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

Not Applicable
Completed
Conditions
Periodontal Pocket
Periodontal Diseases
Interventions
Procedure: Periodontal surgery
Device: Hyaluronic and 0.2% chlorhexidine mouth rinse
Device: Chlorhexidine 0.2% mouth rinse
Registration Number
NCT04345744
Lead Sponsor
University of Pisa
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.

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 1)

* 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.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
33
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).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Control GroupPeriodontal surgeryNo administration of mouth rinses after surgery
Test group 1Periodontal surgeryadministration of a hyaluronic and 0.2% chlorhexidine mouth rinse
Test group 2Periodontal surgeryadministration of chlorhexidine 0.2% mouth rinse
Test group 1Hyaluronic and 0.2% chlorhexidine mouth rinseadministration of a hyaluronic and 0.2% chlorhexidine mouth rinse
Test group 2Chlorhexidine 0.2% mouth rinseadministration of chlorhexidine 0.2% mouth rinse
Primary Outcome Measures
NameTimeMethod
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
NameTimeMethod
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

Bleeding on probing (BOP)Measured at Baseline

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

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

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: %

Angulated bleeding index (AngBI)Measured at day 3, day 7, and day 14

AngBI, measured orally through clinical examination. Unit of measure: %

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

Post-surgical photographsTaken at Baseline, day 3, day 7, and day 14

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

Trial Locations

Locations (1)

University Hospital of Pisa

🇮🇹

Pisa, Italy

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