Clinical Research Directory

Effect of Intraoperative Tetracycline on Postoperative Pain After Mandibular Molar Extraction

Postoperative pain is a common complication following mandibular molar extraction and can negatively affect patient comfort and recovery. Tetracycline is a broad-spectrum antibiotic with anti-inflammatory properties that may reduce postoperative inflammation and pain when applied locally to the extraction socket. This randomized controlled trial aims to evaluate the effect of intraoperative placement of tetracycline on postoperative pain in patients undergoing surgical extraction of mandibular molars. A total of 74 eligible patients will be randomly assigned to receive either intrasocket tetracycline or no local medicament following tooth extraction. All participants will receive the same standard postoperative care and analgesic regimen. Postoperative pain will be assessed using the Visual Analog Scale (VAS) at 24 hours, 48 hours, and 7 days after surgery. The findings of this study will provide evidence regarding the effectiveness of local tetracycline in reducing postoperative pain and may help improve postoperative pain management following mandibular molar extraction.

Post-extraction Bleeding in Older Adults on Uninterrupted Antiplatelet Therapy

This prospective, assessor-blinded, controlled observational study compares bleeding after simple tooth extraction between adults aged 40 years or older who continue their antiplatelet therapy (aspirin, clopidogrel or dual antiplatelet therapy) without interruption and controls taking no drug that affects haemostasis. Socket bleeding is graded at 15, 30, 45 and 60 minutes within a stepwise local haemostatic protocol, and recurrent bleeding is monitored by telephone for 72 hours. The study also explores demographic, clinical and pharmacological factors associated with prolonged and recurrent bleeding among patients on antiplatelet therapy.

Effect of Curcumin Topical Spray on Wound Healing After Tooth Extraction

This randomized, single-blind, controlled clinical trial aims to evaluate the effects of a topical curcumin spray on post-extraction wound healing and postoperative symptoms in adults undergoing first molar extraction. Participants will be randomly assigned to one of three groups: curcumin topical spray, 0.12% chlorhexidine topical spray, or standard postoperative care without a topical spray. The interventions will be applied twice daily for 7 days. Postoperative pain will be assessed using a visual analog scale, while wound healing will be evaluated using the Landry, Turnbull, and Howley Healing Index. Wound dimensions will also be recorded during follow-up. In addition, salivary levels of inflammatory biomarkers, including interleukin-1β (IL-1β), tumor necrosis factor-alpha (TNF-α), and prostaglandin E2 (PGE2), will be analyzed to assess the local inflammatory response during the postoperative healing period.The study aims to compare the clinical effects of topical curcumin with chlorhexidine and standard postoperative care during the early healing period after tooth extraction.

Effect of Collagen Membrane on Ridge Preservation

This study will evaluate whether adding a resorbable collagen membrane to an anorganic bone-collagen composite (ABCC) graft improves ridge preservation after tooth extraction. Ridge preservation is a procedure used to maintain the shape and volume of the jawbone following tooth removal, which is important for future dental implant placement. Participants will be randomly assigned to receive either ABCC alone or ABCC combined with a collagen membrane. Healing outcomes will be assessed after approximately 4 months using three-dimensional cone beam computed tomography (CBCT) scans. The primary outcome is the change in horizontal ridge dimension (width). Secondary outcomes include vertical and contour changes in ridge dimensions, changes in soft tissue contour assessed with digital scans, postoperative healing and complications (such as wound dehiscence, swelling, or infection), and patient-reported outcomes, including pain and satisfaction. In a subset of participants, bone healing will also be evaluated using laboratory and imaging analyses of bone samples obtained at the time of implant placement. The study will additionally assess whether the treatment allows implant placement in the ideal position without the need for further bone grafting.

The Indications of First Molar Extraction at Tufts University, School of Dental Medicine

The aim of the present study is to investigate whether there has been a change of criteria for tooth extraction at Tufts University School of Dental Medicine (TUSDM) from 2005 to 2018. The primary outcome is the change of mean of radiographic interproximal bone loss of extracted teeth. The secondary outcomes are changes of other parameters (periodontal, endodontic and restorative) of extracted teeth and reasons for extraction.

Antibiotic Prophylaxis After Simple Tooth Extraction in Immunosuppressed Patients With Autoimmune Rheumatic Diseases

This randomized, double-blind, placebo-controlled clinical trial aims to evaluate whether single-dose amoxicillin prophylaxis administered prior to simple tooth extraction reduces postoperative infection rates inpatients with autoimmune rheumatic diseases (ARDs). Although antibiotic prophylaxis is not recommended for healthy individuals undergoing simple extractions, immunosuppressed ARD patients frequently receive antibiotics despite limited evidence supporting this practice. Secondary objectives include assessing infection severity, postoperative complications, and the impact of ARD diagnosis and immunosuppressive treatment on infection risk.

Using Different Biomaterials to Preserve Bone After Tooth Extraction

This four-arm randomized controlled clinical trial evaluated the clinical, radiographic, and histological outcomes of different approaches to alveolar ridge preservation following tooth extraction. Forty systemically healthy adults requiring extraction of a maxillary non-molar tooth and subsequent implant placement were randomly allocated to autogenous dentin graft, autogenous dentin graft combined with hyaluronic acid, allograft, or spontaneous healing groups (n = 10/group). Clinical and cone-beam computed tomography assessments were performed at baseline and 4 months. During implant placement at 4 months, bone core biopsies were obtained from all study sites and subjected to histological, histomorphometric, and immunohistochemical analyses.

Volumetric Efficacy of Alveolar Ridge Preservation

The goal of this clinical trial is to compare the effectiveness of four post-extraction socket management approaches in preserving alveolar ridge dimensions following tooth extraction in adults requiring implant-supported rehabilitation in posterior regions. The main questions it aims to answer are: * Which treatment approach provides the greatest preservation of hard- and soft-tissue dimensions 12 weeks after tooth extraction? * Does the use of a dense polytetrafluoroethylene (d-PTFE) membrane improve alveolar ridge preservation compared with approaches that do not use a membrane? * Are there differences among the treatment groups regarding postoperative healing, complications, pain, and bone regeneration? Researchers will compare spontaneous socket healing, autologous blood clot with d-PTFE membrane, autologous blood clot with leukocyte- and platelet-rich fibrin (L-PRF), and autologous blood clot with L-PRF plus d-PTFE membrane to determine which approach provides the best preservation of alveolar ridge dimensions and tissue healing. Participants will: * Undergo tooth extraction and be randomly assigned to one of four treatment groups. * Receive clinical examinations, intraoral scans, photographs, and cone-beam computed tomography (CBCT) imaging at scheduled follow-up visits. * Complete assessments of postoperative pain and oral health-related quality of life. * Undergo implant placement 12 weeks after tooth extraction, including collection of a bone biopsy for histomorphometric analysis. * Attend follow-up visits to evaluate peri-implant tissue health, marginal bone stability, and implant success up to 24 months after implant loading.

Alternatives to Dental Opioid Prescribing After Tooth Extraction

The goal of this clinical trial is to test a three-item intervention in oral surgeons who remove teeth. The main questions it aims to answer are: * Can the intervention reduce opioid prescriptions to adolescents and young adults after tooth removal? * Do oral surgeons' beliefs about the intervention and opioid prescribing change? * Do patients that report using opioids after tooth removal have different experiences than patients that do not? Oral surgeon participants will: * Attend a 1-hour education session with a trained pharmacist * Receive patient instructions and blister packs of pain medicine to give to patients * Complete 2 surveys about feasibility and appropriateness Patient participants will complete a survey about pain and medication use after having a tooth removed. Researchers will compare the intervention to usual care to see if it reduces opioid prescribing.

Autogenous Dentin Graft for Alveolar Ridge Preservatio

When a tooth is extracted, the bone around the empty socket naturally shrinks over time, which can make it difficult to place a dental implant later without additional bone-building procedures. This study investigated whether grafting the socket with the patient's own extracted tooth material, processed into a graft (autogenous dentin graft), can help preserve this bone. The study also examined whether adding platelet-rich fibrin (PRF), a concentrate prepared from the patient's own blood that is rich in healing factors, could further improve outcomes. A total of 56 extraction sockets were randomly assigned to one of four treatment approaches: no grafting (natural healing), dentin graft alone, dentin graft combined with PRF, or a freeze-dried bone allograft, which is a commonly used bone substitute for comparison. Four months after treatment, small bone samples were taken from each site at the time of dental implant placement and examined under the microscope to measure how much new bone had formed, along with other markers of healing such as blood vessel formation and a bone-growth protein called BMP-2. The results showed that sockets treated with dentin graft healed at least as well as those treated with the standard bone substitute, and that combining dentin graft with PRF produced the best healing results of all groups tested. These findings suggest that a patient's own extracted tooth, which would otherwise be discarded, may serve as an effective and low-cost graft material for preserving bone after tooth extraction, particularly when combined with PRF.

Effect of Thymoquinone 0.2% Gel on Bone Density, Bone Width, and Socket Preservation After Tooth Extraction

This study aims to evaluate the clinical and radiographic effects of 0.2% Thymoquinone gel on bone density, bone width, and socket preservation after tooth extraction.

IMMEDIATE IMPLANTS: GRAFT VS NO GRAFT

This prospective, randomized, controlled, split-mouth clinical trial aims to evaluate the effect of bone grafting on mandibular bone microstructure following immediate implant placement using fractal analysis of panoramic radiographs. Forty systemically healthy adults requiring bilateral immediate implant placement in the mandibular anterior region will be enrolled. In each participant, one implant site will receive a bone graft (Gen-Os), while the contralateral site will serve as the non-grafted control. Panoramic radiographs obtained during routine postoperative follow-up at 1 and 3 months will be analyzed using ImageJ software to calculate fractal dimension values. The primary outcome is the comparison of fractal dimension values between grafted and non-grafted implant sites. The results are expected to provide evidence regarding the effect of bone grafting on early bone healing and microstructural changes following immediate implant placement.

Effectiveness of Telephonic and Digital Postoperative Follow-up Communication Strategies on Patient Compliance, Clinical Recovery, and Quality of Life After Dental Extraction

Effectiveness of Telephonic and Digital Postoperative Follow-up Communication Strategies on Patient Compliance, Clinical Recovery, and Oral Health-related Quality of Life Following Dental Extraction (CONNECT Study - CONtinuous post-operative NETwork Communication to Enhance Compliance after Tooth Extraction) Tooth extraction is one of the most commonly performed dental procedures. Although most patients recover uneventfully, complications such as pain, swelling, bleeding, infection, and dry socket may occur if postoperative instructions are not followed correctly. Dentists routinely provide verbal and written instructions after tooth extraction; however, patients may forget or misunderstand these instructions once they leave the clinic, resulting in reduced compliance and delayed recovery. Previous research conducted at our institution demonstrated that postoperative telephone follow-up improved patient compliance with post-extraction instructions compared with routine verbal and written instructions alone. Building on these findings, the present study aims to evaluate whether different methods of postoperative communication-including telephone calls, digital messaging, and a combination of both-can further improve patient compliance and clinical recovery following dental extraction. Participants undergoing routine dental extraction will receive the standard postoperative verbal and written instructions provided by the Department of Oral and Maxillofacial Surgery. Depending on the assigned study group, participants may also receive structured telephone follow-up, digital communication via a secure messaging platform, or both during the early postoperative period. The information provided through these communication methods will reinforce the same postoperative instructions routinely given in the clinic and will not alter the clinical treatment received. Participants will be followed for one week after the extraction. Information will be collected regarding their adherence to postoperative instructions, pain levels, occurrence of complications such as dry socket, and oral health-related quality of life using validated questionnaires. These assessments will help determine whether additional postoperative communication improves patient recovery and overall treatment outcomes. The study involves minimal risk because the communication methods are intended only to reinforce standard postoperative care and provide patients with an opportunity to clarify any concerns they may have during recovery. Participation in the study is entirely voluntary, and patients may withdraw at any time without affecting the quality of their dental treatment. The findings of this study are expected to provide evidence on the most effective postoperative communication strategy following dental extraction. This may help improve patient education, enhance compliance with postoperative instructions, reduce preventable complications, and support the integration of digital communication technologies into routine dental practice.

Ovate Pontic Versus Essix Provisional After Tooth Extraction and Alveolar Ridge Preservation (Pontic-Essix)

This randomized controlled trial compares two provisional socket-sealing concepts following single non-molar tooth extraction and alveolar ridge preservation: a fixed, tooth-supported, 3D-printed ovate pontic provisional restoration providing active soft tissue support (test) versus a removable Essix-type provisional restoration without intentional soft tissue contact combined with a porcine collagen matrix seal (control). Both groups receive alveolar ridge preservation using a deproteinized bovine bone mineral with 10% collagen. The primary endpoint is interproximal soft tissue height at 5 months, adjusted for baseline, assessed by digital superimposition of intraoral surface scans. Up to 40 participants will be enrolled at the University of Bern School of Dental Medicine.

Evaluation of Demineralized Dentin Matrix With and Without Injectable Platelet Rich Fibrin as Grafting Materials

Thirty two healthy patients will be selected from the outpatient clinic of the oral and maxillofacial surgery department, faculty of dentistry, Mansoura university, to be included in this study with non restorable teeth in the maxillary esthetic area. After atraumatic teeth extraction, immediate implant placement will be done and buccal jumping gap will be filled by demineralized dentin matrix in study group and control one by demineralized dentin matrix mixed with in injectable platelet rich fibrin.

The Impact of the Objective Structured Clinical Examination

This study aims to compare two different educational and assessment approaches used for teaching pre-extraction clinical evaluation skills to undergraduate dental students. Before performing a simple tooth extraction, students are expected to obtain a medical history, identify systemic risk factors, determine extraction indications, communicate effectively with patients, and make appropriate clinical decisions. Participants will be assigned to either an Objective Structured Clinical Examination (OSCE)-based educational approach or a traditional teaching and assessment approach. Students' clinical performance, communication skills, clinical reasoning abilities, learning satisfaction, self-confidence, and examination-related anxiety will be evaluated and compared between groups. The findings of this study are expected to provide evidence regarding the effectiveness of OSCE in undergraduate dental education and contribute to the development of more effective training and assessment strategies for clinical competency acquisition.

Assessment of the Impact of Neocement Inject P® (Beta-Tricalcium Phosphate) on Bone Volume in Alveolar Ridge Preservation After Tooth Extraction

The goal of this randomized clinical trial is to assess whether β-TCP (Beta-Tricalcium Phosphate) improves alveolar ridge preservation (ARP) in patients who need tooth extraction. The main question it aims to answer is whether using β-TCP for alveolar ridge preservation has a positive effect on bone volume compared with natural healing. The main questions it aims to answer are: Does β-TCP improve ridge preservation compared with natural healing? Researchers will compare β-TCP grafted sockets to natural healing sockets to see if β-TCP better preserves ridge volume. Participants will: Have a tooth indicated for extraction. Be assigned to either β-TCP or natural healing. Undergo CBCT (Cone Beam Computed Tomography) and intra-oral scanning after extraction and after six months of healing to measure horizontal and vertical resorption and bone density.

Injectable Alloplastic Bone Graft for Socket Preservation: Clinical, Radiographic, and Histological Evaluation

This study will evaluate the clinical efficacy of injectable alloplastic bone grafts in terms of radiography and histology in order to preserve tooth sockets following extraction. Methodology: Twenty new extraction sockets from twenty surgically extracted non-restorable mandibular molar teeth will be used in this clinical investigation.

BMP Effect on Implant Stability and Marginal Bone Level After Immediate Placement

This randomized controlled clinical trial aims to evaluate the effect of recombinant human Bone Morphogenetic Protein-2 (rhBMP-2) on the stability and marginal bone level of dental implants following immediate placement. patients requiring extraction of unrestorable tooth in upper incisors or premolar region will be randomly assigned into two groups: the experimental group will receive immediate implant placement with rhBMP-2 application, while the control group will receive immediate implant placement without rhBMP-2. each group includes 16 immediate implants. Implant stability will be assessed using resonance frequency analysis (RFA) at baseline, and 16 weeks after implant placement. Marginal bone level changes will be evaluated radiographically using cone beam computed tomography (CBCT). The study aims to determine whether the use of rhBMP-2 enhances osseointegration and reduces marginal bone loss compared with conventional immediate implant placement.

Plasma Rich in Growth Factors in Post-extraction Sockets

The purpose of this study is to compare the clinical success, radiographical volume maintenance and histological bone regeneration after using either a bovine bone xenograft or an autogenous platelet rich plasma enrich in growth factors, known as Endoret®-PRGF®.

Reduced Time Interval for Implant Placement After Extraction Socket Preservation Using the Vega Plus Implants

This randomized controlled clinical trial aims to evaluate whether reducing the healing interval for implant placement after extraction socket preservation improves clinical and radiographic outcomes compared with the conventional waiting period. Participants requiring single-tooth extraction and implant therapy will be randomly assigned to implant placement either 4 months or 6 months after ridge preservation using the Vega Plus implant system (Klockner). Clinical and radiographic assessments will be performed at baseline and during follow-up visits. The primary outcome will be the mean change in horizontal alveolar ridge width measured using cone-beam computed tomography (CBCT). Secondary outcomes will include vertical bone height changes measured on CBCT, implant stability measured using resonance frequency analysis (ISQ values), marginal bone level changes assessed on standardized periapical radiographs, and postoperative pain assessed using the Visual Analog Scale (VAS). The results of this study may contribute to optimizing treatment timing and improving efficiency in implant dentistry while maintaining favorable clinical outcomes.

Comparison of Needle-Free Injection and Conventional Syringe for Tooth Extractions in Children

The goal of this clinical trial is to learn whether a needle-free injection system can make tooth extraction less stressful for children than a conventional dental syringe. The study will include healthy children 6 to 12 years old who need a primary tooth extraction with buccal and lingual local anesthesia. The main questions are whether the needle-free method can lower anxiety, lower pain, and reduce changes in vital signs compared with the conventional syringe. Researchers will randomly assign participants to 1 of 2 groups. One group will receive local anesthesia with a needle-free jet injection system. The other group will receive local anesthesia with a conventional syringe and a 27-gauge dental needle. In both groups, a topical lidocaine spray will be used before the injection, and the same anesthetic solution will be given. All tooth extractions will be performed by the same clinician using standard clinical procedures. Participants' anxiety, pain, and vital signs will be checked before the procedure, after anesthesia, and after tooth extraction. Anxiety will be measured with the Face Image Scale (FIS). Pain will be measured with the Face, Legs, Activity, Cry, Consolability (FLACC) scale and the Wong-Baker Faces Pain Rating Scale (WBS). Vital signs will include systolic and diastolic blood pressure, heart rate, and oxygen saturation. No blood, saliva, or tissue samples will be collected, and no audio or video recording will be made.

Effectiveness of Aromatherapy and Digital Anesthesia in Managing Dental Anxiety and Pain in Children

The goal of this clinical study is to learn whether aromatherapy and digital anesthesia are effective in reducing dental anxiety and pain during tooth extraction in children. The study also aims to understand how these methods influence children's comfort and cooperation during treatment. The main questions this study aims to answer are: Do aromatherapy (lavender and orange essential oils) and digital anesthesia reduce dental anxiety and pain during tooth extraction in children? Are these methods more comfortable and less stressful for pediatric patients compared to traditional anesthesia techniques? Does digital anesthesia improve cooperation and ease of management during dental treatment? Researchers will compare aromatherapy and digital anesthesia with conventional anesthesia methods to determine whether these techniques make the extraction process easier and more comfortable for children. Participants will: Receive either aromatherapy, digital anesthesia, conventional anesthesia, or a combination depending on the study group Undergo tooth extraction under controlled clinical conditions Be evaluated before, during, and after treatment using standardized pain and anxiety scales Provide post-treatment feedback along with their parents regarding comfort and anxiety levels This study may help identify gentler and more child-friendly approaches to managing anxiety and pain during pediatric dental procedures.

Evaluation of Stem Cell Exosomes Versus Platelet-Rich Fibrin in Tooth Extraction Socket Healing

This study evaluates two different treatments used to help the jawbone heal after a tooth is removed. When a tooth is extracted, the surrounding bone often shrinks, which can make it difficult to place dental implants later. Currently, doctors often use Platelet-Rich Fibrin (PRF), which is made from the patient's own blood, to help the area heal. This research compares PRF to a newer treatment using "exosomes" derived from stem cells. Exosomes are tiny particles that carry signals to tell the body to repair tissue and grow new bone. The goal of this study is to see if these exosomes work better than PRF at keeping the bone strong and thick after an extraction. Researchers will use specialized X-rays (CBCT) to measure the bone three months after the procedure to see which treatment provided better results.