Gingival Hyperplasia Treatment With Surgical Scalpel vs Diode Laser in Orthodontic Patients.

NCT ID: NCT07263763

Last Updated: 2025-12-04

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

13 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-08-01

Study Completion Date

2025-02-15

Brief Summary

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Gingival enlargement is a common complication in orthodontic patients, often resulting from plaque accumulation and chronic inflammatory response during fixed appliance therapy. Surgical gingivectomy is frequently required to restore gingival contour, improve esthetics, and facilitate oral hygiene. Traditionally, gingivectomy is performed using a scalpel, but laser-assisted techniques have recently gained popularity due to their potential benefits, including reduced bleeding, postoperative discomfort, and faster healing.

This randomized split-mouth clinical trial aims to compare the clinical and microbiological outcomes of gingivectomy performed with a diode laser versus conventional scalpel surgery in orthodontic patients presenting with gingival enlargement. Clinical parameters, microbial profiles, and patient-reported outcomes will be evaluated at baseline and at multiple postoperative intervals to assess the effectiveness and advantages of each technique.

Detailed Description

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Gingival enlargement is a frequent periodontal manifestation in patients undergoing fixed orthodontic treatment, primarily resulting from increased plaque retention and subsequent chronic inflammation. This condition can compromise esthetics, interfere with effective oral hygiene, and lead to periodontal complications if left untreated. Gingivectomy is the treatment of choice for removing excess gingival tissue and reestablishing physiological gingival contours. Conventional scalpel gingivectomy has been widely used; however, the advent of laser technology, particularly diode lasers, has provided an alternative surgical approach with potential clinical advantages, including better hemostasis, reduced intraoperative discomfort, faster wound healing, and less postoperative pain.

This study is designed as a randomized split-mouth clinical trial to compare the clinical and microbiological outcomes of gingivectomy performed using a scalpel versus a diode laser in orthodontic patients with gingival enlargement. Eligible participants will be recruited from the Orthodontics Department of the Ho Chi Minh City National Hospital of Odonto-Stomatology. Each patient will undergo gingivectomy on two contralateral quadrants: one quadrant treated with conventional scalpel surgery (control side) and the other with diode laser surgery (test side). The allocation of quadrants will be randomized.

Clinical parameters including Plaque Index (PlI), Gingival Index (GI), Probing Pocket Depth (PPD), Gingival Margin Position (GMP), and Bleeding on Probing (BoP) will be recorded at baseline and at multiple postoperative intervals. Subgingival plaque samples will be collected for microbiological analysis using real-time polymerase chain reaction (qPCR) to evaluate the presence and levels of periodontopathogenic bacteria. Patient-reported outcomes such as postoperative pain will also be assessed using a visual analog scale (VAS).

All surgical procedures will be performed by the same calibrated operator to minimize variability. Standardized oral hygiene instructions will be provided to all participants throughout the study period. The collected data will be analyzed to determine differences in clinical healing, microbial changes, and patient comfort between the two treatment modalities. The findings are expected to provide evidence-based insights into the advantages and limitations of diode laser gingivectomy compared with the traditional scalpel technique in orthodontic patients.

Conditions

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Gingival Enlargement

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

This is a randomized, split-mouth clinical trial using a crossover design. Each participant received both interventions (scalpel gingivectomy and diode laser gingivectomy) at different sites within the same arch.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
Due to the nature of the interventions, masking of participants and operators was not feasible. Outcome assessors were blinded to the type of intervention performed at each site.

Study Groups

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Scalpel Gingivectomy

Conventional gingivectomy performed using a surgical scalpel. Gingival overgrowth was excised using standard surgical technique under local anesthesia.

Group Type EXPERIMENTAL

Scalpel Gingivectomy

Intervention Type PROCEDURE

Conventional gingivectomy performed using a surgical scalpel. Gingival overgrowth was excised using standard surgical technique under local anesthesia.

Diode Laser Gingivectomy

Gingivectomy performed using a diode laser. Laser parameters were set according to manufacturer's recommendations. No sutures required.

Group Type EXPERIMENTAL

Diode laser Gingivectomy

Intervention Type PROCEDURE

Gingivectomy performed using a diode laser. Laser parameters were set according to manufacturer's recommendations. No sutures required.

Interventions

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Scalpel Gingivectomy

Conventional gingivectomy performed using a surgical scalpel. Gingival overgrowth was excised using standard surgical technique under local anesthesia.

Intervention Type PROCEDURE

Diode laser Gingivectomy

Gingivectomy performed using a diode laser. Laser parameters were set according to manufacturer's recommendations. No sutures required.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Participants aged 18 years or older who agree to take part in the study.
* Individuals in good general health with no history of systemic diseases.
* Patients undergoing fixed orthodontic treatment with metallic brackets for at least 6 months and presenting with gingival enlargement.
* Patients with good oral hygiene (Plaque Index \[PlI\] \< 1) and who comply with the instructions provided by the dentist during the treatment period.

Exclusion Criteria

* History of using medications associated with gingival enlargement, such as anticonvulsants, immunosuppressants, or calcium channel blockers (e.g., phenytoin, cyclosporine, nifedipine, verapamil, diltiazem, felodipine, nitredipine, etc.).
* Pregnant or breastfeeding women, or individuals using hormonal therapy.
* Patients who have undergone periodontal treatment within the last 6 months.
* Use of antibiotics within 3 months prior to study enrollment.
* Presence or history of systemic diseases.
* Patients who refuse the use of laser in treatment.
* Patients who are uncooperative, have poor oral hygiene (PlI \> 1), discontinue participation during the study, or fail to follow instructions throughout the study period.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Nguyen Thu Thuy

OTHER

Sponsor Role lead

Responsible Party

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Nguyen Thu Thuy

Associate Professor - PhD

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Thi Hong Nhung Nguyen

Role: PRINCIPAL_INVESTIGATOR

University of Medicine and Pharmacy at Ho Chi Minh City

Locations

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University of Medicine and Pharmacy at Ho Chi Minh City - Faculty of Odonto-Stomatology

Ho Chi Minh City, Ho Chi Minh, Vietnam

Site Status

Countries

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Vietnam

References

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Newman MG, Takei H, Klokkevold PR, Carranza FA. Newman and Carranza's Clinical Periodontology and Implantology. 14th ed. St. Louis: Elsevier / Saunders; 2023.

Reference Type RESULT

SILNESS J, LOE H. PERIODONTAL DISEASE IN PREGNANCY. II. CORRELATION BETWEEN ORAL HYGIENE AND PERIODONTAL CONDTION. Acta Odontol Scand. 1964 Feb;22:121-35. doi: 10.3109/00016356408993968. No abstract available.

Reference Type RESULT
PMID: 14158464 (View on PubMed)

Krishnan V, Ambili R, Davidovitch Z, Murphy NC. Gingiva and Orthodontic Treatment. Semin Orthod. 2007;13(4):257-271. doi:10.1053/j.sodo.2007.08.007.

Reference Type RESULT

Fornaini C, Rocca JP, Bertrand MF, Merigo E, Nammour S, Vescovi P. Nd:YAG and diode laser in the surgical management of soft tissues related to orthodontic treatment. Photomed Laser Surg. 2007 Oct;25(5):381-92. doi: 10.1089/pho.2006.2068.

Reference Type RESULT
PMID: 17975951 (View on PubMed)

Maboudi A, Fekrazad R, Shiva A, Salehabadi N, Moosazadeh M, Ehsani H, Yazdani O. Gingivectomy with Diode Laser Versus the Conventional Scalpel Surgery and Nonsurgical Periodontal Therapy in Treatment of Orthodontic Treatment-Induced Gingival Enlargement: A Systematic Review. Photobiomodul Photomed Laser Surg. 2023 Sep;41(9):449-459. doi: 10.1089/photob.2023.0060.

Reference Type RESULT
PMID: 37738371 (View on PubMed)

Lione R, Pavoni C, Noviello A, Clementini M, Danesi C, Cozza P. Conventional versus laser gingivectomy in the management of gingival enlargement during orthodontic treatment: a randomized controlled trial. Eur J Orthod. 2020 Jan 27;42(1):78-85. doi: 10.1093/ejo/cjz032.

Reference Type RESULT
PMID: 31111882 (View on PubMed)

Zanatta FB, Ardenghi TM, Antoniazzi RP, Pinto TM, Rosing CK. Association between gingival bleeding and gingival enlargement and oral health-related quality of life (OHRQoL) of subjects under fixed orthodontic treatment: a cross-sectional study. BMC Oral Health. 2012 Nov 27;12:53. doi: 10.1186/1472-6831-12-53.

Reference Type RESULT
PMID: 23186371 (View on PubMed)

Gong Y, Lu J, Ding X. Clinical, microbiologic, and immunologic factors of orthodontic treatment-induced gingival enlargement. Am J Orthod Dentofacial Orthop. 2011 Jul;140(1):58-64. doi: 10.1016/j.ajodo.2010.02.033.

Reference Type RESULT
PMID: 21724088 (View on PubMed)

Related Links

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https://ump.edu.vn

University of Medicine and Pharmacy at Ho Chi Minh City

Other Identifiers

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1427/ĐHYD-HĐĐĐ

Identifier Type: OTHER

Identifier Source: secondary_id

1427/ĐHYD-HDDD

Identifier Type: -

Identifier Source: org_study_id

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