NCT06330662

Brief Summary

The goal of this clinical randomized trial is to examine the effectiveness of hyaluronic acid in treatment of multiple adjacent gingival recessions in 2 groups. Control group will be presented by using a coronally advanced flap only (CAF) and experimental group will be presented with addition of hyaluronic acid to a coronally advanced flap (CAF+HA). The main question it aims to answer is: is there any difference in the reduction of multiple gingival recessions between the control (CAF) and the test group (CAF + HA)? The research would be conducted on subjects referred for specialist treatment at the Department of Periodontology (Faculty of dental medicine, University of Zagreb). A record would be kept of all patients who underwent a detailed clinical examination, those who did not meet the criteria for inclusion in the study and those who refused to participate in it. Participants who meet the inclusion criteria will undergo a detailed clinical examination and if they agree to participate in the research, they will sign the informed form. During the pre-treatment, patients will receive instructions and a demonstration on proper maintenance of oral hygiene as well as a teeth cleaning. In addition to the informed form, they will fill out the OHIP-14 questionnaire, and the researcher will measure the periodontal indices at the very beginning before the operation, as well as the Schiff index. Patients will be photographed at the baseline as well as at follow-up examinations. The total number of subjects would be 42, or 21 patients in the 2 observed groups. The control group refers to surgical intervention using a coronally advanced flap to cover multiple gingival recessions without the addition of hyaluronic acid (CAF) and the experimental group indicates the surgical intervention using a coronally advanced flap to cover multiple adjacent gingival recessions with the addition of hyaluronic acid intraoperatively (CAF + HA).

Trial Health

55
Monitor

Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
42

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started Sep 2023

Geographic Reach
1 country

1 active site

Status
enrolling by invitation

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

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

September 1, 2023

Completed
6 months until next milestone

First Submitted

Initial submission to the registry

March 11, 2024

Completed
15 days until next milestone

First Posted

Study publicly available on registry

March 26, 2024

Completed
5 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 1, 2024

Completed
9 months until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2025

Completed
Last Updated

March 26, 2024

Status Verified

March 1, 2024

Enrollment Period

1 year

First QC Date

March 11, 2024

Last Update Submit

March 18, 2024

Conditions

Keywords

periodontal surgeryhyaluronic acidcoronally advanced flap

Outcome Measures

Primary Outcomes (1)

  • The effect of hyaluronic acid on recession reduction

    The primary outcome is to examine the effectiveness of hyaluronic acid on the percentage of root coverage when treating multiple adjacent gingival recessions with the coronally advanced flap surgical technique

    1 year

Secondary Outcomes (11)

  • To examine the effect of tissue thickness on recession coverage (KTt)

    1 year

  • To examine keratinized gingiva width (KTw)

    1 year

  • To examine changes in periodontal clinical parameters: PPD

    1 year

  • To examine changes in periodontal clinical parameters: CAL

    1 year

  • To examine changes in periodontal clinical parameters: REC

    1 year

  • +6 more secondary outcomes

Study Arms (2)

Coronally advanced flap with the hyaluronic acid

EXPERIMENTAL

The experimental group indicates the surgical intervention using a coronally advanced flap to cover multiple adjacent gingival recessions with the addition of hyaluronic acid intraoperatively (CAF+HA).

Procedure: Testing the effectiveness of hyaluronic acid in experimental group using a coronally advanced flap compared to a control group using a coronally advanced flap only

Coronally advanced flap

OTHER

The control group refers to surgical intervention using a coronally advanced flap only to cover multiple gingival recessions without the addition of hyaluronic acid (CAF).

Procedure: Testing the effectiveness of hyaluronic acid in experimental group using a coronally advanced flap compared to a control group using a coronally advanced flap only

Interventions

The potential benefit of adding hyaluronic acid (HA) to the coronally advanced flap (CAF) operative technique to cover multiple adjacent recessions has not been sufficiently investigated. Improving aesthetics is one of the primary goals of root recession coverage periodontal surgery, and little is known about the same in multiple adjacent gingival recession coverage therapy. In patients with a sufficient amount (≥2 mm) of keratinized tissue, the coronally advanced flap (CAF) has been shown to be very effective in the treatment of multiple recessions, especially in terms of aesthetic results. The researchers concluded from a database search (Epistemonikos, Cochrane, Medline) that there is no evidence to support the use of HA + CAF to achieve greater root coverage in the treatment of multiple gingival recessions.

Coronally advanced flapCoronally advanced flap with the hyaluronic acid

Eligibility Criteria

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

You may qualify if:

  • age ≥ 18 years
  • people without systemic diseases and chronic regular therapy
  • non-smokers
  • percentage of areas affected by plaque (FMPS) and percentage of bleeding sites on probing (FMBS) ≤25%
  • the presence of a non-carious cervical lesion (NCCL) associated with recession
  • gingival recessions on at least two adjacent teeth with a minimum depth of 2 mm and a clearly visible enamel-cement junction
  • selection of patients capable of understanding and maintaining oral hygiene instructions with regular follow-up appointments
  • selection of patients who fully understand the nature of the proposed surgical procedure and agree to informed consent

You may not qualify if:

  • untreated periodontitis
  • the presence of fixed prosthetic work (crown or bridge) on the examined adjacent teeth
  • smokers
  • pregnant and lactating women
  • patients with uncontrolled type I and II diabetes
  • patients with medical contraindications for surgical therapy
  • medical history related to malignancies, radiotherapy, chemotherapy for the last 5 years
  • taking chronic therapy that affects soft tissue healing such as: steroids, high doses of anti-inflammatory drugs, anticoagulants
  • patients with active systemic infection
  • allergies to hyaluronic acid
  • allergies to local anesthesia
  • alcohol or drug use
  • participation in another clinical research in the past 6 months

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of Zagreb - School of dental medicine

Zagreb, Hrvatska, 10 000, Croatia

Location

MeSH Terms

Conditions

Gingival Recession

Condition Hierarchy (Ancestors)

Gingival DiseasesPeriodontal DiseasesMouth DiseasesStomatognathic DiseasesPeriodontal Atrophy

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
Masking Details
Randomization would first be generated using a computer-selected program, and then the protocol itself would be placed in opaque sealed envelopes and handed to the operator immediately before the procedure with a decision as to whether or not hyaluronic acid (HA) would be applied. In treated areas where HA will not be applied, the operative site will be treated only with saline. The patient as well as the researcher and the outcomes assesssor will not be informed which patient belongs to which group. Randomization and allocation of envelopes as well as allocation of patients to groups will be determined by a fourth party.
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: The control group refers to surgical intervention using a coronally advanced flap to cover multiple gingival recessions without the addition of hyaluronic acid (CAF) and the experimental group indicates the surgical intervention using a coronally advanced flap to cover multiple adjacent gingival recessions with the addition of hyaluronic acid intraoperatively (CAF + HA).
Sponsor Type
OTHER
Responsible Party
SPONSOR INVESTIGATOR
PI Title
doctor of dental medicine

Study Record Dates

First Submitted

March 11, 2024

First Posted

March 26, 2024

Study Start

September 1, 2023

Primary Completion

September 1, 2024

Study Completion

June 1, 2025

Last Updated

March 26, 2024

Record last verified: 2024-03

Data Sharing

IPD Sharing
Will not share

Locations