FGGvsBSG+CM: Buccal Graft + Collagen Matrix Versus Free Gingival Graft for Keratinized Mucosa Augmentation at Implant Sites

Sponsor
Harvard Medical School (HMS and HSDM) (Other)
Overall Status
Recruiting
CT.gov ID
NCT05844475
Collaborator
Osteology Foundation (Other)
32
1
2
32.3
1

Study Details

Study Description

Brief Summary

The study aims at comparing two different approaches for soft tissue augmentation at implants lacking keratinized and adherent mucosa width: the free gingival graft (FGG) vs the Buccal Strip Graft in combination with a xenogeneic collagen matrix (BSG + CM)

Condition or Disease Intervention/Treatment Phase
  • Procedure: Conventional Free Gingival Graft Approach (FGG)
  • Procedure: Buccal Strip Graft with a collagen matrix (bSG + CM)
N/A

Detailed Description

Conventional free gingival graft (FGG), serving as control group, will be compared to buccal strip gingival graft (BSG) in combination with a collagen matrix (CM), serving as test group, in terms of clinical, volumetric, ultrasonographic, and patient-reported outcomes related to soft tissue augmentation at implant sites lacking keratinized and adherent mucosa.

Study Design

Study Type:
Interventional
Anticipated Enrollment :
32 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
Double (Investigator, Outcomes Assessor)
Primary Purpose:
Treatment
Official Title:
Buccal Strip Gingival Graft With a Xenogeneic Collagen Matrix Versus Free Gingival Graft for Keratinized Mucosa Augmentation at Implant Sites: A Randomized, Controlled, Clinical Trial
Actual Study Start Date :
Apr 13, 2023
Anticipated Primary Completion Date :
Jun 21, 2025
Anticipated Study Completion Date :
Dec 21, 2025

Arms and Interventions

Arm Intervention/Treatment
Active Comparator: Free gingival graft (FGG)

Conventional free gingival graft, involving the harvesting of an epithelialized graft from the hard palate, which is then stabilized/sutured to the recipient site (implant).

Procedure: Conventional Free Gingival Graft Approach (FGG)
Conventional Free Gingival Graft Approach involving palatal soft tissue harvesting

Experimental: Buccal Strip Graft + Collagen matrix (bSG + CM)

Strip graft obtained from the buccal mucosa of a site showing abundant keratinized gingiva, combined with a collagen matrix. The bSG + CM graft is stabilized/sutured to the recipient site (implant).

Procedure: Buccal Strip Graft with a collagen matrix (bSG + CM)
A small strip of keratinized gingiva is harvested from the buccal gingiva of a site showing abundant keratinized gingiva, and combined with a xenogeneic collagen matrix

Outcome Measures

Primary Outcome Measures

  1. Sites showing KM≥ 2 mm and AM≥ 1 mm [6 months]

    Number of sites showing at least 2 mm of keratinized mucosa width (in millimeters) and at least of 1 mm of attached mucosa (in millimeters) (outcome expressed as a number)

Secondary Outcome Measures

  1. KM width gain [6 months]

    Gain in keratinized mucosa width obtained after the intervention compared to baseline (expressed in millimeters)

  2. AM gain [6 months]

    Gain in attached mucosa width obtained after the intervention compared to baseline (expressed in millimeters)

  3. Mucosal thickness (MT) gain [6 months]

    Gain of mucosal thickness (MT) obtained after the intervention compared to baseline (expressed in millimeters)

  4. Volumetric change [6 months]

    Volumetric change occurring at the treated sites analyzed by superimposing digital impressions obtained using optical scanners at baseline and 6 months (expressed in mm^3)

  5. Ultrasonographic tissue perfusion [Baseline, 1 week, 2 weeks, 1 month, 3 months, and 6 months]

    Tissue perfusion changes over the healing assessed with ultrasonography (expressed in cm/s)

  6. Post-operative morbidity [Daily, for the first 4 weeks after the procedure]

    Patient-reported outcome assessed using a daily questionnaire first the first 4 weeks (expressed as a number using a 0-100 visual analogue scale [VAS])

  7. Treatment satisfaction [6 months]

    Patient-reported outcome assessed with questionnaire including a 0-100 visual analogue scale (VAS) at the last visit (expressed as a number)

  8. Esthetic assessment [Baseline and 6 months]

    Patient-reported outcome assessed with questionnaire including a 0-100 visual analogue scale (VAS) at the initial and last visit (expressed as a number)

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years and Older
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
Yes
Inclusion Criteria:
  • Age ≥ 18 years,

  • Periodontally and systemically healthy,

  • Full-mouth plaque score and full-mouth bleeding ≤ 20% (measured at four sites per tooth),

  • Presence of at least one dental implant with < 2 mm of KM and lack of firm/adherent mucosa,

  • Presence of at least 4 mm of keratinized gingiva in two or more teeth nonadjacent to the implant to be treated,

  • Implants diagnosed as healthy (Berglundh et al. 2018),

  • The patient must be able to perform good oral hygiene.

Exclusion criteria:
  • Contraindications for surgery,

  • Systemic condition (e.g. diabetes mellitus, HIV, cancer, etc) that could compromise wound healing,

  • Patients pregnant or attempting to get pregnant (self-reported),

  • Untreated periodontitis,

  • Untreated peri-implant mucositis or peri-implantitis (Berglundh et al. 2018),

  • Smoking,

  • Allergy to collagen-based medical products or iodine,

  • Previous free gingival graft procedure at the target site.

Contacts and Locations

Locations

Site City State Country Postal Code
1 Harvard School of Dental Medicine Boston Massachusetts United States 02115

Sponsors and Collaborators

  • Harvard Medical School (HMS and HSDM)
  • Osteology Foundation

Investigators

  • Principal Investigator: Lorenzo Tavelli, DDS, MS, PhD, Harvard School of Dental Medicine, Boston, USA

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
Lorenzo Tavelli, Assistant Professor, Harvard Medical School (HMS and HSDM)
ClinicalTrials.gov Identifier:
NCT05844475
Other Study ID Numbers:
  • IRB23-0131
First Posted:
May 6, 2023
Last Update Posted:
May 6, 2023
Last Verified:
Apr 1, 2023
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

Study Results

No Results Posted as of May 6, 2023