Healing After Connective Tissue Graft Harvesting in the Palatal Area With and Without Suture

NCT ID: NCT04513886

Last Updated: 2020-08-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

36 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-11-19

Study Completion Date

2019-08-26

Brief Summary

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This study evaluated the outcomes in the early healing of palatal wounds after harvesting a subepithelial connective tissue graft (SCTG) using the single incision technique with placement of a collagen haemostatic sponge (CHS) without suturing the palate. The primary outcome of this study was to evaluate the early wound healing index (EHI).

Detailed Description

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The aim of this study was to compare the outcomes in the early wound healing after harvesting a subepithelial connective tissue graft (SCTG) using the single incision technique and collagen haemostatic sponge (CHS) placement, with and without suturing the palate. 36 subjects were randomized to receive (n=18, Suture group-SG) or not a suture (n=18, no Suture group-nSG). Outcomes variables were: Early healing index (EHI) at 7, 14 and 30 days, self-reported pain using a visual analogue scale (VAS) at 7 and 14 days, immediate (iB) and delayed bleeding (dB). Data obtained were compared by Fisher's exact test, T test for independent sample, Mann-Whitney test (U test) and Wilcoxon sign test as appropriate. The level of significance was set at p \< 0.05. Statistical analysis was performed with Infostat version 2015.

Conditions

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Wound Healing

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants were assigned to one of two groups in parallel for the duration of the study: This study was a non-masked, randomized, controlled clinical trial, with a parallel design, comparing early healing of palatal wounds after harvesting subepithelial connective tissue graft using the single incision technique, with and without palatal sutures.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Suture Group

After harvesting a subepithelial connective tissue graft using the single incision technique collagen haemostatic sponge placement and subsequent compression with gauze soaked in saline for 5 minutes, a cross- mattress suture and interrupted single sutures were performed using nylon 5-0 when appropriate.

Group Type ACTIVE_COMPARATOR

Subepithelial connective tissue graft (SCTG) using the single incision technique, with and without suturing the palate

Intervention Type PROCEDURE

A SCTG was harvested using the single incision technique described by Hürzeler \& Weng. The palatal incisions were standardized to extend between the area between mesial of the canine and mesial of the first molar.In the Suture Group sites a cross- mattress suture and interrupted single sutures were performed using nylon 5-0 when appropriate. In the no Suture Group sites, no suture was performed. In both groups, a CHS was placed after removing the graft to achieve the haemostasis of the palate and subsequent compressed with gauze soaked in saline for 5 minutes.

no Suture Group

After harvesting a subepithelial connective tissue graft using the single incision technique, collagen haemostatic sponge placement and subsequent compression with gauze soaked in saline for 5 minutes no suture was performed.

Group Type EXPERIMENTAL

Subepithelial connective tissue graft (SCTG) using the single incision technique, with and without suturing the palate

Intervention Type PROCEDURE

A SCTG was harvested using the single incision technique described by Hürzeler \& Weng. The palatal incisions were standardized to extend between the area between mesial of the canine and mesial of the first molar.In the Suture Group sites a cross- mattress suture and interrupted single sutures were performed using nylon 5-0 when appropriate. In the no Suture Group sites, no suture was performed. In both groups, a CHS was placed after removing the graft to achieve the haemostasis of the palate and subsequent compressed with gauze soaked in saline for 5 minutes.

Interventions

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Subepithelial connective tissue graft (SCTG) using the single incision technique, with and without suturing the palate

A SCTG was harvested using the single incision technique described by Hürzeler \& Weng. The palatal incisions were standardized to extend between the area between mesial of the canine and mesial of the first molar.In the Suture Group sites a cross- mattress suture and interrupted single sutures were performed using nylon 5-0 when appropriate. In the no Suture Group sites, no suture was performed. In both groups, a CHS was placed after removing the graft to achieve the haemostasis of the palate and subsequent compressed with gauze soaked in saline for 5 minutes.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Subjects with an indication of mucogingival surgery for single gingival recession treatment that required harvesting a subepithelial connective tissue graft
* Age \>18 years ≤ 60 years.
* Periodontally and systemically healthy.
* Palatal fibromucosa width ≥ 2mm evaluated with a North Carolina probe placed perpendicular to the hard palate, prior to surgery.

Exclusion Criteria

* Smoking.
* Contraindications for periodontal surgery.
* Subjects presenting coagulation disorders (history of Haemophilia, von Willebrand disease or anticoagulant therapy).
* Subjects taking medications known to interfere with periodontal tissue health or healing.
* Subjects that had been operated on the palate (connective tissue removed) previously from that same donor area.
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Maimonides University

OTHER

Sponsor Role collaborator

Mariel Viviana Gómez

OTHER

Sponsor Role lead

Responsible Party

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Mariel Viviana Gómez

Associate Professor. Department of Postgraduate Periodontics.

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Mariel V Gómez, Assoc Prof

Role: STUDY_DIRECTOR

Maimonides University

Guillermo Schinini, Assoc Prof

Role: PRINCIPAL_INVESTIGATOR

Maimonides University

Hugo J Romanelli, Chair Prof

Role: STUDY_CHAIR

Maimonides University

Diego Sales, Assist Prof

Role: PRINCIPAL_INVESTIGATOR

Maimonides University

Leandro Chambrone, Chair Prof

Role: PRINCIPAL_INVESTIGATOR

Ibirapuera University

Locations

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Maimonides University

Buenos Aires, Buenos Aires F.D., Argentina

Site Status

Countries

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Argentina

References

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Maino GNE, Valles C, Santos A, Pascual A, Esquinas C, Nart J. Influence of suturing technique on wound healing and patient morbidity after connective tissue harvesting. A randomized clinical trial. J Clin Periodontol. 2018 Aug;45(8):977-985. doi: 10.1111/jcpe.12960. Epub 2018 Jul 24.

Reference Type BACKGROUND
PMID: 29908088 (View on PubMed)

Stavropoulou C, Atout RN, Brownlee M, Schroth RJ, Kelekis-Cholakis A. A randomized clinical trial of cyanoacrylate tissue adhesives in donor site of connective tissue grafts. J Periodontol. 2019 Jun;90(6):608-615. doi: 10.1002/JPER.18-0475. Epub 2018 Dec 26.

Reference Type BACKGROUND
PMID: 30517975 (View on PubMed)

Lorenzana ER, Allen EP. The single-incision palatal harvest technique: a strategy for esthetics and patient comfort. Int J Periodontics Restorative Dent. 2000 Jun;20(3):297-305.

Reference Type BACKGROUND
PMID: 11203571 (View on PubMed)

Fickl S, Fischer KR, Jockel-Schneider Y, Stappert CF, Schlagenhauf U, Kebschull M. Early wound healing and patient morbidity after single-incision vs. trap-door graft harvesting from the palate--a clinical study. Clin Oral Investig. 2014 Dec;18(9):2213-9. doi: 10.1007/s00784-014-1204-7. Epub 2014 Feb 23.

Reference Type BACKGROUND
PMID: 24562700 (View on PubMed)

Lektemur Alpan A, Torumtay Cin G. PRF improves wound healing and postoperative discomfort after harvesting subepithelial connective tissue graft from palate: a randomized controlled trial. Clin Oral Investig. 2020 Jan;24(1):425-436. doi: 10.1007/s00784-019-02934-9. Epub 2019 May 18.

Reference Type BACKGROUND
PMID: 31104113 (View on PubMed)

Rossmann JA, Rees TD. A comparative evaluation of hemostatic agents in the management of soft tissue graft donor site bleeding. J Periodontol. 1999 Nov;70(11):1369-75. doi: 10.1902/jop.1999.70.11.1369.

Reference Type BACKGROUND
PMID: 10588501 (View on PubMed)

Wessel JR, Tatakis DN. Patient outcomes following subepithelial connective tissue graft and free gingival graft procedures. J Periodontol. 2008 Mar;79(3):425-30. doi: 10.1902/jop.2008.070325.

Reference Type BACKGROUND
PMID: 18315424 (View on PubMed)

Del Pizzo M, Modica F, Bethaz N, Priotto P, Romagnoli R. The connective tissue graft: a comparative clinical evaluation of wound healing at the palatal donor site. A preliminary study. J Clin Periodontol. 2002 Sep;29(9):848-54. doi: 10.1034/j.1600-051x.2002.290910.x.

Reference Type BACKGROUND
PMID: 12423299 (View on PubMed)

Hurzeler MB, Weng D. A single-incision technique to harvest subepithelial connective tissue grafts from the palate. Int J Periodontics Restorative Dent. 1999 Jun;19(3):279-87.

Reference Type RESULT
PMID: 10635174 (View on PubMed)

Other Identifiers

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2310/18

Identifier Type: -

Identifier Source: org_study_id

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