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Gingival PigmentationNCT05930366

Comparative Evaluation of Microsurgery vs Diode Laser Technique of Gingival Depigmentation

A study testing Gingival depigmentation using microsurgery and Gingival Depigmentation using Diode Laser in people with Gingival Pigmentation and Melanosis, run by Postgraduate Institute of Dental Sciences Rohtak at 1 site in India.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Gingiva being the most frequently pigmented tissue of the oral cavity challenges a lot of people with an esthetic concern. Increased production of melanin, a pigment produced by the melanocytes present in the basal and suprabasal cell layers of the epithelium leads to the hyper-pigmented appearance of these tissues. Read more about this study

Who is it for?
Ages 20 to 45 yearsHealthy volunteers can take part
Conditions the study is for
Gingival Pigmentation, Melanosis
What is being tested?
Gingival depigmentation using microsurgery and Gingival Depigmentation using Diode Laser
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
22 participants
Where
1 siteIndia
Study dates
1 Jul 2023to 29 Oct 2023
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 20 to 45 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • 1) Systemically healthy patients seeking treatment for gingival hyper-pigmentation.

Who cannot join

  • Gingival index (Leo and silliness 1963) of greater than or equal to 1 at any site of surgical field.
  • Patients with periodontitis
  • Patients with pathologic or drug-induced gingival hyper-pigmentation
  • Patients with history of systemic illness with the potential to influence the
  • Periodontal status or outcome of periodontal intervention;
  • Patients with Miller Grade II /Grade III tooth mobility;
Show all 10Show fewer
  • Patients taking medications such as NSAIDS, corticosteroids, statins or calcium 8
  • Channel blockers, which are known to influence periodontal status;
  • Pregnant or lactating women;
  • History of use of tobacco;

Trial locations and contacts

1 site in 1 country.

RAJINDER KR SHARMA, MDS contact

9416258222

rksharmamds@yahoo.in

India1 site
  • Post graduate institute of dental sciences

    Rohtak, Haryana, 110015

    Ritika Arora, 09810734445, drritika44@gmail.com

Other trials in India

About this study

Official title: Comparative Evaluation of Microsurgery vs Diode Laser Technique of Gingival Depigmentation on Pink Esthetics and Patient-related Outcomes: A Split-mouth Randomised Controlled Clinical Study.

Gingiva being the most frequently pigmented tissue of the oral cavity challenges a lot of people with an esthetic concern. Increased production of melanin, a pigment produced by the melanocytes present in the basal and suprabasal cell layers of the epithelium leads to the hyper-pigmented appearance of these tissues. Over the decades many non-surgical as well as surgical techniques have been developed to remove the melanin induced hyper-pigmentation of gingival tissue with comparable efficacies. The surgical treatment modalities include use of scalpel, laser ablation, bur abrasion, electrocautery, cryosurgery, radio-surgery, free gingival grafts and acellular dermal matrix allograft etc. Diode lasers have frequently been used in a variety of soft tissue surgical procedures and have many advantages such as less pain, bleeding, scar formation and infection. Examined histologically, laser wounds have been resulted in less wound contracture or scarring, and ultimately improved healing. Depigmentation with lasers has become popular in recent times due to good results but requires sophisticated equipment and occupies a large space. Therefore the most practical gingival depigmentation procedure, both patient and operator wise, with satisfactory results remains the conventional scalpel (#15 blade) method. Nowadays, minimally traumatising the surgical field and gaining maximum outputs with help of microscopy and microsurgical instruments has attained a level of utmost importance in surgical procedures including periodontal therapy. Improved results in terms of increased vascularization of the grafts, relatively better percentages of root coverage a significant increase in width and thickness of keratinized tissue, an improved esthetic outcome and decreased patient morbidity in cases of gingival recession treated via microsurgical approach have been observed and well documented. However, perusal of the literature available suggests that clinical outcomes and esthetic potential of the results of gingival depigmentation using principles of microsurgery is an area of interest that still needs to be explored further. This study is therefore aimed at evaluating and comparing the clinical, esthetic and patient-related outcomes of gingival depigmentation performed using microsurgery vs diode laser technique.

Read the detailed description

AIM: To evaluate and compare the clinical, esthetic and patient-related outcomes of gingival depigmentation performed via Microsurgery vs Diode Laser technique.

OBJECTIVES:

To evaluate and compare melanin pigmentation using Dummett Oral Pigmentation Index (DOPI), Hedin melanin index (HMI) between both the treatment modalities at baseline, 1 week, 1 month and 3 months post-operatively.

To assess a) patient-related outcome measures (PROMs) such as post-operative pain perception/discomfort on a visual analog scale (VAS) , patient's preference of the mode of treatment /esthetic satisfaction and b) clinical parameters13 such as bleeding, redness, swelling, wound healing, gingival colour, gingival morphology at baseline, within 24 hours, 1 week, 1 month and 3 months.

To evaluate the effect of different treatment modalities on melanocyte histopathologic count (MHC).

SETTING: Department of Periodontology and Oral Implantology, PGIDS, Rohtak, Haryana.

STUDY DESIGN: Split-mouth Comparative Randomised Controlled Clinical Study. TIME FRAME: 3 months SAMPLE SIZE: To achieve a power of 80%, level of significance of 5% and assuming an effect size of 0.8, a minimum sample size of 18 patients is needed in each group. Accounting for a 20% drop out rate, 22 patients are needed in each group.

METHODOLOGY: Patients with a chief complaint of unpleasant appearance of gingival tissue will be recruited from the outpatient Department of Periodontology, PGIDS, Rohtak. Patients fulfilling the eligibility criteria will be enrolled in the study after obtaining an informed written consent. A split-mouth design with maxillary and mandibular anteriors being randomly allocated into test (Microsurgery) and control (Diode laser technique) group to each patient using a chit method.

STATISTICAL ANALYSIS: Data recorded will be processed by standard statistical analysis. The normality of distribution of data will be examined by Shapiro Wilk test. Statistical analysis will be performed according to distribution of data. If it is in normal distribution, intra group comparison will be done by paired t-test between two time points and inter group comparison will be done by using unpaired t-test between two groups. If it is in non-normal distribution, intra group comparison will be done by Wilcoxon signed rank test and inter group comparison will be done by Mann-Whitney U test.

Being tested
Gingival depigmentation using microsurgery, Gingival Depigmentation using Diode Laser
Medical subject headings
Melanosis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Gingival depigmentation using microsurgeryProcedure or surgery

    GINGIVAL DEPIGMENTATION USING MICROSURGICAL BLADE AND MAGNIFICATION LOUPES

  • Gingival Depigmentation using Diode LaserProcedure or surgery

    GINGIVAL DEPIGMENTAION USING DIODE LASER

Study groups in NCT05930366
Study groupRoleWhat they receive
Gingival depigmentation using microsurgeryActive comparatorSurgical excision of hyper-pigmented gingival tissue using microsurgical blade (keratome 2.2) and magnification loupes under local anaesthesia.
Receives: Procedure: Gingival depigmentation using microsurgery
Gingival Depigmentation using Diode LaserActive comparatorAblation of hyper-pigmented gingival tissue using Diode Laser under local anaesthesia.
Receives: Procedure: Gingival Depigmentation using Diode Laser

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. CLINICAL PARAMETER- BLEEDING

    Bleeding score classification in accordance to Ishi et al and Kawashima et al

    A: NONE B: SLIGHT C: MODERATE D: SEVERE

    Measured: 3 MONTHS

  2. CLINICAL PARAMETER- REDNESS

    Redness score classification in accordance to Ishi et al and Kawashima et al

    A: NONE B: SLIGHT C: MODERATE D: SEVERE

    Measured: 3 MONTHS

  3. CLINICAL PARAMETERS- SWELLING

    Swelling score classification in accordance to Ishi et al and Kawashima et al

    A: NONE B: SLIGHT C: MODERATE D: SEVERE

    Measured: 3 MONTHS

  4. CLINICAL PARAMETER- WOUND HEALING

    wound healing score classification in accordance to Ishi et al and Kawashima et al

    A: COMPLETE EPITHELIALIZATION B: INCOMPLETE OR PARTIAL EPITHELIALIZATION C: ULCER D: TRISSUE EFECT OR NECROSIS

    Measured: 3 MONTHS

  5. CLINICAL PARAMETER- GINGIVAL COLOR

    gingival color score classification in accordance to Ishi et al and Kawashima et al

    A: IMPROVEMENT B: SLIGHT IMPROVEMENT C: NO CHANGE D: DETERIORATION

    Measured: 3 MONTHS

  6. DUMMETT ORAL PIGMENTATION INDEX (DOPI)

    DOPI

    Score Criteria 0 Pink tissue (no clinical pigmentation)

    1. Mild light brown tissue (mild clinical pigmentation)
    2. Medium brown or mixed brown and pink tissue (moderate clinical pigmentation)
    3. Deep brown/ blue-black tissue (heavy clinical pigmentation)

    Measured: 3 MONTHS

  7. HEDIN MELANIN INDEX (HMI)

    HMI

    Score Criteria 0 No pigmentation

    1. One or two solitary units of pigmentation in the papillary gingiva
    2. >3 units of pigmen- tation in the papillary gingiva without formation of a continuous ribbon
    3. More than equal to 1 short continuous ribbons of pigmentation
    4. One continuous ribbon including the entire area between the canines

    Measured: 3 MONTHS

  8. Patient-related outcome measures (PROMs) - POST-OPERATIVE PAIN PERCEPTION

    post-operative pain perception/discomfort and esthetic satisfaction on a visual analog scale (VAS)

    Pain will be assessed on a 100-mm horizontal, continuous interval scale with the left endpoint marked ''no pain'' and the right endpoint marked ''worst pain.'' The patient placed a mark to coincide with the level of pain. Scores were calculated as: 0 = no pain; 0.1 to 3.0 cm (1 to 30 mm) = slight pain; 3.1 to 6.0 cm (31 to 60 mm) = moderate pain; 6.1 to 10 cm (61 to 100 mm) = severe pain.

    Measured: 3 MONTHS

  9. Patient-related outcome measures (PROMs) - ESTHETIC SATISFACTION

    OVERALL ESTHETIC SATISFACTION WILL BE EVALUATED AS PER PATIENTS REPSONSE TO PREFERRED CHOICE OF TREATMENT - MICROSURGICAL OR DIODE LASER

    Measured: 3 MONTHS

Secondary outcomes (7)
  1. MELANOCYTE HISTOPATHOLOGIC COUNT (MHC)

    EFFECT ON MHC

    The grading will be done using the following scale: 0 = absence of melanin granules (no pigmentation); 1 = rare and scattered melanin granules (mild pigmentation); 2 = dense but not aggregated melanin granules (moderate pigmentation); or 3 = dense and aggregated melanin granules (heavy pigmentation).

    Measured: 3 MONTHS

  2. PERIODONTAL PARAMETER- PLAQUE INDEX (PI)

    PLAQUE INDEX (PI)

    " SCORE" " CRITERIA" 0 No plaque

    1. A film of plaque adhering to the free gingival margin and adjacent area of the tooth. The plaque could only be recognized by running a probe across the tooth surface area
    2. Moderate accumulation of soft deposits within the gingival pocket, or the tooth and gingival margin, which can be seen with the naked eyes.
    3. Abundance of soft matter on tooth and/or on the gingival margin.

    Measured: 3 MONTHS

  3. PERIODONTAL PARAMETER - GINGIVAL INDEX (GI)

    GINGIVAL INDEX (GI)

    Score Criteria 0 Absence of inflammation/normal gingiva.

    1. Mild inflammation, slight change in colour, slight oedema; no bleeding on probing within 30 seconds.
    2. Moderate inflammation; moderate glazing, redness, oedema, hypertrophy and bleeding on probing.
    3. Severe inflammation; marked redness and hypertrophy ulceration of gingival margin. Tendency to spontaneous bleeding.

    Measured: 3 MONTHS

  4. PERIODONTAL PARAMETER- BLEEDING ON PROBING (BOP)

    BLEEDING ON PROBING (BOP)

    BOP will be recorded as 1 (present) if it occurs within 15 secs of probing and 0 (absent) if no bleeding occurs. It will be calculated in %. After adding all the scores, total score will be divided by the total number of surfaces accessed and multiplied by 100. It will be designed as % sites

    Measured: 3 MONTHS

  5. PERIODONTAL PARAMETER - PROBING POCKET DEPTH (PPD)

    PROBING POCKET DEPTH (PPD)

    Probing pocket depth will be measured as the distance from the gingival margin to the base of pocket. The probing depth measurements will be assessed using a calibrated manual periodontal probe (PCP-UNC 15 Hu-Friedy, Chicago, IL, USA). The probe will be inserted with a firm, gentle pressure to the bottom of the pocket and maintained parallel to the vertical axis of the tooth. Measurements will be noted at 6 sites of each tooth - mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual and disto-lingual. Measurements will be rounded to the nearest whole millimetre.

    Measured: 3 MONTHS

  6. PERIODONTAL PARAMETER - CLINICAL ATTACHMENT LEVEL (CAL)

    CLINICAL ATTACHMENT LEVEL (CAL)

    Clinical Attachment Level will be measured as the distance between the base of the pocket and the cemento-enamel junction (CEJ). Measurements will be made at 6 sites of each tooth- mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual and disto-lingual using UNC-15 probe

    Measured: 3 MONTHS

  7. PERIODONTAL PARAMETER - GINGIVAL RECESSION (GR)

    GR will be measured as the vertical distance from the CEJ to the deepest part of gingival margin in the middle of the buccal aspect of the crown.

    Measured: 3 MONTHS

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Jul 2023
  2. Study start1 Jul 2023 (estimated)
  3. Primary completion25 Sep 2023 (estimated)
  4. Study completion29 Oct 2023 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
22 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05930366
Sponsor's protocol ID
AANCHAL SAHNIPERIO3
Status last verified
Jun 2023
First submitted
4 May 2023
Last updated
5 Jul 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing Gingival depigmentation using microsurgery and Gingival Depigmentation using Diode Laser in people with Gingival Pigmentation and Melanosis, run by Postgraduate Institute of Dental Sciences Rohtak at 1 site in India.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 5 Jul 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in India. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact RAJINDER KR SHARMA, MDS (9416258222, rksharmamds@yahoo.in), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

CLINICAL PARAMETER- BLEEDING (time frame: 3 MONTHS). The study lists 9 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Jul 2023.

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