The PR-DENT study is an interventional, single-center, controlled clinical investigation aimed at evaluating the clinical performance and safety of a Class III medical device based on linear hyaluronic acid for the treatment of oral surgical wounds. The investigational device consists of high molecular weight sodium hyaluronate (2500-3500 kDa), obtained through bacterial fermentation, combined with amino acids (L-proline, L-hydroxyproline, glycine, and L-lysine HCl), formulated at a concentration of 25 mg/ml. The device is designed to promote wound healing through the hydrating and film-forming properties of hyaluronic acid, creating a favorable microenvironment for re-epithelialization and tissue regeneration. The study is sponsored by The Wave Innovation Srl and conducted at the Oral Surgery and Stomatology Unit of the Azienda Ospedaliera Universitaria Luigi Vanvitelli, under the scientific responsibility of Prof. Luigi Laino. No additional costs are foreseen for the National Health Service, and no compensation is provided to investigators. The primary objective of the study is to assess the safety and clinical performance of the device in improving the healing of post-surgical oral wounds. The main outcomes include improvement in the Clinical Healing Score (CHS)-a clinical score assessing redness, edema, suppuration, healthy granulation tissue, and signs of re-epithelialization-the rate of wound closure evaluated through morphometric analysis, and the incidence of adverse events. The study population consists of adult patients requiring extraction of at least two teeth. For each patient, two surgical sites are identified: one treated with the hyaluronic acid-based device and one serving as an internal control, allowing for direct intra-patient comparison. The device is injected into the post-extraction socket prior to suturing or applied to the adjacent soft tissues. The study design includes a screening visit (Visit 0), a surgical treatment visit (Visit 1), and three follow-up visits at 7, 14, and 30 days after treatment completion (Visits 2, 3, and 4). During follow-up visits, the Clinical Healing Score, wound closure via morphometric analysis, and the occurrence of any adverse events are assessed. Inclusion criteria include adult patients in good systemic and oral health, able to comply with study procedures, and who have provided written informed consent. Exclusion criteria include factors that may interfere with wound healing, such as smoking more than 10 cigarettes per day, recent oncological therapies, recent antibiotic therapy, bisphosphonate treatment, pregnancy or breastfeeding, and acute infection at the surgical site. Safety is evaluated through the recording and classification of all adverse events (AEs) and serious adverse events (SAEs), in accordance with applicable regulations and Good Clinical Practice (ISO 14155). Risks associated with the use of the device are considered minimal and mainly related to the surgical procedure itself. Based on extensive scientific literature supporting the use of hyaluronic acid in oral wound healing, the overall risk-benefit profile is considered favorable. The study is conducted in compliance with the principles of the Declaration of Helsinki, Good Clinical Practice, and Regulation (EU) 2017/745 on medical devices.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
28
Combined Ingredients: Unlike many standalone hyaluronic acid (HA) treatments, this intervention uses a specific complex of high molecular weight linear HA (25 mg/ml) combined with a precise pool of four amino acids: L-proline, L-hydroxyproline, Glycine, and L-lysine HCl. Specific HA Molecular Weight: The sodium hyaluronate used has a high molecular weight range of 2500-3500 Kd, produced specifically from Streptococcus equi bacteria. Class III Classification: The device is classified under Class III (EU 2017/745), emphasizing its biological effect and absorption characteristics within the human body. Specific Delivery and Surgical Application: Intra-Operative Timing: The device is not just a topical post-operative gel; it is specifically injected into the surgical wound or applied to the soft tissues before suturing. Versatile Delivery Tools: The protocol allows for the use of both pointed or blunt needles applied to a 2 ml pre-filled syringe.
Intervention Type: Other (Standard Care/Sham). Description: This arm consists of the second surgical site (post-extractive alveolar socket) within the same patient that does not receive the study device. Procedure: The site undergoes the identical standard surgical extraction protocol as the experimental site but is sutured without the injection or application of the hyaluronic acid-based gel. Objective: To serve as an internal baseline control for assessing the natural healing process and to compare the safety and performance outcomes (Clinical Healing Score and morphometric analysis) against the experimental intervention.
Dipartimento Multidisciplinare di Specialità Medico-Chirurgiche e Odontoiatriche - Via Luigi De Crecchio,6 , 80138 NAPOLI
Naples, Italy
Improvement in Clinical Healing Score (CHS)
The Clinical Healing Score is a clinician-reported assessment used to evaluate the quality of wound healing on a scale from 1 to 5. 5 (Excellent): All wound area is pink; no bleeding on palpation; no granulation tissue; no connective tissue at incision margin. 4 (Very Good): Less than one quarter of wound area is red; no bleeding on palpation; no granulation tissue; no connective tissue at incision margin. 3 (Good): Less than half of the wound area is red; no bleeding on palpation; no granulation tissue; no connective tissue at incision margin. 2 (Poor): More than half of the wound area is red; bleeding on palpation; granulation tissue evident; incision margin not epithelialized. 1 (Very Poor): Two or more features present, such as more than half of the wound area being red, bleeding on palpation, evident granulation tissue, no epithelium at incision margin, or infection with suppuration.
Time frame: 7 days after the surgical treatment (Visit 2).
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