An Early Phase 1 interventional study of PRF under non-eugenol containing periodontal pack and Non-eugenol containing periodontal pack in Gingival Pigmentation, sponsored by Cairo University. Status unknown at 1 site in Egypt. Open to participants aged 18 Years to 40 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2020-07-31.
Sponsored by Cairo University · Early Phase 1, Interventional, and Supportive care
In an era where less than ideal esthetics is not accepted, the request for esthetic procedures is widely sought after. Melanin, a brown pigment, is the most common natural pigment contributing to endogenous pigmentation of gingiva. It is a non-hemoglobin-derived pigment formed by cells called melaonocytes
Dental cosmetic procedures including gingival depigmentation among the young generation are vastly becoming popular due to the public advertising of what the "ideal smile" should be. This means that brown/ pigmented gingiva is not esthetically accepted by modern standards. Numerous techniques for depigmentation were developed including surgical abrasion, lasers, chemicals and thermal techniques.
The use of post-operative non-eugenol containing periodontal packs acts as a mechanical barrier for coverage of the denuded area which prevents bleeding and promotes healing by preventing trauma to the area.
Platelet Rich Fibrin (PRF) is a form of concentrated suspension of growth factors that promote healing and tissue regeneration. Its use in the medical and dental fields is expanding during the recent year.
Gingival depigmentation procedures especially bur abrasion and scalpel surgical techniques require the use of post-operative periodontal pack. The periodontal pack protects the surgical site from surface trauma, stops the post-operative bleeding and infection as well as stabilizing the blood clot and accelerate healing.
However, a review article discussed the adverse effects of periodontal pack as it may cause plaque induced inflammation, patient discomfort due to difficulty in eating and irritation of the tissues. In the article, there were clinical trials that advocated that wound healing could occur without the need of periodontal pack if the surgical wound was kept clean alone indicating that the pack does not affect the wound healing.
This gave rise to idea to use a material that has been proven to accelerate wound healing and decrease the patient discomfort to be placed under the periodontal pack which would be used only as a protective barrier.
Several studies tested platelet rich concentrates as adjunctive methods under periodontal packs verses periodontal packs alone after surgical abrasion of gingival depigmentation. They found that there was a clinical, histological and statistical difference between the groups favoring the platelet concentrate groups.
Using PRF which is a second generation platelet concentrate first developed by Choukroun et al in 2001 used as a membrane could provide accelerated wound healing properties which would accelerate ginigival re-epithelization . Using a periodontal pack is conventionally used which will provide a mechanical barrier to protect the wound from any stimulus.
Exclusion Criteria:
Non-eugenol containing periodontal packs with PRF after gingival de-pigmentation
Biological: PRF under non-eugenol containing periodontal pack
Non-eugenol containing periodontal packs after gingival de-pigmentation
Other: Non-eugenol containing periodontal pack
Platelet Rich Fibrin under non-eugenol containing periodontal pack
Also known as: Platelet Rich Fibrin
Non-eugenol containing periodontal pack after gingival depigmentation
Post-operative pain
Visual Analog Scale: minimum score 0 (no pain), maximum score 10 (unbearable pain)
Time frame: 1st day post-operative
Post-operative pain
Visual Analog Scale: minimum score 0 (no pain), maximum score 10 (unbearable pain)
Time frame: 3rd day post-operative
Post-operative pain
Visual Analog Scale: minimum score 0 (no pain), maximum score 10 (unbearable pain)
Time frame: 5th day post-operative
Re-epithelization
Toulodine Blue test: dark blue = positive (worst score), light blue = negative (better score)
Time frame: 5th day post-operative
Wound healing
Healing Index (Landry, 1985): minimum score 1 (very poor), maximum score 5 (excellent)
Time frame: 3rd day post-operative
Wound healing
Healing Index (Landry, 1985): minimum score 1 (very poor), maximum score 5 (excellent)
Time frame: 5th day post-operative
Re-pigmentation
Re-pigmentation of de pigmented site (Kumar, Bhat and Bhat, 2012): minimum score 0 (absence of depigmentation, maximum score 3 (Diffuse brown to black pigmentation, marginal, and attached)
Time frame: 6 months post-operative
Plan to share: No
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Cairo University