CLOR_3: Evaluation of the Rinse With Chlorhexidine Plus Hyaluronic Acid Mouthwash in Periodontal Surgical Wound Healing

Sponsor
University of Pisa (Other)
Overall Status
Completed
CT.gov ID
NCT04345744
Collaborator
(none)
60
1
3
50
1.2

Study Details

Study Description

Brief Summary

Evaluate the response of the gingival tissues to the use of mouthwash with chlorhexidine and chlorhexidine + hyaluronic acid in terms of healing of the periodontal surgical wound.

Condition or Disease Intervention/Treatment Phase
  • Procedure: Periodontal surgery
  • Device: Hyaluronic and 0.2% chlorhexidine mouth rinse
  • Device: Chlorhexidine 0.2% mouth rinse
N/A

Detailed Description

Patients included in the study will undergo a thorough clinical examination aiming at collecting all the data desired: periodontal parameters of Probing Pocket Depth (PPD) and presence of recession of the gingival margin (Rec) will be recorded on six sites/tooth in the area selected for periodontal surgery by a single calibrated examiner using a University of North Carolina (UNC) 15-mm periodontal probe at a 0.3 N probing pressure. Surgery will be performed following a standardized protocol by a single operator.

After surgery, patients will be randomly assigned to study groups corresponding to mouth rinse prescription. The mouth rinse will be assigned by an experimenter not involved in the following steps of the study, in order to maintain the examiner blind. The patient will receive a non-labelled mouth rinse to avoid biases both of the examiner and the patient. The patient will also be given a diary for the registration of the number of rinses per day, to be returned to the examiner at T14. The mouth rinse protocol assigned to each study participant includes a 10 ml-rinse for 60 seconds twice-a-day (every 12 hours) for 14 days.

The patients will be allocated in one of the three distinct study groups as it follows:
  • Group A: no administration of mouth rinses after surgery (control group)

  • Group B: administration of a hyaluronic and 0.2% chlorhexidine mouth rinse (test group

  • Group C: administration of chlorhexidine 0.2% mouth rinse (test group 2).

Post-treatment photographs of surgical incision will be taken immediately after periodontal surgery and at 3 (T3), 7 (T7), and 14 (T14) days post-op, in order to allow the evaluation of the degree of wound healing. The degree of surgical healing will be evaluated using the Periodontal Wound Healing Index (Wachtel classification) on all the incisions, and a score from 1 to 5 will be assigned.

At T3, T7, and T14 the following clinical parameters will be recorded for each tooth in the surgical area: PPD, Rec, PI, and BOP. The clinical examinations will be performed by calibrated examiner blind to group allocation.

Study Design

Study Type:
Interventional
Actual Enrollment :
60 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Intervention Model Description:
Single-centre randomized, parallel design, clinical trial with a 2 week follow-upSingle-centre randomized, parallel design, clinical trial with a 2 week follow-up
Masking:
Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Masking Description:
After surgery, patients will be randomly assigned to study groups corresponding to mouth rinse prescription. The mouth rinse will be assigned by an experimenter not involved in the following steps of the study, in order to maintain the examiner blind. The patient will receive a non-labelled mouth rinse to avoid biases both of the examiner and the patient
Primary Purpose:
Supportive Care
Official Title:
Evaluation of the Rinse With Chlorhexidine Plus Hyaluronic Acid Mouthwash in Periodontal Surgical Wound Healing
Actual Study Start Date :
Jan 1, 2016
Actual Primary Completion Date :
Dec 1, 2018
Actual Study Completion Date :
Mar 1, 2020

Arms and Interventions

Arm Intervention/Treatment
Experimental: Test group 1

administration of a hyaluronic and 0.2% chlorhexidine mouth rinse

Procedure: Periodontal surgery
Surgery will be performed following a standardized protocol by a single operator (FG). The procedure consists in the performance of a primary full-thickness flap incision, and of a secondary releasing vertical incision of maximum 3 mm limited to keratinized gingiva. At the end of the surgical procedure, soft tissues will be repositioned by means of a suture involving only the primary incision, while it will not be performed on the releasing incision.

Device: Hyaluronic and 0.2% chlorhexidine mouth rinse
The mouth rinse protocol assigned to each study participant included a 10 ml-rinse for 60 seconds twice-a-day (every 12 hours) for 14 days.

Experimental: Test group 2

administration of chlorhexidine 0.2% mouth rinse

Procedure: Periodontal surgery
Surgery will be performed following a standardized protocol by a single operator (FG). The procedure consists in the performance of a primary full-thickness flap incision, and of a secondary releasing vertical incision of maximum 3 mm limited to keratinized gingiva. At the end of the surgical procedure, soft tissues will be repositioned by means of a suture involving only the primary incision, while it will not be performed on the releasing incision.

Device: Chlorhexidine 0.2% mouth rinse
The mouth rinse protocol assigned to each study participant included a 10 ml-rinse for 60 seconds twice-a-day (every 12 hours) for 14 days.

Active Comparator: Control Group

No administration of mouth rinses after surgery

Procedure: Periodontal surgery
Surgery will be performed following a standardized protocol by a single operator (FG). The procedure consists in the performance of a primary full-thickness flap incision, and of a secondary releasing vertical incision of maximum 3 mm limited to keratinized gingiva. At the end of the surgical procedure, soft tissues will be repositioned by means of a suture involving only the primary incision, while it will not be performed on the releasing incision.

Outcome Measures

Primary Outcome Measures

  1. Pocket probing depth (PPD) [Measured at Baseline and at day 3, day 7, and day 14]

    Changes in PPD, measured orally through clinical examination. Unit of measure: mm

Secondary Outcome Measures

  1. Clinical attachment level (CAL) [Measured at Baseline and at day 3, day 7, and day 14]

    Changes in CAL , measured orally through clinical examination. Unit of measure: mm

  2. Recession of the gingival margin (REC) [Measured at Baseline and at day 3, day 7, and day 14]

    Changes in REC, measured orally through clinical examination. Unit of measure: mm

  3. Bleeding on probing (BOP) [Measured at Baseline and at day 3, day 7, and day 14]

    Changes in BOP, measured orally through clinical examination. Unit of measure: %

  4. Plaque index (PI) [Measured at Baseline and at day 3, day 7, and day 14]

    Changes in PI, measured orally through clinical examination. Unit of measure: %

  5. Periodontal Wound Healing Index (PWHI) (Wachtel classification) [Measured at day 3, day 7, and day 14]

    Changes in PWHI, measured orally through clinical examination on all the incisions, assigning a score from 1 to 5. Score 1: complete wound healing: absence of fibrin line in the interproximal area Score 2: complete wound healing: presence of a thin fibrin line in the interproximal area Score 3: complete wound healing: presence of fibrin clot in the interproximal area Score 4: incomplete wound healing: presence of partial necrosis of the interproximal area Score 5: incomplete wound healing: total necrosis of the interproximal area

  6. Post-surgical photographs [Taken at Baseline, day 3, day 7, and day 14]

    Post-surgical photographs will be taken and analysed after the completion of the trial

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years to 70 Years
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
Yes
Inclusion Criteria:
  • males or females of age range between 18 and 70 years,

  • good health status,

  • indication to perform periodontal surgery,

  • patients willing to give informed consent,

  • compliance to the study follow-up,

  • plaque index (PI) score 0 and

  • bleeding on probing (BOP) <25%

Exclusion Criteria:
  • pregnancy or breast-feeding,

  • therapy with oral contraceptives,

  • indication to antibiotic therapy prior to surgical treatment,

  • chronic infections,

  • systemic diseases (including cardiovascular, pulmonary, cerebral, and metabolic diseases),

  • previous therapy with the mouth rinses employed in the present study, and

  • smoking habit (>20 cigarettes per day, and/or pipe or cigar smoking).

Contacts and Locations

Locations

Site City State Country Postal Code
1 University Hospital of Pisa Pisa Italy 56121

Sponsors and Collaborators

  • University of Pisa

Investigators

None specified.

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
Filippo Graziani, DDS MClinDent PhD, Full Professor of Periodontology, University of Pisa
ClinicalTrials.gov Identifier:
NCT04345744
Other Study ID Numbers:
  • CLOR_3
First Posted:
Apr 14, 2020
Last Update Posted:
Apr 14, 2020
Last Verified:
Apr 1, 2020
Individual Participant Data (IPD) Sharing Statement:
No
Plan to Share IPD:
No
Studies a U.S. FDA-regulated Drug Product:
No
Studies a U.S. FDA-regulated Device Product:
No
Additional relevant MeSH terms:

Study Results

No Results Posted as of Apr 14, 2020