Alternative Gingival De-Epithelialization Techniques

NCT ID: NCT05947305

Last Updated: 2026-01-16

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

ENROLLING_BY_INVITATION

Clinical Phase

NA

Total Enrollment

48 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-04-04

Study Completion Date

2026-07-01

Brief Summary

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The goal of this clinical trial is to compare different de-epithelialization methods in patients undergoing soft tissue augmentation surgery. The main questions it aims to answer are:

• Which technique is superior for de-epithelialization in terms of remaining epithelium, wound healing of the donor site, and clinical outcomes?

Detailed Description

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Participants will be randomly assigned to one of four surgical techniques during their surgical procedure and the wound site will be assessed on post-operative days 1, 7, 14, and 21.

Researchers will compare the use of mucotome, Er:YAG laser, surgical diamond bur, or blade to observe patterns of wound healing and assess if one method is superior in terms of removing the epithelium.

Conditions

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Recession, Gingival Surgical Procedure, Unspecified Graft Complication Wound Heal

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Surgical Blade

A surgical blade will be used to de-epithelialize gum tissue during the subject's regularly scheduled dental surgery.

Group Type PLACEBO_COMPARATOR

Surgical Blade

Intervention Type PROCEDURE

Using a 15c blade to de-epithelialize the soft tissue extra-orally

Mucotome

A mucotome will be used to de-epithelialize gum tissue during the subject's regularly scheduled dental surgery.

Group Type EXPERIMENTAL

Mucotome

Intervention Type PROCEDURE

Using Megagen Mucotome to de-epithelialize the soft tissue intra-orally

Diamond Bur

A diamond bur will be used to de-epithelialize gum tissue during the subject's regularly scheduled dental surgery.

Group Type EXPERIMENTAL

Diamond Bur

Intervention Type PROCEDURE

Using a surgical diamond bur to de-epithelialize the soft tissue intra-orally

Er:YAG Laser

A dental laser will be used to de-epithelialize gum tissue during the subject's regularly scheduled dental surgery.

Group Type EXPERIMENTAL

Er:YAG Laser

Intervention Type PROCEDURE

Using an Er:YAG Laser to de-epithelialize the soft tissue intra-orally

Interventions

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Surgical Blade

Using a 15c blade to de-epithelialize the soft tissue extra-orally

Intervention Type PROCEDURE

Mucotome

Using Megagen Mucotome to de-epithelialize the soft tissue intra-orally

Intervention Type PROCEDURE

Diamond Bur

Using a surgical diamond bur to de-epithelialize the soft tissue intra-orally

Intervention Type PROCEDURE

Er:YAG Laser

Using an Er:YAG Laser to de-epithelialize the soft tissue intra-orally

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* American Society of Anesthesiologists (ASA) Physical Status Classification I or II
* Subjects undergoing periodontal surgical procedures that involve harvesting of soft tissue samples, who have a treatment plan including the use or removal of keratinized mucosa or subepithelial connective tissue that will not require additional anesthesia for sample collection
* Adequate physical and mental health to undergo routine dental treatment
* Ability and willingness to follow instructions related to the study procedures

Exclusion Criteria

* Poorly controlled diabetes, defined as HbA1c \>/= 7.0
* Autoimmune or inflammatory conditions such as systemic lupus erythematous, rheumatoid arthritis.
* Pregnant women or nursing mothers, or unsure of pregnancy status (self-reported)
* Severe hematologic disorders, such as leukemia or hemophilia
* Subjects on anticoagulant or antiplatelet therapy
* Local or systemic infection that may interfere with healing
* Hepatic or renal diseases
* Currently under cancer treatment or within 18 months from completion of radio- or chemotherapy
* History of antibiotic or immunosuppressant use in the last 3 months
* Subjects on concomitant drug therapy for systemic conditions that may affect outcomes of the study
* Current smokers (CDC definition): heavy smokers: subjects who have smoked \>10 cigarettes per day within 6 months of study onset, and have smoked \>100 cigarettes in their lifetime
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Delta Dental Foundation

OTHER

Sponsor Role collaborator

University of Michigan

OTHER

Sponsor Role lead

Responsible Party

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Sandra Hyon Mi Stuhr

Clinical Assistant Professor of Dentistry, Periodontics and Oral Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Sandra Stuhr, DMD, MS

Role: PRINCIPAL_INVESTIGATOR

University of Michigan

Locations

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University of Michigan School of Dentistry

Ann Arbor, Michigan, United States

Site Status

Countries

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United States

References

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El-Kholey KE. Efficacy and safety of a diode laser in second-stage implant surgery: a comparative study. Int J Oral Maxillofac Surg. 2014 May;43(5):633-8. doi: 10.1016/j.ijom.2013.10.003. Epub 2013 Nov 7.

Reference Type BACKGROUND
PMID: 24210453 (View on PubMed)

Bosco AF, Bosco JM. An alternative technique to the harvesting of a connective tissue graft from a thin palate: enhanced wound healing. Int J Periodontics Restorative Dent. 2007 Apr;27(2):133-9.

Reference Type RESULT
PMID: 17514885 (View on PubMed)

Zucchelli G, Amore C, Sforza NM, Montebugnoli L, De Sanctis M. Bilaminar techniques for the treatment of recession-type defects. A comparative clinical study. J Clin Periodontol. 2003 Oct;30(10):862-70. doi: 10.1034/j.1600-051x.2003.00397.x.

Reference Type RESULT
PMID: 14710766 (View on PubMed)

Zucchelli G, Tavelli L, McGuire MK, Rasperini G, Feinberg SE, Wang HL, Giannobile WV. Autogenous soft tissue grafting for periodontal and peri-implant plastic surgical reconstruction. J Periodontol. 2020 Jan;91(1):9-16. doi: 10.1002/JPER.19-0350. Epub 2019 Oct 6.

Reference Type BACKGROUND
PMID: 31461778 (View on PubMed)

Chambrone L, Chambrone D, Pustiglioni FE, Chambrone LA, Lima LA. Can subepithelial connective tissue grafts be considered the gold standard procedure in the treatment of Miller Class I and II recession-type defects? J Dent. 2008 Sep;36(9):659-71. doi: 10.1016/j.jdent.2008.05.007. Epub 2008 Jun 26.

Reference Type BACKGROUND
PMID: 18584934 (View on PubMed)

Zuhr O, Baumer D, Hurzeler M. The addition of soft tissue replacement grafts in plastic periodontal and implant surgery: critical elements in design and execution. J Clin Periodontol. 2014 Apr;41 Suppl 15:S123-42. doi: 10.1111/jcpe.12185.

Reference Type BACKGROUND
PMID: 24640997 (View on PubMed)

Dellavia C, Ricci G, Pettinari L, Allievi C, Grizzi F, Gagliano N. Human palatal and tuberosity mucosa as donor sites for ridge augmentation. Int J Periodontics Restorative Dent. 2014 Mar-Apr;34(2):179-86. doi: 10.11607/prd.1929.

Reference Type BACKGROUND
PMID: 24600654 (View on PubMed)

Sanz-Martin I, Rojo E, Maldonado E, Stroppa G, Nart J, Sanz M. Structural and histological differences between connective tissue grafts harvested from the lateral palatal mucosa or from the tuberosity area. Clin Oral Investig. 2019 Feb;23(2):957-964. doi: 10.1007/s00784-018-2516-9. Epub 2018 Jun 18.

Reference Type BACKGROUND
PMID: 29915931 (View on PubMed)

Tavelli L, Barootchi S, Ravida A, Oh TJ, Wang HL. What Is the Safety Zone for Palatal Soft Tissue Graft Harvesting Based on the Locations of the Greater Palatine Artery and Foramen? A Systematic Review. J Oral Maxillofac Surg. 2019 Feb;77(2):271.e1-271.e9. doi: 10.1016/j.joms.2018.10.002. Epub 2018 Oct 11.

Reference Type BACKGROUND
PMID: 30395825 (View on PubMed)

Edel A. Clinical evaluation of free connective tissue grafts used to increase the width of keratinised gingiva. J Clin Periodontol. 1974;1(4):185-96. doi: 10.1111/j.1600-051x.1974.tb01257.x. No abstract available.

Reference Type BACKGROUND
PMID: 4533490 (View on PubMed)

Langer B, Langer L. Subepithelial connective tissue graft technique for root coverage. J Periodontol. 1985 Dec;56(12):715-20. doi: 10.1902/jop.1985.56.12.715.

Reference Type BACKGROUND
PMID: 3866056 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 1527693 (View on PubMed)

Carranza N, Rojas MA. Bilaminar Palatal Connective Tissue Grafts Obtained With the Modified Double Blade Harvesting Technique: Technical Description and Case Series. Clin Adv Periodontics. 2020 Dec;10(4):186-194. doi: 10.1002/cap.10124. Epub 2020 Sep 20.

Reference Type BACKGROUND
PMID: 32862553 (View on PubMed)

Wei PC, Geivelis M. A gingival cul-de-sac following a root coverage procedure with a subepithelial connective tissue submerged graft. J Periodontol. 2003 Sep;74(9):1376-80. doi: 10.1902/jop.2003.74.9.1376.

Reference Type BACKGROUND
PMID: 14584873 (View on PubMed)

Zucchelli G, Mele M, Stefanini M, Mazzotti C, Marzadori M, Montebugnoli L, de Sanctis M. Patient morbidity and root coverage outcome after subepithelial connective tissue and de-epithelialized grafts: a comparative randomized-controlled clinical trial. J Clin Periodontol. 2010 Aug 1;37(8):728-38. doi: 10.1111/j.1600-051X.2010.01550.x. Epub 2010 Jun 24.

Reference Type RESULT
PMID: 20590963 (View on PubMed)

Tavelli L, Ravida A, Lin GH, Del Amo FS, Tattan M, Wang HL. Comparison between Subepithelial Connective Tissue Graft and De-epithelialized Gingival Graft: A systematic review and a meta-analysis. J Int Acad Periodontol. 2019 Apr 1;21(2):82-96.

Reference Type RESULT
PMID: 31522155 (View on PubMed)

Other Identifiers

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HUM00231789

Identifier Type: -

Identifier Source: org_study_id

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