Palatal Wound Clinical Trial
Official title:
Influence of Electrical Stimulation on Palatal Wound Healing. Randomized Clinical Trial
The aim of this present study is to evaluate the clinical and patients-centered parameters of electric stimulation on wound healing process of the donor palatal area after free gingival graft (FGG) removal.
This is a randomized, parallel, double-blind clinical trial. The population that will be
evaluated in this is study will be select at Science and Technology Institute - ICT-Sao Jose
dos Campos, College of Dentistry.
Patients will be assigned to one of the treatments groups:
- Sham Group - Free Gingival Graft (n = 22): Atraumatic extraction surgery and free
gingival graft for sealing the entrance of the alveolus associated with SHAM electrical
stimulation simulation.
- Test Group - Free Gingival Graft + Electric stimulus (n = 22): Atraumatic extraction
surgery with placement of a free gingival graft to seal the entrance of the alveolus
associated with electrical stimulation in the open wound on the palate.
All surgeries will be performed by the same expert periodontist (MMVM). A blade 15c
(Swann-Morton® - Sheffield, England) mounted on No. 3 scalpel handle will make an
intrasulcular incision around the tooth indicated for exodontia. Then, the tooth will be
extracted through the use of appropriate instruments in order to obtain a minimally traumatic
exodontia. With the aim to ridge preservation after tooth extraction the socket will be
sealed with a free gingival graft removed from the palate. For the free gingival graft
removal, a circular template of 9 millimeters in diameter will be used. This mold has the
objective of standardizing the palatal graft removal ensuring the wounds will have always the
same size. After the circular incision, the graft will be removed with a thickness of 2
millimeters. After free gingival graft removal from palate, it will be adjusted to the
entrance of the socket and sutured with Vicryl® 5.0 reabsorbable (Ethicon Johnsons do Brasil,
São José dos Campos - SP).
For electrical stimulation, a unit consisting of a signal generator (Keysight Technologies.,
Inc., Santa Rosa-CA, USA), a power supply (Keysight Technologies., Inc., Santa Rosa-CA, USA)
and circuit board will be used. Conductive electrodes for electrical current application will
be applied to the palatal donor area on each side of the wound at a distance of 3 mm from the
wound edge. An alternating current of 100 microamperes (μA) at 9 kilohertz (kHz), will be
distributed in order to traverse the operated area. A single application of electrical
stimulation will be given for 120 seconds, five consecutive days. The electric current will
have its visualization optimized through an oscilloscope. Patients randomized to the Control
Group (SHAM) will receive the simulation of the electrical stimulation (ES) process.
The evaluated clinical parameters will be: wound remaining area (WRA), scar and tissue
colorimetry (TC), tissue thickness (TT) and epithelization (E). Moreover, patient-centered
also will be evaluated as: number of pills (NP), tissue edema (TE), postoperative discomfort
(D) and Oral Health Impact Profile (OHIP).
All data will be expressed as mean ± standard deviation (SD), and normality will be tested
using the Shapiro-Wilk test. Values for remaining wound area, scar and tissue colorimetry,
tissue thickness, and epithelization will be examined by repeated measures ANOVA to assess
differences within and between groups, followed by a Tukey test for multiple comparisons when
the value of p Shapiro-Wilk ≥ 0.05. Those with Shapiro-Wilk p values <0.05 will be analyzed
using the Friedman test (for intragroup comparisons) and Mann-Whitney tests (for intergroup
comparisons). Values referring to patient-centered parameters such as postoperative
discomfort, the number of analgesics taken, tissue edema and oral health impact profile
measurements will be analyzed using the T-Test.
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