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.
研究概览
详细说明
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.
研究类型
注册 (实际的)
阶段
- 第一阶段早期
联系人和位置
学习地点
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Cairo、埃及、11757
- Ain Shams University
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
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.
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:单身的
武器和干预
参与者组/臂 |
干预/治疗 |
---|---|
实验性的:study group
Use of free fat graft to cover exposed root
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fat harvested from patient will be used to cover exposed root
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有源比较器:control group
use of sub epithelial connective tissue graft to cover exposed root
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subepitheial graft harvested from palate
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
---|---|---|
evaluation of root coverage esthetic score
大体时间:6 months
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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%
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6 months
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合作者和调查者
调查人员
- 首席研究员:shehad wael、Ain Shams University
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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free fat graft的临床试验
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Hadassah Medical Organization完全的
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University Hospital, Gentofte, CopenhagenB. Braun Melsungen AG完全的间歇性跛行 | 严重肢体缺血