Clinical and Histological Evaluation of Subepithelial Connective Tissue Graft Maturation at Different Healing Timepoints, With and Without Topical Application of a Polynucleotide- and Hyaluronic Acid-Based Gel
13 juli 2026 bijgewerkt door: Marcella Kahn, University of Sao Paulo
Clinical and Histological Evaluation of Subepithelial Connective Tissue Graft Maturation at Different Healing Timepoints, With and Without Topical Application of a Polynucleotide- and Hyaluronic Acid-Based Gel: A Randomized, Blinded, Controlled Clinical Trial With a Split-Mouth Design
This study evaluates whether a 9-week healing interval is sufficient for subepithelial connective tissue graft (SCTG) maturation after palatal harvesting, and whether topical application of a polynucleotide and hyaluronic acid gel (Regenfast®) improves tissue quality.
This is a randomized, blinded, controlled clinical trial with a split-mouth design involving 15 participants.
Each participant undergoes bilateral SCTG harvesting from the palate in two surgical sessions 9 weeks apart.
In the first session, one randomized side receives a single topical application of Regenfast® after graft removal; the contralateral side serves as control.
Standardized tissue fragments (3×3 mm, 1.5 mm thickness) are collected from each graft for histological (HE, Picrosirius Red) and immunohistochemical analyses.
Comparisons are made between grafts collected at baseline and after 9 weeks, and between sides treated with or without the gel.
Studie Overzicht
Toestand
Nog niet aan het werven
Conditie
Gedetailleerde beschrijving
Surgical procedures and sample collections will be performed at Instituto Kahn Odontologia (Rio de Janeiro, Brazil). Laboratory analyses will be conducted at the Histology Laboratory of the School of Dentistry of Ribeirao Preto, University of Sao Paulo (FORP-USP).
SCTG removal will be performed using the double incision technique (Harris, 2003) with a standardized 1.5 mm guide scalpel, under local anesthesia (2% lidocaine, 1:100,000 epinephrine). From each graft, a standardized fragment (3×3 mm, 1.5 mm thickness) will be collected from the distal portion and immediately fixed in 10% buffered formalin for 24-48 hours, then transferred to 70% alcohol.
Laboratory analyses will include: (1) Hematoxylin-eosin (HE) for general morphological assessment; (2) Picrosirius Red under polarized light for quantification of collagen density and proportion of type I and type III collagen fibers; (3) Immunohistochemistry for vascularization assessment, measuring microvessel density (n/mm²) and vascular area (%).
Statistical analysis will use paired Student's t-test or Wilcoxon test for paired samples, depending on data distribution (Shapiro-Wilk test), with significance level of 5% (p<0.05).
Studietype
Ingrijpend
Inschrijving (Geschat)
15
Fase
- Niet toepasbaar
Contacten en locaties
In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.
Studiecontact
- Naam: Marcella Kahn, DDS, MS Candidate
- Telefoonnummer: +5521988483846
- E-mail: mbkahn@usp.br
Studie Contact Back-up
- Naam: Michel Reis Messora, DDS, MS, PhD
- E-mail: m.messora@forp.usp.br
Deelname Criteria
Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
Accepteert gezonde vrijwilligers
Nee
Beschrijving
Inclusion Criteria:
- Age between 18 and 60 years
- Good general systemic health
- Presence of multiple bilateral gingival recessions with indication for root coverage
Exclusion Criteria:
- Smoking of any intensity
- Pregnancy or lactation
- Oral lesions or alterations in the palatal mucosa
- Previous history of graft harvesting from the donor area
- Continuous use of medications that interfere with the inflammatory response, such as corticosteroids or immunosuppressants
- Autoimmune diseases, coagulation disorders, or other systemic conditions affecting wound healing
Studie plan
Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Fundamentele wetenschap
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Verdrievoudigen
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Experimenteel: Regenfast Gel Application Test Side
Palatal side randomized to receive a single topical application of polynucleotide and hyaluronic acid gel (Regenfast, 0.3 ml) immediately after subepithelial connective tissue graft (SCTG) harvesting in the first surgical session.
The contralateral side receives no intervention.
SCTG is harvested again from the same site after 9 weeks for histological and immunohistochemical analyses.
|
Single topical application of polynucleotide and hyaluronic acid gel (Regenfast, 0.3 ml) to the palatal donor site immediately after subepithelial connective tissue graft harvesting in the first surgical session, before suturing.
Bilateral subepithelial connective tissue graft harvesting from the palatal donor site using the double incision technique (Harris, 2003) with a standardized 1.5 mm guide scalpel, under local anesthesia (2% lidocaine with 1:100,000 epinephrine).
Performed in two surgical sessions with a 9-week interval.
|
|
Actieve vergelijker: No Intervention - Control Side
Contralateral palatal side receiving no topical intervention after SCTG harvesting in the first surgical session.
SCTG is harvested again from the same site after 9 weeks.
This arm serves as control for both the healing time comparison (baseline vs 9 weeks) and the biomaterial effect comparison.
|
Bilateral subepithelial connective tissue graft harvesting from the palatal donor site using the double incision technique (Harris, 2003) with a standardized 1.5 mm guide scalpel, under local anesthesia (2% lidocaine with 1:100,000 epinephrine).
Performed in two surgical sessions with a 9-week interval.
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Histological Tissue Architecture of the Subepithelial Connective Tissue Graft
Tijdsspanne: Baseline and 9 weeks after initial graft harvesting
|
Morphological evaluation of tissue architecture using hematoxylin-eosin (HE) staining, assessing cellular organization, connective tissue maturation, and overall structural quality of grafts harvested at baseline and 9 weeks after initial harvesting, with and without topical application of polynucleotide and hyaluronic acid gel (Regenfast®).
|
Baseline and 9 weeks after initial graft harvesting
|
|
Collagen Density and Fiber Maturation of the Subepithelial Connective Tissue Graft
Tijdsspanne: Baseline and 9 weeks after initial graft harvesting
|
Quantification of collagen density and proportion of type I and type III collagen fibers using Picrosirius Red staining under polarized light microscopy, comparing grafts harvested at baseline and 9 weeks after initial harvesting, with and without topical application of polynucleotide and hyaluronic acid gel (Regenfast®).
|
Baseline and 9 weeks after initial graft harvesting
|
|
Microvascular Density and Vascular Area of the Subepithelial Connective Tissue Graft
Tijdsspanne: Baseline and 9 weeks after initial graft harvesting
|
Immunohistochemical evaluation of vascularization, assessing microvessel density (number/mm²) and vascular area (%) of grafts harvested at baseline and 9 weeks after initial harvesting, with and without topical application of polynucleotide and hyaluronic acid gel (Regenfast®).
|
Baseline and 9 weeks after initial graft harvesting
|
Medewerkers en onderzoekers
Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.
Sponsor
Medewerkers
Onderzoekers
- Hoofdonderzoeker: Marcella B Kahn, DDS, MS Candidate, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo (FORP-USP)
- Studie stoel: Michel Reis Messora, DDS, MS, PhD, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo (FORP-USP) Role: Study Chair
- Studie directeur: Sergio Kahn, DDS, MS, PhD, Instituto Kahn Odontologia, Rio de Janeiro
Publicaties en nuttige links
De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.
Algemene publicaties
- Soileau KM, Brannon RB. A histologic evaluation of various stages of palatal healing following subepithelial connective tissue grafting procedures: a comparison of eight cases. J Periodontol. 2006 Jul;77(7):1267-73. doi: 10.1902/jop.2006.050129.
- Harris RJ. The connective tissue and partial thickness double pedicle graft: a predictable method of obtaining root coverage. J Periodontol. 1992 May;63(5):477-86. doi: 10.1902/jop.1992.63.5.477.
- Pilloni A, Rojas MA, Trezza C, Carere M, De Filippis A, Marsala RL, Marini L. Clinical effects of the adjunctive use of polynucleotide and hyaluronic acid-based gel in the subgingival re-instrumentation of residual periodontal pockets: A randomized, split-mouth clinical trial. J Periodontol. 2023 Mar;94(3):354-363. doi: 10.1002/JPER.22-0225. Epub 2022 Nov 23.
- Tavelli L, Barootchi S, Stefanini M, Zucchelli G, Giannobile WV, Wang HL. Wound healing dynamics, morbidity, and complications of palatal soft-tissue harvesting. Periodontol 2000. 2023 Jun;92(1):90-119. doi: 10.1111/prd.12466. Epub 2022 Dec 30.
- Tavelli L, Barootchi S, Siqueira R, Kauffmann F, Majzoub J, Stefanini M, Zucchelli G, Wang HL. Three-Dimensional Volumetric Analysis of the Palatal Donor Site Following Soft Tissue Harvesting. Int J Periodontics Restorative Dent. 2022 May-Jun;42(3):393-399. doi: 10.11607/prd.5268.
- Harris RJ. Histologic evaluation of connective tissue grafts in humans. Int J Periodontics Restorative Dent. 2003 Dec;23(6):575-83.
- Cairo F, Cavalcanti R, Barbato L, Nieri M, Castelluzzo W, di Martino M, Pilloni A. Polynucleotides and Hyaluronic Acid (PN-HA) Mixture With or Without Deproteinized Bovine Bone Mineral as a Novel Approach for the Treatment of Deep Infrabony Defects: A Retrospective Case Series. Int J Periodontics Restorative Dent. 2025 Mar 6;45(2):153-163. doi: 10.11607/prd.7065.
- Skierska I, Gorski B, Fus L. Tunnel technique and subepithelial connective tissue graft, with or without cross-linked hyaluronic acid, in the treatment of multiple gingival recessions: 12-month outcomes of a randomized clinical trial. J Periodontol. 2024 Nov;95(11):1060-1072. doi: 10.1002/JPER.24-0093. Epub 2024 May 29.
Studie record data
Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.
Bestudeer belangrijke data
Studie start (Geschat)
1 juli 2026
Primaire voltooiing (Geschat)
31 oktober 2026
Studie voltooiing (Geschat)
27 februari 2027
Studieregistratiedata
Eerst ingediend
1 juli 2026
Eerst ingediend dat voldeed aan de QC-criteria
13 juli 2026
Eerst geplaatst (Werkelijk)
16 juli 2026
Updates van studierecords
Laatste update geplaatst (Werkelijk)
16 juli 2026
Laatste update ingediend die voldeed aan QC-criteria
13 juli 2026
Laatst geverifieerd
1 juli 2026
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- 95625625.9.0000.5419 (Andere identificatie: Plataforma Brasil)
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
NEE
Beschrijving IPD-plan
Individual participant data will not be shared.
Participant confidentiality is ensured through numerical coding, and all collected data will be used exclusively for scientific purposes within the scope of this study, in accordance with the ethical principles of the Declaration of Helsinki and the approved protocol.
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Nee
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
Nee
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