAPDH and ACTB will be used as reference genes. SOST will be evaluated as a secondary exploratory marker of local periodontal-alveolar remodeling.
Changes in clinical and molecular outcomes will be evaluated over time and between treatment groups, including assessment of group, time, and group-by-time effects.
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Non applicabile
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: Burçin AVCI, DDS
- Numero di telefono: +905359558140
- Email: burcinavci@yyu.edu.tr
Luoghi di studio
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Van, Turchia (Türkiye)
- Van Yüzüncü Yıl University Faculty of Dentistry
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Contatto:
- Burçin AVCI, DDS
- Numero di telefono: +905359558140
- Email: burcinavci@yyu.edu.tr
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Inclusion Criteria:
- Children aged 8-12 years.
- Presence of a clinical indication for maxillary labial frenectomy.
- Systemically healthy.
- No previous frenulum surgery in the relevant region.
- Ability to attend scheduled clinical follow-up and gingival crevicular fluid sampling visits.
- Written informed consent provided by a parent or legal guardian.
- Age-appropriate assent provided by the child.
- Adequate cooperation to undergo the planned clinical procedures and gingival crevicular fluid sampling.
Exclusion Criteria:
- Presence of a systemic disease or condition that may affect wound healing or inflammatory responses.
- Active local infection or clinically significant inflammation in the relevant region.
- Use of systemic antibiotics, anti-inflammatory drugs, or corticosteroids within the previous month.
- Regular use of medications known to affect wound healing or inflammatory responses.
- Inadequate cooperation preventing completion of the surgical procedure or gingival crevicular fluid sampling.
- Absence of parental/legal guardian consent or child assent.
- Inability to complete the scheduled follow-up and sampling visits.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Nessuno (etichetta aperta)
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
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Sperimentale: Diode Laser Frenectomy
Children aged 8-12 years assigned to this arm will undergo maxillary labial frenectomy using a diode laser. Clinical evaluations and gingival crevicular fluid sampling will be performed at baseline (Day 0) and on postoperative Days 3, 7, and 14. |
Maxillary labial frenectomy will be performed using a Woodpecker LX16 Plus diode laser under standardized clinical conditions. The procedure will be carried out by the Department of Periodontology. Laser parameters, including wavelength, power, operating mode, fiber diameter, and application technique, will be standardized according to the final study protocol. |
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Comparatore attivo: Conventional Scalpel Frenectomy
Children aged 8-12 years assigned to this arm will undergo maxillary labial frenectomy using a conventional surgical scalpel. Clinical evaluations and gingival crevicular fluid sampling will be performed at baseline (Day 0) and on postoperative Days 3, 7, and 14. |
Maxillary labial frenectomy will be performed using a conventional surgical scalpel under standardized clinical conditions. The procedure will be carried out by the Department of Periodontology according to the study protocol. |
Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Relative IL1B Gene Expression in Gingival Crevicular Fluid
Lasso di tempo: Baseline (Day 0) and postoperative Days 3, 7, and 14
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Relative IL1B gene expression in gingival crevicular fluid will be quantified using RT-qPCR. Expression levels will be normalized using GAPDH and ACTB as reference genes. Changes over time and differences between the diode laser and conventional scalpel frenectomy groups will be evaluated. |
Baseline (Day 0) and postoperative Days 3, 7, and 14
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Relative TNF Gene Expression in Gingival Crevicular Fluid
Lasso di tempo: Baseline (Day 0) and postoperative Days 3, 7, and 14
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Relative TNF gene expression in gingival crevicular fluid will be quantified using RT-qPCR. Expression levels will be normalized using GAPDH and ACTB as reference genes. Changes over time and differences between the diode laser and conventional scalpel frenectomy groups will be evaluated. |
Baseline (Day 0) and postoperative Days 3, 7, and 14
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Relative IL8 Gene Expression in Gingival Crevicular Fluid
Lasso di tempo: Baseline (Day 0) and postoperative Days 3, 7, and 14
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Relative IL8 gene expression in gingival crevicular fluid will be quantified using RT-qPCR. Expression levels will be normalized using GAPDH and ACTB as reference genes. Changes over time and differences between the diode laser and conventional scalpel frenectomy groups will be evaluated. |
Baseline (Day 0) and postoperative Days 3, 7, and 14
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Relative FGF2 Gene Expression in Gingival Crevicular Fluid
Lasso di tempo: Baseline (Day 0) and postoperative Days 3, 7, and 14
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Relative FGF2 gene expression in gingival crevicular fluid will be quantified using RT-qPCR. Expression levels will be normalized using GAPDH and ACTB as reference genes. Changes over time and differences between the diode laser and conventional scalpel frenectomy groups will be evaluated. |
Baseline (Day 0) and postoperative Days 3, 7, and 14
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Relative TGFB1 Gene Expression in Gingival Crevicular Fluid
Lasso di tempo: Baseline (Day 0) and postoperative Days 3, 7, and 14
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Relative TGFB1 gene expression in gingival crevicular fluid will be quantified using RT-qPCR. Expression levels will be normalized using GAPDH and ACTB as reference genes. Changes over time and differences between the diode laser and conventional scalpel frenectomy groups will be evaluated. |
Baseline (Day 0) and postoperative Days 3, 7, and 14
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Relative LDHA Gene Expression in Gingival Crevicular Fluid
Lasso di tempo: Baseline (Day 0) and postoperative Days 3, 7, and 14
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Relative LDHA gene expression in gingival crevicular fluid will be quantified using RT-qPCR. Expression levels will be normalized using GAPDH and ACTB as reference genes. Changes over time and differences between the diode laser and conventional scalpel frenectomy groups will be evaluated. |
Baseline (Day 0) and postoperative Days 3, 7, and 14
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Postoperative Wound Healing Assessed Using the Landry, Turnbull and Howley Wound Healing Index
Lasso di tempo: Postoperative Days 3, 7, and 14
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Postoperative wound healing will be evaluated using the Landry, Turnbull and Howley Wound Healing Index. Healing will be scored from 1 (very poor healing) to 5 (excellent healing). Scores will be compared between treatment groups and across postoperative follow-up time points. |
Postoperative Days 3, 7, and 14
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Postoperative Pain Intensity Assessed Using the Visual Analog Scale
Lasso di tempo: Postoperative Days 3, 7, and 14
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Postoperative pain intensity will be assessed using a 0-10 Visual Analog Scale (VAS), where 0 indicates no pain and 10 indicates the worst imaginable pain. VAS scores will be compared between treatment groups and across postoperative follow-up time points. |
Postoperative Days 3, 7, and 14
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Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Relative SOST Gene Expression in Gingival Crevicular Fluid
Lasso di tempo: Baseline (Day 0) and postoperative Days 3, 7, and 14
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Relative SOST gene expression in gingival crevicular fluid will be quantified using RT-qPCR. Expression levels will be normalized using GAPDH and ACTB as reference genes. SOST will be evaluated as an exploratory marker of local periodontal-alveolar remodeling following frenectomy. |
Baseline (Day 0) and postoperative Days 3, 7, and 14
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Postoperative Analgesic Use
Lasso di tempo: Postoperative Days 3, 7, and 14
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Postoperative analgesic use will be recorded during follow-up. The number of analgesic doses taken by each participant will be documented and compared between the diode laser and conventional scalpel frenectomy groups. |
Postoperative Days 3, 7, and 14
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Postoperative Feeding Difficulty
Lasso di tempo: Postoperative Days 3, 7, and 14
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Feeding difficulty will be assessed using a 0-10 numerical rating scale, where 0 indicates no difficulty with eating and 10 indicates the greatest possible difficulty. Scores will be compared between the diode laser and conventional scalpel frenectomy groups. |
Postoperative Days 3, 7, and 14
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Postoperative Daily Comfort
Lasso di tempo: Postoperative Days 3, 7, and 14
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Daily comfort will be assessed using a 0-10 numerical rating scale, where 0 indicates extreme discomfort and 10 indicates complete comfort. Scores will be compared between the diode laser and conventional scalpel frenectomy groups. |
Postoperative Days 3, 7, and 14
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Collaboratori e investigatori
Sponsor
Sponsor
Investigatori
Investigatori
- Investigatore principale: Burçin AVCI, Van Yüzüncü Yıl Universityc
Studiare le date dei record
Studia le date principali
Inizio studio (Stimato)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- VYYU-PEDO-FREN-2026-01
Piano per i dati dei singoli partecipanti (IPD)
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Descrizione del piano IPD
Individual participant data are not planned to be shared because the study involves pediatric participants and molecular biomarker data. De-identified aggregate results will be reported in scientific publications in accordance with applicable ethical and institutional requirements.
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