Clinical Trial Details
— Status: Withdrawn
Administrative data
NCT number |
NCT05295771 |
Other study ID # |
Pro00112336 |
Secondary ID |
|
Status |
Withdrawn |
Phase |
N/A
|
First received |
|
Last updated |
|
Start date |
April 1, 2022 |
Est. completion date |
January 23, 2024 |
Study information
Verified date |
January 2024 |
Source |
University of Alberta |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Interventional
|
Clinical Trial Summary
Teenage children and adults often undergo orthodontic treatment each year to improve their
dental esthetics and chewing function. One common problem they present with is having a small
maxilla compared to the mandible. The standard of treatment to correct this issue is to
expand the maxilla using either a tooth-anchored expander, a bone-anchored expander, or
braces. Unfortunately, these treatment options can sometimes result in a loss of gum tissue
and supporting structures of the teeth. Certain patients, especially ones that have thin gum
tissue, are at a higher risk of this gum tissue loss. Orthodontic treatment for these
patients will expand their jaw, causing further pressure on already thin gums. An
increasingly common treatment to prevent this is to proactively modify patient's thin tissue
surgically prior to their orthodontic treatment so they can withstand the tooth movement. The
gold standard of doing this surgical intervention consists of harvesting a connective tissue
from the palate which is not well tolerated by the younger population. Our study will
evaluate the use of a biomaterial substitute instead of harvesting the patient's own tissue
to thicken the gingival tissues. Surgical healing, patient satisfaction, pain index, as well
as tissue contour post orthodontic treatment will be assessed thoroughly. This study will
help us understand: 1) if biomaterials can be a substitute for traditional autogenous gum
grafts to help thicken the patient's gum tissue prior to orthodontic treatment, and 2) if
they are able to withstand the pressure of orthodontic movement. This will be the first
long-term study of this kind.
Description:
This study will be a prospective, single-center, blinded, randomized, split-mouth study. Upon
ethics approval from the University of Alberta research information services (ARISE),
patients will be recruited from Kaye Edmonton Clinic (KEC). This study evaluates the
long-term success of Geistlich Fibro-Gide® in comparison to autogenous connective tissue
graft for the treatment of gingival phenotype modification of patients with thin gingiva
undergoing orthodontic arch expansion in the KEC Graduate Orthodontics clinic. A total of 30
subjects (n=30) will be enrolled in this study. Sample size was estimated based on 80% power,
alpha of 0.025, and results from past studies that have been conducted to detect a 10 to 15%
difference in gingival tissue recession post orthodontic treatment with a 15% standard
deviation (a patient sample of 25 would be ideal). Given the long-term nature of this study,
with normal drop-out rates, 30 subjects will ensure an adequate sample size for effective
statistical comparison.
In this study, 30 patients with bilaterally thin gingival phenotype and minimal keratinized
tissues as determined by standardized studies will be treated randomly (left or right
maxillary site to be randomized) with either Geistlich Fibro- Gide ® (Test arm) on one side,
and autogenous connective tissue graft (Control arm) on the contralateral side of the mouth.
Regular post-surgical follow-up visits will be conducted at weeks 2, 4, 12, 24, and up to 2
years post orthodontic treatment completion. Since orthodontic maxillary expansion most
commonly affects maxillary molars (predominantly mesial root), canines and both premolars,
the study will restrict treatment sites to only these teeth. The selection of these teeth
will help distinguish directly anchored teeth (molars), having force applied through wire
(premolars) and secondary expansion effect (canine). In this interventional study, each
patient will be randomly assigned to receive either Fibro-Gide® or autogenous connective
tissue graft (split-mouth, parallel assignment). The outcomes examiner will be blinded to the
intervention used by the periodontist. The primary outcome will be measured by standardized
periodontal charting and gingival measurements recorded in axiUm at each visit during the
study. This will include recording clinical attachment levels, periodontal probing, gingival
margin level in relation to cemento-enamel junction (CEJ), gingival phenotype class,
thickness and width of keratinized tissue, periapical radiographs, and clinical photographs
recorded during each phase of the study for comparative analyses. Secondary outcomes will be
analyzed by utilizing standardized pain indices and post surgical wound healing assessments
as described in previous studies.
Patients eligible to participate in the study will be presented with study details and
relevant consent forms. Surgical incision design and suturing will be done in accordance with
an envelope technique.