NCT05684068

Brief Summary

The goal of this clinical trial is to evaluate the dimensional changes in the short and long-term in patients with thin gum tissues who have gum grafts placed on either denuded bone or gum grafts placed on a bone with some tissues remaining. The main question this study aims to answer is: \- Does the placement of free-epithelized gingival grafts (gum grafts) on full thickness bed preparation (having all of the tissue removed from the bone) lead to similar clinical, digital, and patient-related outcomes and measurements over a period of 12 months versus split thickness bed preparation (where a small layer of tissue is left over the bone) in patients with thin gum tissue phenotypes (gum tissue is generally less than 1.5 millimeters) who are in need of soft tissue augmentation procedures? Participants will be asked to attend 8 visits, which include: (i) screening visit, (ii) prophylaxis visit, (iii) random assignment to Group A or Group B along with surgery and digital data collection, (iv) 2-week post-operative visit, (v) 6-week post-operative visit, (vi) 3-month follow-up visit, (vii) 6-month follow-up visit, (viii) 12-month follow-up visit. Also, Group A will have a free epithelialized gingival/mucosal graft (gum graft) placed on full thickness periosteal bed preparation where all of the tissue was removed (test group). Group B will have a free epithelialized gingival/mucosal graft (gum graft) on split thickness periosteal bed preparation where only a portion of the tissue was removed (control group). Researchers will compare Group A and Group B to see if there is a difference in clinical, digital, and patient-related outcomes and measurements over a period of 12 months.

Trial Health

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Trial Health Score

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

Enrollment
50

participants targeted

Target at P25-P50 for not_applicable

Timeline
31mo left

Started Aug 2028

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
not yet recruiting

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

First Submitted

Initial submission to the registry

January 4, 2023

Completed
9 days until next milestone

First Posted

Study publicly available on registry

January 13, 2023

Completed
5.6 years until next milestone

Study Start

First participant enrolled

August 1, 2028

Expected
1.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 1, 2030

8 months until next milestone

Study Completion

Last participant's last visit for all outcomes

March 1, 2031

Last Updated

August 19, 2025

Status Verified

August 1, 2025

Enrollment Period

1.9 years

First QC Date

January 4, 2023

Last Update Submit

August 13, 2025

Conditions

Outcome Measures

Primary Outcomes (1)

  • Change from Baseline in Gingival Thickness as assessed by measurement.

    Tissue changes will be assessed in millimeters and percentage.

    Multiple time points (i.e., Baseline, 3 months, 6 months, 12 months)

Study Arms (2)

Gum Graft Placed on Denuded Bone

EXPERIMENTAL

Subjects in this arm will have a free epithelialized gingival/mucosal graft (gum graft) placed on full thickness periosteal bed preparation where all of the tissue was removed (test group).

Procedure: Gum Graft Placed on Denuded Bone

Gum Graft Placed on Split Thickness Periosteal Bed Preparation

ACTIVE COMPARATOR

Group B will have a free epithelialized gingival/mucosal graft (gum graft) on split thickness periosteal bed preparation where only a portion of the tissue was removed (control group).

Procedure: Gum Graft Placed on Split Thickness Periosteal Bed Preparation

Interventions

The provider will administer local anesthesia into the subject's gum in order to numb both the subject's donor and recipient areas for gum grafts. Next, the provider will use a surgical blade to dissect the gum graft from the subject's donor site. At the subject's recipient gum recession defect site, the provider will remove all of the subject's tissue, so that the bone is fully exposed before placing a gum graft from the donor site. Afterward, the provider will place sutures in the subject's recipient site in order to promote healing/re-growth.

Gum Graft Placed on Denuded Bone

The provider will administer local anesthesia into the subject's gum in order to numb both the subject's donor and recipient areas for gum grafts. Next, the provider will use a surgical blade to dissect the gum graft from the subject's donor site. At the subject's recipient gum recession defect site, the provider will dissect some of the tissue at the subject's recipient site but still keep a small layer of tissue at the subject's recipient site before placing a gum graft from the donor site. Afterward, the provider will place sutures in the subject's recipient site in order to promote healing/re-growth.

Gum Graft Placed on Split Thickness Periosteal Bed Preparation

Eligibility Criteria

Age18 Years - 95 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patients 18-95 years of age
  • Inactive periodontal disease
  • Lack of, or an insufficient (less than 2 millimeters) band of keratinized tissue width on the buccal site (closest to the cheek)
  • Shallow vestibule depth (the space between the soft tissue (lips and cheeks), and the teeth and gums)
  • Thin gingival phenotype (less than 1.5mm of gum tissue depth).
  • Aberrant frenum attachment in need of free-epithelized gingival grafts.
  • At least one RT1, 2, or 3 (Cairo's classification) gingival recession defect on the mandibular anterior sextant (Teeth #22-27).
  • Non-smokers or past smokers (those who have stopped at minimum 6 months ago).
  • Patient willing and able to follow instruction related to the study procedures.

You may not qualify if:

  • Previous soft tissue augmentation procedures at the area of interest.
  • Current smokers (Light smokers meaning less than 10 cigarettes/day, heavy smokers meaning more than 10 cigarettes/day, or social smokers)
  • Uncontrolled systemic disease (uncontrolled diabetes defined by blood sugar HbA1c greater than 7%)
  • Any active local or systemic infections
  • Any diseases or medications that may compromise normal wound healing
  • Currently receiving chemotherapy or radiotherapy or a history of radiotherapy in head and neck area.
  • Severe hematologic (blood) disorders
  • Pregnancy or nursing mother
  • Patients undergoing orthodontic therapy
  • Patients taking antibiotics in the past 3 months

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of Iowa College of Dentistry and Dental Clinics

Iowa City, Iowa, 52242, United States

Location

MeSH Terms

Conditions

Gingival Recession

Condition Hierarchy (Ancestors)

Gingival DiseasesPeriodontal DiseasesMouth DiseasesStomatognathic DiseasesPeriodontal Atrophy

Study Officials

  • Carlos Garaicoa, DDS, MS

    University of Iowa College of Dentistry

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Carlos Garaicoa Pazmino, DDS, MS

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Clinical Assistant Professor

Study Record Dates

First Submitted

January 4, 2023

First Posted

January 13, 2023

Study Start (Estimated)

August 1, 2028

Primary Completion (Estimated)

July 1, 2030

Study Completion (Estimated)

March 1, 2031

Last Updated

August 19, 2025

Record last verified: 2025-08

Data Sharing

IPD Sharing
Will not share

Locations