CClinicalTrials.gg
Status unknownNCT04217434LASERUpdated Jan 3, 2020

Comparative Evaluation of Various Patient Centered Outcomes Following Gingival Depigmentation Using Diode LASER in Different Modes: A Randomized Clinical Trial

An interventional study of 400 µm fibre length will be used in continuous contact mode and 400 µm fibre length will be used in pulsed contact mode in Pain, Postoperative, Healing Surgical Wounds and Analgesia, sponsored by Krishnadevaraya College of Dental Sciences & Hospital. Status unknown at 1 site in India. Open to participants aged 18 Years to 45 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2020-01-03.

Sponsored by Krishnadevaraya College of Dental Sciences & Hospital · Not applicable, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Jan 2020), so the status shown — last known as Enrolling by invitation — may be out of date.
Phase
Not applicable
Study type
Interventional
Enrollment
40
Allocation
Randomized
Ages
18 Years to 45 Years
Sex
All
01

Study summary

Purpose of this study is to clinically evaluate and compare various patient centered outcomes using diode LASER in Continuous mode (CW) and Pulsed Mode (PM) using 300µm and 400µm fiber for depigmentation procedure.

Read the detailed description

The colour of gingiva has a tremendous impact on the esthetics of the smile. Clinically gingival melanin hyperpigmentation is presented as 'black gum' which is common esthetic problem especially for those who have gummy smile. Currently the growing aesthetic concerns among the patients require the removal of hyper pigmented gingival areas to create an aesthetically-pleasant smile. The harmony of the smile is determined not only by the shape, position and colour of the teeth or lips as well as by the by the gingival tissues.Several attempts have been made for removal of gingival pigmentation by different techniques like scalpel, electrocautery, LASER etc. Each technique has its own advantages and disadvantages. In the present study an effort has been made to compare two different modes viz. Continuous mode and Pulsed mode of LASER in the treatment of depigmentation.Diode LASERs for dentistry operate in the near infrared region. The most commonly used wavelengths are 810, 940 and 980 nm , because these wavelengths are very well absorbed by pigmented tissues, haemoglobin and melanin.There are several different ways LASER light operates: Continuous wave (CW), Pulse wave mode (PM). The continuous wave diodes emit continuous LASER energy with a fixed power output for the entire duration. Pulse modulated diodes create a 'pulse' by cutting the beam or turning LASER on \& off [1s] at regular intervals.

During the first years of diode LASER treatment in dentistry only CW mode was possible but application of 3-4 Watt in CW mode led to carbonization of the soft tissue.To approach better results in soft tissue treatment without much carbonization it was necessary to interrupt the CW mode. That was done by chopping the CW mode. Pulses down to several 100μs were released.LASER in Continuous wave mode is suggested in some studies to cause increase in surgical site temperature which may cause necrosis or jeopardize healing. Application of the LASER in Pulsed mode prevents overheating of surrounding tissues. This study aims to determine the comparative increase in the onsite temperature between the two modes.Decrease in post-operative pain is likely to reduce the consumption of Non-steroidal Anti-inflammatory Drugs (NSAID's). The study aims to quantify the need for NSAID's post-operatively in both Pulsed and continuous wave modes and also in 300µ and 400µ fibers.

The change in the diameter of the fibers used in LASER irradiation could bring about a change in the outcome of the procedure as small diameter fibers means high energy density, faster cutting and more heat whereas with larger diameter fibers more energy is needed to cover a broader area to work more quickly and less heat.

02

Conditions studied

  • Pain, Postoperative
  • Healing Surgical Wounds
  • Analgesia
  • Temperature Change, Body
03

Who can participate

Ages eligible
18 Years to 45 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  1. Presence of melanin hyper pigmentation of the anterior labial gingival segment
  2. Systemically healthy patients who desires correction of gingival pigmentation
  3. Patients with healthy periodontium
  4. Patients in age group of 18-45 years old

Exclusion criteria

Exclusion Criteria:

  1. Presence of uncontrolled systemic diseases example uncontrolled Diabetes, Hypertension etc.
  2. Pregnant and lactating women
  3. Gingival enlargement
  4. Patients who are on Non-steroidal Anti-inflammatory Drugs (NSAID's) or who have taken antibiotics for last 6 months
  5. Patients who are on drugs that could possibly affect gingival status like phenytoin
  6. Patients who have undergone any form of oral surgery in last 6 months
  7. Asthma patients
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
40 participants (estimated)

Study arms

  • Experimental
    Group 300µm in continous contact mode

    Diode LASER (A.R.C Fox , Germany, UK) with wavelength of 810nm is selected for the procedure. Before applying the LASER, operating staff and the patient will wear special LASER protective eye glasses. Local infiltration is administered with Lignox®\[ 2% lignocaine in 1:80000 adrenaline.LASER tip will be used in contact mode on pigmented gingiva in short light paint brush strokes , 300 µm fibre length will be used in continuous contact mode at a power setting of 1.5 to 3 W. • Simultaneously, increase in temperature on site will be recorded using FLUKETM 59 Mini (IR) infrared thermometer in non contact mode. Water spray will be used to keep the area moist. Same procedure will be repeated till no pigments remain. Post operative instructions will be given.

    Procedure: 300 µm fibre length will be used in continuous mode

  • Experimental
    Group 300µm in pulsed contact mode

    Diode LASER (A.R.C Fox, Germany, UK) with wavelength of 810nm is selected for the procedure. Before applying the LASER, operating staff and the patient will wear special LASER protective eye glasses. Local infiltration is administered with Lignox®\[ 2% lignocaine in 1:80000 adrenaline\].LASER tip will be used in contact mode on pigmented gingiva in short light paint brush strokes, 300 µm fibre length will be used in pulsed contact mode at a power setting of 1.5 - 3 W. Simultaneously, increase in temperature on site will be recorded using FLUKETM 59 Mini (IR) infrared thermometer in non contact mode. Water spray will be used to keep the area moist. Same procedure will be repeated till no pigments remain. Post operative instructions will be given.

    Procedure: 300 µm fibre length will be used in pulsed contact mode

  • Experimental
    Group 400µm in continous contact mode

    Diode LASER (A.R.C Fox , Germany, UK) with wavelength of 810nm is selected for the procedure. Before applying the LASER, operating staff and the patient will wear special LASER protective eye glasses. Local infiltration is administered with Lignox®\[ 2% lignocaine in 1:80000 adrenaline.LASER tip will be used in contact mode on pigmented gingiva in short light paint brush strokes , 400 µm fibre length will be used in continuous contact mode at a power setting of 1.5 - 3 W. • Simultaneously, increase in temperature on site will be recorded using FLUKETM 59 Mini (IR) infrared thermometer in non contact mode. Water spray will be used to keep the area moist. Same procedure will be repeated till no pigments remain. Post operative instructions will be given.

    Procedure: 400 µm fibre length will be used in continuous contact mode

  • Experimental
    Group 400µm in pulsed contact mode

    Diode LASER (A.R.C Fox , Germany, UK) with wavelength of 810nm is selected for the procedure. Before applying the LASER, operating staff and the patient will wear special LASER protective eye glasses. Local infiltration is administered with Lignox®\[ 2% lignocaine in 1:80000 adrenaline.LASER tip will be used in contact mode on pigmented gingiva in short light paint brush strokes , 400 µm fibre length will be used in pulsed contact mode at a power setting of 1.5 t 3 W. • Simultaneously, increase in temperature on site will be recorded using FLUKETM 59 Mini (IR) infrared thermometer in non contact mode. Water spray will be used to keep the area moist. Same procedure will be repeated till no pigments remain. Post operative instructions will be given.

    Procedure: 400 µm fibre length will be used in pulsed contact mode

Interventions

  • Procedure400 µm fibre length will be used in continuous contact mode

    Diode LASER (A.R.C Fox, Germany, UK) with wavelength of 810nm is selected for the procedure. Before applying the LASER, operating staff and the patient will wear special LASER protective eye glasses. Local infiltration is administered with Lignox®\[ 2% lignocaine in 1:80000 adrenaline\]. LASER tip will be used in contact mode on pigmented gingiva in short light paint brush strokes using 400 µm fibre length will be used in continuous contact mode at a power setting of 1.5 - 3W. Simultaneously, increase in temperature on site will be recorded using FLUKE 59 Mini (IR) infrared thermometer in non contact mode. Water spray will be used to keep the area moist. Same procedure will be repeated till no pigments remain.Post operative instructions will be given.

  • Procedure400 µm fibre length will be used in pulsed contact mode

    Diode LASER (A.R.C Fox, Germany, UK) with wavelength of 810nm is selected for the procedure. Before applying the LASER, operating staff and the patient will wear special LASER protective eye glasses. Local infiltration is administered with Lignox®\[ 2% lignocaine in 1:80000 adrenaline\]. LASER tip will be used in contact mode on pigmented gingiva in short light paint brush strokes using 400µm fibre length will be used pulsed contact mode at a power setting of 1.5 - 3W. Simultaneously, increase in temperature on site will be recorded using FLUKE 59 Mini (IR) infrared thermometer in non contact mode. Water spray will be used to keep the area moist. Same procedure will be repeated till no pigments remain.Post operative instructions will be given.

  • Procedure300 µm fibre length will be used in continuous mode

    Diode LASER (A.R.C Fox, Germany, UK) with wavelength of 810nm is selected for the procedure. Before applying the LASER, operating staff and the patient will wear special LASER protective eye glasses. Local infiltration is administered with Lignox®\[ 2% lignocaine in 1:80000 adrenaline\]. LASER tip will be used in contact mode on pigmented gingiva in short light paint brush strokes using 300 µm fibre length will be used continous contact mode at a power setting of 1.5 - 3W. Simultaneously, increase in temperature on site will be recorded using FLUKE 59 Mini (IR) infrared thermometer in non contact mode. Water spray will be used to keep the area moist. Same procedure will be repeated till no pigments remain.Post operative instructions will be given.

  • Procedure300 µm fibre length will be used in pulsed contact mode

    Diode LASER (A.R.C Fox, Germany, UK) with wavelength of 810nm is selected for the procedure. Before applying the LASER, operating staff and the patient will wear special LASER protective eye glasses. Local infiltration is administered with Lignox®\[ 2% lignocaine in 1:80000 adrenaline\]. LASER tip will be used in contact mode on pigmented gingiva in short light paint brush strokes using 300 µm fibre length will be used pulsed contact mode at a power setting of 1.5 - 3W. .Simultaneously, increase in temperature on site will be recorded using FLUKE 59 Mini (IR) infrared thermometer in non contact mode. Water spray will be used to keep the area moist. Same procedure will be repeated till no pigments remain.Post operative instructions will be given.

05

What researchers measure

Primary outcomes

  1. pain assessing

    visual analogue scale (VAS) method - a questionnaire will be given to the patients in which their responses for Visual Analog Score that ranges from 1-10 values and highest values indicate the worst outcomes.

    Time frame: 1st day post operatively.

  2. pain assessing

    visual analogue scale (VAS) method - a questionnaire will be given to the patients in which their responses for Visual Analog Score that ranges from 1-10 values and highest values indicate the worst outcomes.

    Time frame: 3rd day post operatively.

  3. pain assessing

    visual analogue scale (VAS) method - a questionnaire will be given to the patients in which their responses for Visual Analog Score that ranges from 1-10 values and highest values indicate the worst outcomes.

    Time frame: 7th day post operatively.

  4. pain assessing

    visual analogue scale (VAS) method - a questionnaire will be given to the patients in which their responses for Visual Analog Score that ranges from 1-10 values and highest values indicate the worst outcomes.

    Time frame: 14th day post operatively.

  5. pain assessing

    visual analogue scale (VAS) method - a questionnaire will be given to the patients in which their responses for Visual Analog Score that ranges from 1-10 values and highest values indicate the worst outcomes.

    Time frame: 1 month post operatively.

  6. Healing of gingiva

    hick healing index- score ranges from 0 to 4, higher values indicate the worst outcomes.

    Time frame: 1st day post operatively

  7. Healing of gingiva

    hick healing index- score ranges from 0 to 4, higher values indicate the worst outcomes.

    Time frame: 3rd day post operatively

  8. Healing of gingiva

    hick healing index- score ranges from 0 to 4, higher values indicate the worst outcomes.

    Time frame: 7th day post operatively

  9. Healing of gingiva

    hick healing index- score ranges from 0 to 4, higher values indicate the worst outcomes.

    Time frame: 14th day post operatively

  10. Healing of gingiva

    hick healing index- score ranges from 0 to 4, higher values indicate the worst outcomes.

    Time frame: 1 month post operatively

  11. epithelial healing

    3% of hydrogen peroxide is applied on the operated area. no bubble- complete epithelization, bubble formation- incomplete epithelization.

    Time frame: 7th day post operatively

  12. epithelial healing

    3% of hydrogen peroxide is applied on the operated area. no bubble- complete epithelization, bubble formation- incomplete epithelization.

    Time frame: 14th day post operatively

  13. epithelial healing

    3% of hydrogen peroxide is applied on the operated area. no bubble- complete epithelization, bubble formation- incomplete epithelization.

    Time frame: 1 month post operatively

  14. need of analgesics

    on scale of 0-9, where higher variable represents more pain

    Time frame: 1st day post operatively

  15. need of analgesics

    on scale of 0-9, where higher variable represents more pain

    Time frame: 2nd day post operatively

  16. need of analgesics

    on scale of 0-9, where higher variable represents more pain

    Time frame: 3rd day post operatively

  17. rise in temperature

    FLUKETM 59 Mini (IR) infrared thermometer is used to measure temperature at surgical site, more rise in temperature indicate more carbanoization.

    Time frame: baseline

Secondary outcomes

  1. ease of cutting

    on scale on 1-3, more value represents better cutting.

    Time frame: Baseline

  2. duration of operation

    time duration taken for completing surgical procedure in minutes

    Time frame: intraoperative

  3. presence/ absence of carbonization

    on scale of 0-3, higher value indicates more carbonization

    Time frame: Baseline

06

Study locations

1 site
  • Krishnadevaraya college of dental sciences
    Bangalore, Karnataka 562157, India
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT04217434
Lead sponsor
Krishnadevaraya College of Dental Sciences & Hospital
Responsible party
Dr Prabhuji MLV (Head of the Department, Krishnadevaraya College of Dental Sciences & Hospital) — Principal investigator
First posted
Jan 3, 2020
Start date
Nov 20, 2018
Primary completion
Mar 21, 2020 (estimated)
Completion
Nov 22, 2020 (estimated)
Last update
Jan 3, 2020

Study contacts

Dr Hafsa Shereen, MDS
principal investigator · Rajiv Gandhi University of Health Sciences
Dr Kishore H C, MDS
study director · Rajiv Gandhi University of Health Sciences

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
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