NCT02433899

Brief Summary

BACKGROUND: The semilunar coronally repositioned flap (SLCRF) has been used for the treatment of recession defects (GR). Recently a microsusgical (MICRO) has been successfully employed with the procedure apparently resulting in improved results, however, no previous controlled clinical study has evaluated the MICRO SLCRF in comparison with SLCRF performed as originally described (MACRO). The objective of the present study was to compare the clinical outcomes of the MICRO and MACRO SLCRF in the treatment of human GR. METHODS: Fourteen patients, with bilateral Miller class I GR defects were randomly assigned to MICRO or MACRO SLCRF. Clinical parameters, assessed at baseline and 6 months later, included recession height (RECH), recession width (RECW), width of keratinized tissue (WKT), probing depth (PD), clinical attachment level (CAL), pain measurements and esthetic evaluation with the Root Coverage Score (RCS). Inter-measurements differences were analyzed with a Chi-square or a paired t-test, with significance set at α\<0.05.

Trial Health

100
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
14

participants targeted

Target at below P25 for phase_4

Timeline
Completed

Started Oct 2010

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Start

First participant enrolled

October 1, 2010

Completed
1.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 1, 2012

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

April 1, 2012

Completed
2.8 years until next milestone

First Submitted

Initial submission to the registry

January 8, 2015

Completed
4 months until next milestone

First Posted

Study publicly available on registry

May 5, 2015

Completed
Last Updated

May 5, 2015

Status Verified

April 1, 2015

Enrollment Period

1.5 years

First QC Date

January 8, 2015

Last Update Submit

May 4, 2015

Conditions

Outcome Measures

Primary Outcomes (1)

  • Root coverage

    Distance between the cementum-enamel junction and the gingival margin. Measurements will be performed at baseline (RECH1) and after 6 months (RECH2). The amount of root coverage will be calculated as REC2x100/REC1

    6 months

Study Arms (2)

Test - Microsurgical semilunar flap

EXPERIMENTAL

Semilunar coronally repositioned flap performed under magnification with a surgical microscope. SLI was carried out following the outline of the gingival margin with a microsurgical blade under (8x) magnification. An ISI was performed mid-facially. Then, a split-thickness dissection was performed from the initial incision coronally until connecting to the ISI. The mid-facial tissue was completely released, positioned coronally to the CEJ and held in place against the tooth. A cyanoacrilate adhesive (CAA) was applied over the post-surgical gingival margin and tooth enamel to stabilize the flap.

Procedure: MICROSURGERYDrug: DexamethasoneDrug: Chlorhexidine gluconateDrug: 2.0% Mepivacaine + 1:100.000 epinephrine

Control - Conventional Semilunar flap

ACTIVE COMPARATOR

Semilunar coronally repositioned flap performed without magnification. A semilunar incision (SLI) was carried out with a 15c surgical blade. An ISI was performed mid-facially. Then, a split-thickness dissection was performed from the initial incision coronally until connecting to the ISI. The mid-facial tissue was completely released, positioned coronally to the CEJ and held in place against the tooth. A cyanoacrilate adhesive (CAA) was applied over the post-surgical gingival margin and tooth enamel to stabilize the flap.

Procedure: MACROSURGERYDrug: DexamethasoneDrug: Chlorhexidine gluconateDrug: 2.0% Mepivacaine + 1:100.000 epinephrine

Interventions

MICROSURGERYPROCEDURE

Semilunar coronally repositioned flap performed under magnification with a surgical microscope

Also known as: Microsurgical semilunar flap
Test - Microsurgical semilunar flap
MACROSURGERYPROCEDURE

Semilunar coronally repositioned flap performed without magnification

Also known as: Original semilunar flap
Control - Conventional Semilunar flap

8mg Dexamethasone, single dose, 1 hour before surgery

Control - Conventional Semilunar flapTest - Microsurgical semilunar flap

Oral rinses with chlorhexidine gluconate, BID, for 14 days

Also known as: Gengilacer, LACER
Control - Conventional Semilunar flapTest - Microsurgical semilunar flap

Regional block

Also known as: Mepiadre
Control - Conventional Semilunar flapTest - Microsurgical semilunar flap

Eligibility Criteria

Age20 Years - 50 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64)

You may qualify if:

  • Presence of bilateral Miller class I gingival recessions (≤ 3mm) exhibiting at least 2mm of keratinized tissue width (WKT) in endodontically-vital maxillary canines or premolars.
  • These teeth presented shallow (\<3mm) probing depth (PD) without bleeding on probing. Moreover, the elegible individuals demonstrated absence of contraindications for periodontal surgery, and were not being taking medications known to interfere with periodontal tissue health or healing in the preceding 6 months.
  • Experimental teeth were free of caries or restorations in the areas to be treated.

You may not qualify if:

  • Patients with untreated periodontal disease, smokers, subjects with immunosuppressive systemic diseases (i.e., cancer, AIDS, diabetes) were not included in the study.
  • Miller class II, III or class IV recession defects, presence of apical radiolucency or caries or restorations in the areas to be treated, and previous lack of cooperation with the maintenance program (as evaluated by unjustified absence from scheduled maintenance visits, continued traumatic tooth brushing technique or faulty plaque control measures).

Contact the study team to confirm eligibility.

Sponsors & Collaborators

MeSH Terms

Conditions

Gingival Recession

Interventions

MicrosurgeryDexamethasonechlorhexidine gluconateMepivacaineEpinephrine

Condition Hierarchy (Ancestors)

Gingival DiseasesPeriodontal DiseasesMouth DiseasesStomatognathic DiseasesPeriodontal Atrophy

Intervention Hierarchy (Ancestors)

Surgical Procedures, OperativeMicromanipulationInvestigative TechniquesPregnadienetriolsPregnadienesPregnanesSteroidsFused-Ring CompoundsPolycyclic CompoundsSteroids, FluorinatedPiperidinesHeterocyclic Compounds, 1-RingHeterocyclic CompoundsEthanolaminesAmino AlcoholsAlcoholsOrganic ChemicalsAminesBiogenic MonoaminesBiogenic AminesCatecholaminesCatecholsPhenolsBenzene DerivativesHydrocarbons, AromaticHydrocarbons, CyclicHydrocarbons

Study Officials

  • Ronaldo B Santana, DDS,MScD,DSc

    Federal Fluminense University

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, CARE PROVIDER, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

January 8, 2015

First Posted

May 5, 2015

Study Start

October 1, 2010

Primary Completion

April 1, 2012

Study Completion

April 1, 2012

Last Updated

May 5, 2015

Record last verified: 2015-04