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A Clinical Trial to Evaluate Kerecis Oral™ Compared to Autogenous Free Gingival Graft (AFGG) Tissue to Augment Gingival Soft Tissue and Wound Healing

Primary Purpose

Mucogingival Deformity - Insufficient Keratinized Tissue

Status
Completed
Phase
Early Phase 1
Locations
Study Type
Interventional
Intervention
Kerecis Oral™
Free Gingival Graft
Sponsored by
Kerecis Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional device feasibility trial for Mucogingival Deformity - Insufficient Keratinized Tissue

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age must be at least 18 years but no more than 70 years.
  2. There must be at least two non-adjacent teeth in contralateral sides of the same jaw with an insufficient zone (≤ 2mm) of Keratinized gingiva that requires soft tissue grafting. (1-4 teeth may be treated). If adjacent teeth require grafting, only a single chosen tooth at each site will act as the test or control site, all teeth will however get the same treatment).
  3. The goal of grafting will not be root coverage.
  4. Females must have a documented negative urine pregnancy test if they are of childbearing potential.
  5. All subjects must have read, understood and signed an Informed Consent Form (approved by the institutional review board (IRB)).
  6. All subjects must be willing and able to follow study instructions and protocols.

Exclusion Criteria:

  1. Any subject that has class III/IV recession with a shallow vestibule.
  2. Any subject that has a vestibule depth of less than 7mm from the base of recession.
  3. Any subjects with systemic conditions (i.e., diabetes mellitus, HIV, cancer, bone metabolic diseases) that typically precludes periodontal surgery.
  4. Any subjects who are currently taking/received or have taken/received within two months prior to study entry, systemic corticosteroids, immunosupressive agents, radiation therapy, and/or chemotherapy which could compromise wound healing and preclude periodontal surgery. Any subjects taking intramuscular or intravenous bisphosphonates.
  5. Any subjects with any acute lesions in the areas intended for surgery/or with a history of aphthous ulcers.
  6. Any subjects who currently smoke.
  7. Any subject with molar teeth that require treatment at the time of surgery.
  8. Any subjects with teeth with Miller Grade =>2 mobility.
  9. Any patients with known hypersensitivity to bovine collagen and/or iodine (shellfish allergy).
  10. Any subjects who have received an investigational drug or biological/bioactive treatment within 30 days prior to study enrollment (medical or dental).
  11. Any subjects previously treated with any allografts at the target site(s) or immediately adjacent teeth.
  12. Any subjects who will not be able to complete the study per protocol.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    Kerecis Oral™

    Autogenous Free Gingival Graft

    Arm Description

    The Fish Skin Graft will be is cut to shape of wound bed and placed directly on the appropriate prepared recipient wound bed. The Fish skin graft has the smooth side down and the scaly side facing out. The graft will be sutured in place at either coronal end with resorbable sutures and may be secured apically if needed. A surgical dressing (Coe-Pak® ) will be placed over the graft if needed.

    The recipient bed will be prepared at the appropriate sequential time as described. The graft will be harvested from the same side that the Free Gingival Graft is to be placed. A measurement will be made to determine the size of the donor tissue needed to be placed at the recipient site. Local anesthetic will be administered. The donor tissue will be harvested using the usual techniques. The width will be 5 mm and the length will match the predetermined measurement. The graft will be thinned as is usual practice. The harvested palatal graft will be centered on the study tooth and placed on the appropriately prepared recipient wound bed. The graft will be sutured with resorbable sutures on the mesial and distal aspects of the tooth. A surgical dressing (Coe-Pak® ) will be placed over the graft if needed.

    Outcomes

    Primary Outcome Measures

    Change in KT width from time of surgery to 3 months post-surgery
    Increase in KT Width in MM

    Secondary Outcome Measures

    Probing depth
    mm
    Papillary height and widht
    mm
    Horizontal recession
    mm
    Subject completed discomfort questionaire
    Standard questionare
    Bleeding on probing
    Y/N

    Full Information

    First Posted
    August 30, 2018
    Last Updated
    September 11, 2018
    Sponsor
    Kerecis Ltd.
    Collaborators
    Tufts University School of Dental Medicine
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    1. Study Identification

    Unique Protocol Identification Number
    NCT03664401
    Brief Title
    A Clinical Trial to Evaluate Kerecis Oral™ Compared to Autogenous Free Gingival Graft (AFGG) Tissue to Augment Gingival Soft Tissue and Wound Healing
    Official Title
    A Clinical Trial to Evaluate Kerecis Oral™ Compared to Autogenous Free Gingival Graft (AFGG) Tissue to Augment Gingival Soft Tissue and Wound Healing
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2018
    Overall Recruitment Status
    Completed
    Study Start Date
    September 1, 2016 (Actual)
    Primary Completion Date
    September 1, 2017 (Actual)
    Study Completion Date
    December 1, 2017 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Kerecis Ltd.
    Collaborators
    Tufts University School of Dental Medicine

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    Yes
    Studies a U.S. FDA-regulated Device Product
    Yes
    Device Product Not Approved or Cleared by U.S. FDA
    Yes
    Product Manufactured in and Exported from the U.S.
    No
    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The purpose of this study is to evaluate Omega-3 Wound™ as an alternative to autogenous free gingival grafts harvested from the palate to treat human subjects with insufficient KT (< 2 mm)
    Detailed Description
    Primary objective: The primary aim will be to see if Omega-3 Wound™ is clinically superior to tissue harvested from the palate (Autogenous Free Gingival Graft) when comparing before and after measurements of: keratinized tissue. Change in KT width from time of surgery to 6 months post-surgery (22). Secondary objectives: Measures of periodontal health (probing depth, recession levels, bleeding on probing, plaque score, clinical attachment level, resistance to muscle pull, vestibular depth, healing time) over 3 months (at study entry, 4 weeks, 3 months and 6 months) Time of surgery Subject Discomfort Survey during healing and at 1 week and 4 weeks Subject Preference Questionnaire at month 6 Safety endpoints assessed by monitoring adverse events

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Mucogingival Deformity - Insufficient Keratinized Tissue

    7. Study Design

    Primary Purpose
    Device Feasibility
    Study Phase
    Early Phase 1
    Interventional Study Model
    Parallel Assignment
    Model Description
    Prospective, randomized controlled, split mouth (within subject) non-inferiority, single-center trial.
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    6 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Kerecis Oral™
    Arm Type
    Experimental
    Arm Description
    The Fish Skin Graft will be is cut to shape of wound bed and placed directly on the appropriate prepared recipient wound bed. The Fish skin graft has the smooth side down and the scaly side facing out. The graft will be sutured in place at either coronal end with resorbable sutures and may be secured apically if needed. A surgical dressing (Coe-Pak® ) will be placed over the graft if needed.
    Arm Title
    Autogenous Free Gingival Graft
    Arm Type
    Active Comparator
    Arm Description
    The recipient bed will be prepared at the appropriate sequential time as described. The graft will be harvested from the same side that the Free Gingival Graft is to be placed. A measurement will be made to determine the size of the donor tissue needed to be placed at the recipient site. Local anesthetic will be administered. The donor tissue will be harvested using the usual techniques. The width will be 5 mm and the length will match the predetermined measurement. The graft will be thinned as is usual practice. The harvested palatal graft will be centered on the study tooth and placed on the appropriately prepared recipient wound bed. The graft will be sutured with resorbable sutures on the mesial and distal aspects of the tooth. A surgical dressing (Coe-Pak® ) will be placed over the graft if needed.
    Intervention Type
    Device
    Intervention Name(s)
    Kerecis Oral™
    Other Intervention Name(s)
    Acellular Fish Skin Graft
    Intervention Type
    Other
    Intervention Name(s)
    Free Gingival Graft
    Other Intervention Name(s)
    FGG
    Intervention Description
    A free gingival autograft from patient palate placed and secured on wound bed
    Primary Outcome Measure Information:
    Title
    Change in KT width from time of surgery to 3 months post-surgery
    Description
    Increase in KT Width in MM
    Time Frame
    3 months
    Secondary Outcome Measure Information:
    Title
    Probing depth
    Description
    mm
    Time Frame
    3 months
    Title
    Papillary height and widht
    Description
    mm
    Time Frame
    3 months
    Title
    Horizontal recession
    Description
    mm
    Time Frame
    3 months
    Title
    Subject completed discomfort questionaire
    Description
    Standard questionare
    Time Frame
    3 months
    Title
    Bleeding on probing
    Description
    Y/N
    Time Frame
    3 months

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    70 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Age must be at least 18 years but no more than 70 years. There must be at least two non-adjacent teeth in contralateral sides of the same jaw with an insufficient zone (≤ 2mm) of Keratinized gingiva that requires soft tissue grafting. (1-4 teeth may be treated). If adjacent teeth require grafting, only a single chosen tooth at each site will act as the test or control site, all teeth will however get the same treatment). The goal of grafting will not be root coverage. Females must have a documented negative urine pregnancy test if they are of childbearing potential. All subjects must have read, understood and signed an Informed Consent Form (approved by the institutional review board (IRB)). All subjects must be willing and able to follow study instructions and protocols. Exclusion Criteria: Any subject that has class III/IV recession with a shallow vestibule. Any subject that has a vestibule depth of less than 7mm from the base of recession. Any subjects with systemic conditions (i.e., diabetes mellitus, HIV, cancer, bone metabolic diseases) that typically precludes periodontal surgery. Any subjects who are currently taking/received or have taken/received within two months prior to study entry, systemic corticosteroids, immunosupressive agents, radiation therapy, and/or chemotherapy which could compromise wound healing and preclude periodontal surgery. Any subjects taking intramuscular or intravenous bisphosphonates. Any subjects with any acute lesions in the areas intended for surgery/or with a history of aphthous ulcers. Any subjects who currently smoke. Any subject with molar teeth that require treatment at the time of surgery. Any subjects with teeth with Miller Grade =>2 mobility. Any patients with known hypersensitivity to bovine collagen and/or iodine (shellfish allergy). Any subjects who have received an investigational drug or biological/bioactive treatment within 30 days prior to study enrollment (medical or dental). Any subjects previously treated with any allografts at the target site(s) or immediately adjacent teeth. Any subjects who will not be able to complete the study per protocol.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Nadeem Karimbux, DMD, MMSc
    Organizational Affiliation
    Tufts University of Dental Medicine
    Official's Role
    Study Chair

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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    A Clinical Trial to Evaluate Kerecis Oral™ Compared to Autogenous Free Gingival Graft (AFGG) Tissue to Augment Gingival Soft Tissue and Wound Healing

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