Clinical trials

Periodontal disease remains a highly prevalent chronic inflammatory condition affecting the supporting structures of the teeth and is a leading cause of tooth loss worldwide. Contemporary periodontal therapy is structured into sequential phases, with non-surgical periodontal therapy (NSPT) forming the cornerstone of initial management. Following this phase, re-evaluation of periodontal status is critical to determine treatment outcomes and guide further intervention, including surgical therapy if required (1,2). Re-evaluation phase serves multiple purposes: it allows assessment of tissue response to therapy, measurement of reductions in probing pocket depth (PPD), gains in clinical attachment level (CAL), and evaluation of patient compliance with oral hygiene practices. It also aids in identifying residual pockets or persistent inflammation that may necessitate additional treatment (1,3). Despite its clinical importance, the optimal timing of re-evaluation remains inconsistently defined in the literature (1). Generally, current literature utilizes a timing frame from 1-3 months; up to 9 months (3,4). Current clinical guidelines, including those from the European Federation of Periodontology (EFP), generally recommend assessing whether the end points have been achieved; no periodontal pockets ≥ 5mm with bleeding on probing and no pocket ≥ 6mm (5). Emerging evidence suggests that certain clinical improvements, particularly reductions in inflammation and bleeding on probing (BOP), may occur as early as 4 weeks following therapy, raising questions about whether earlier re-evaluation could be clinically beneficial (2,3). Early reassessment may allow for more timely identification of non-responding sites, enabling prompt intervention and potentially improving overall treatment outcomes. Conversely, other studies indicate that full periodontal healing and maturation of tissues may require longer periods, supporting delayed re-evaluation intervals (1,2,3). Furthermore, patient-related factors such as systemic health, smoking status, and baseline disease severity may influence healing dynamics and thus the appropriate timing for reassessment (1). The heterogeneity of these factors highlights the potential need for a more individualized approach to re-evaluation rather than a fixed universal timeframe. Despite these considerations, there is a notable lack of high-quality comparative studies directly evaluating short-term versus conventional re-evaluation intervals following NSPT. Most available studies focus on treatment outcomes rather than the timing of reassessment itself. This creates a significant gap in the literature, particularly regarding whether earlier re-evaluation could enhance clinical decision-making, improve patient outcomes, or optimize resource utilization in clinical practice. In addition, with increasing emphasis on minimally invasive and patient-centered care, there is a growing need to refine periodontal treatment protocols to ensure efficiency without compromising effectiveness. Determining the optimal timing of re-evaluation could contribute to improved treatment planning, reduced disease progression, and enhanced long-term periodontal stability. Therefore, this study aims to address this gap by investigating the effectiveness and clinical implications of shorter re-evaluation intervals following periodontal therapy, compared to conventional timeframes.

Rehabilitation of the posterior maxilla with dental implants is frequently complicated by insufficient residual bone height resulting from alveolar ridge resorption and maxillary sinus pneumatization. Lateral sinus floor elevation has become a predictable and widely accepted procedure for increasing bone volume and enabling implant placement in severely atrophic posterior maxillary sites. The long-term success of this procedure is largely dependent on the grafting material used to maintain space beneath the elevated Schneiderian membrane and promote new bone formation. Deproteinized bovine bone mineral (DBBM), commonly known as xenograft, remains the most extensively documented grafting material for sinus augmentation due to its osteoconductive properties, volumetric stability, and favorable long-term clinical outcomes. However, xenografts are characterized by slow remodeling and prolonged persistence of residual graft particles, which may delay replacement by vital bone. Consequently, strategies to enhance the biological activity of xenografts and accelerate bone regeneration have become an area of considerable research interest. Leukocyte- and platelet-rich fibrin (L-PRF) is a second-generation autologous platelet concentrate containing a fibrin matrix enriched with platelets, leukocytes, cytokines, and growth factors including platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), and transforming growth factor-β (TGF-β). These biological mediators may enhance angiogenesis, accelerate wound healing, stimulate osteoblast proliferation, and improve bone regeneration. Several studies have demonstrated promising outcomes when L-PRF is used in sinus augmentation procedures. Mazor et al. reported successful bone formation and implant placement following sinus augmentation using PRF as the sole grafting material after six months of healing. Histological analysis demonstrated the formation of newly regenerated vital bone within the augmented sinus compartment. More recently, Cortellini et al. conducted a randomized controlled trial comparing L-PRF block and DBBM in lateral sinus floor elevation. Although both techniques allowed successful implant placement after six months, differences in volumetric stability and graft remodeling were observed. The authors suggested that L-PRF-containing grafts may represent a biologically active alternative capable of enhancing healing while maintaining sufficient bone volume for implant placement. Pichotano et al. further demonstrated that combining L-PRF with DBBM accelerated bone maturation and facilitated earlier implant placement when compared with xenograft alone. Histomorphometric findings revealed greater percentages of newly formed bone and reduced healing times in the L-PRF group. Despite these promising findings, the available evidence remains limited, and there is no clear consensus regarding whether the addition of L-PRF to xenografts results in clinically significant improvements in bone regeneration, volumetric maintenance, and implant site development. Therefore, a randomized controlled clinical trial comparing xenograft alone versus L-PRF block combined with xenograft during lateral sinus floor elevation is warranted.

Crown lengthening is a clinical procedure that involves reshaping the gingiva, and sometimes bone, in order to expose more of tooth's structure. The procedures is performed for both functional and aesthetic reasons. In certain instances, this procedure is performed to This procedure is commonly performed for both functional and aesthetic reasons, such as to prepare a tooth for a crown or to enhance the appearance of a smile. Traditional crown lengthening techniques typically involve surgical methods that can be invasive, leading to extended recovery times and postoperative discomfort in this study we compare traditional versus the laser aided crown lengthening to compare the periodontal parameters in both cases.

An effective biological seal is crucial for protecting and supporting dental implants, particularly in the anterior region for the desired esthetic outcome.PRF membrane and CTG has been utilized to improve peri-implant soft tissue thickness and increase the width of keratinized tissue around dental implants. The stability of the PRF membrane is maintained by securing it with the healing abutment of the implant. While a few longitudinal studies have assessed the benefits of using PRF membrane with Sohn's Poncho technique in the posterior region, its effectiveness in the anterior region of the mouth remains to be evaluated.

Stroke is a leading cause of death and disability worldwide. A major complication of stroke is spasticity, marked by increased muscle tone and impaired movement. It affects majority stroke patients and complicates rehabilitation, affecting the upper limb function of survivors. While traditional treatments like oral medications and botulinum toxin injections offer some relief, they have notable limitations, causing the need for novel, non-invasive approaches. Extracorporeal shock wave therapy (ESWT), which uses acoustic waves for regeneration and neuromodulation, has shown promise in reducing spasticity with minimal side effects, though its precise mechanisms and ideal protocols need further study. Current evidence supports ESWT's efficacy and safety, often matching established treatments, but gaps remain regarding standardized application and long-term functional outcomes, highlighting the need for more robust research.

This randomized controlled clinical trial aims to compare peri-implant hard and soft tissue dimensional changes following immediate implant placement with the socket shield technique and immediate restoration versus early type II implant placement with contour graft in the esthetic zone. The primary outcome is the Pink Esthetic Score (PES), while secondary outcomes include mid-facial mucosal recession, radiographic vertical and horizontal buccal bone remodeling, and patient satisfaction after 12 months.

Dental implants are widely used to replace missing teeth and restore oral function and aesthetics. One of the key factors affecting the long-term success of dental implants is the stability of the bone surrounding the implant, particularly the crestal bone around the implant neck. Implant insertion depth relative to the alveolar crest may influence peri-implant tissue health and marginal bone remodeling. This randomized controlled clinical trial aims to evaluate the influence of implant placement depth on peri-implant health and radiographic bone changes around short dental implants placed using guided surgical protocol. All implants will be placed using the Bicon Implant System following computer-guided implant planning and surgical guide fabrication to ensure precise implant positioning. Participants requiring implant therapy will be randomly allocated into two groups. In the test group, implants will be placed 2 mm below the crestal bone level (subcrestal placement). In the control group, implants will be placed at the crestal bone level (crestal placement). Implant placement will be performed using guided implant surgery to standardize surgical positioning and minimize variability in implant angulation and depth. Clinical parameters related to peri-implant health, including Modified Plaque Index, Implant Mucosal Index, Peri-implant Mucosal Tissue Index and Probing Depth during follow-up visits at 3, 6 and 12 months. In addition, standardized radiographic examinations will be performed to measure peri-implant Crestal bone level changes at 12 months. The primary objective of this study is to determine whether subcrestal implant placement (2 mm below the bone crest) results in improved preservation of peri-implant crestal bone compared with crestal implant placement. Secondary outcomes will include assessment of peri-implant soft tissue health and overall implant stability. The findings of this study may help clarify the optimal implant insertion depth for short implants placed using guided surgery and may contribute to improving long-term implant success and peri-implant tissue stability.

This randomized controlled clinical trial aims to evaluate the effectiveness of individualized oral hygiene education using the Individually Trained Oral Prophylaxis (iTOP) method compared with conventional oral hygiene instruction using model demonstration and video-based education in orthodontic patients diagnosed with gingivitis. Sixty orthodontic patients underwent professional mechanical plaque removal and received oral hygiene instruction using calibrated interdental brushes. Participants were randomly assigned to either the iTOP training group or the conventional education group. Clinical outcomes including Approximal Plaque Index (API), Gingival Index (GI), and Full Mouth Bleeding Score (FMBS) were assessed at baseline and after three months to determine the effectiveness of the educational interventions on plaque control and gingival health.

The goal of this clinical trial is to see which type of strengthening exercise with a tight band (blood flow restriction) helps people recover better after ACL reconstruction. The study includes adults after ACL surgery who are doing physiotherapy to rebuild thigh muscle strength and knee function. The main questions are: * Does heavy strengthening with blood flow restriction improve thigh strength, knee function, and daily activities more than light strengthening with blood flow restriction after ACL surgery? * Can light strengthening with blood flow restriction give similar benefits to heavy strengthening while putting less strain on the knee? Researchers will compare a heavy-exercise program plus blood flow restriction to a light-exercise program plus blood flow restriction to see which gives better strength and functional improvements. Participants will: * Come for supervised physiotherapy sessions and do knee exercises on a machine, using either heavy or light loads while a cuff on the thigh gently squeezes to reduce blood flow. * Have their leg strength, and knee questionnaires checked several times during the study.

Football players require good core strength and balance to perform well and reduce the risk of injury. The muscles of the trunk and diaphragm play an important role in maintaining stability, posture, and movement control during sports activities. This randomized controlled trial aims to evaluate the effects of core stability training combined with balloon breathing exercises on dynamic balance, hop performance, and core endurance in professional football players. Balloon breathing exercises are designed to improve diaphragmatic breathing and trunk muscle activation. Eligible football players will be randomly assigned to one of two groups: one group will receive core stability training combined with balloon breathing exercises along with regular football training, while the other group will receive core stability training with regular football training only. The intervention will be performed three times per week for eight weeks under the supervision of a physiotherapist. Outcome measures, including dynamic balance, hop performances, core endurance, and maximum voluntary ventilation (MVV), will be assessed at baseline, during the intervention, at the end of the program, and at a three-month follow-up. The findings of this study may help improve training strategies aimed at enhancing performance and reducing injury risk in football players.

This study is designed to help people with chronic low back pain, which is pain in the lower back that persists for more than three months and can affect daily life, including sitting, standing, walking, lifting, and other routine activities. Chronic low back pain can also impact work, mood, and overall quality of life, making it important to find effective rehabilitation methods that reduce pain and improve function. The study compares the effects of three different rehabilitation approaches: 1. Active aquatic therapy - participants perform exercises in water where they actively move their back, core, and legs. The water helps support the body and reduces stress on the spine, allowing safer and easier movement. This approach aims to improve strength, flexibility, core stability, and overall function. 2. Passive aquatic therapy - participants receive assisted movements in water guided by a trained physiotherapist. This gentle method helps increase spinal mobility, reduces stiffness, promotes relaxation, and can relieve pain without placing stress on the lower back. 3. Conventional physiotherapy - participants perform standard exercises on land, including stretching, strengthening, and core stabilization exercises. All sessions are supervised by licensed physiotherapists to ensure exercises are done safely and effectively. Participants will be randomly assigned to one of the three groups. Each intervention lasts 4 weeks, with multiple sessions each week. All sessions are supervised to provide proper guidance, ensure safety, and adapt exercises to each participant's needs. Before starting therapy, participants' pain levels, core strength, flexibility, spinal mobility, and ability to perform daily activities will be measured using simple and understandable assessments. These measures will be repeated at the end of the 4-week intervention to evaluate improvements and compare the effectiveness of each rehabilitation approach. The study is safe and non-invasive. No surgery, injections, or medications are involved. Participants' personal information is kept confidential, and all collected data will be used solely for research purposes. By participating in this study, patients may benefit from structured, supervised rehabilitation that could help reduce pain, improve mobility and strength, enhance balance and core stability, and increase confidence in performing daily activities. Patients' feedback during sessions will also help researchers understand their experiences and preferences, which can improve future treatment recommendations. The results of this study will help patients, families, physiotherapists, and healthcare providers understand which type of rehabilitation is most effective for chronic low back pain. This information can guide treatment decisions, improve individualized care plans, and support patients in returning to normal activities with less discomfort and greater independence. Overall, the study aims to provide clear, practical information about rehabilitation options for chronic low back pain, improve functional outcomes, and enhance quality of life. Participants' contributions will help generate evidence that may benefit others with similar conditions in the future, while also receiving safe and professional care throughout the study.

To evaluate the short-term effectiveness of neural mobilization targeting the posterior tibial nerve compared to traditional physiotherapy in cases diagnosed with plantar fasciitis, a pilot study will be conducted on 12 patients who will have been diagnosed with plantar fasciitis. Participants will be randomly divided into either the neural mobilization group or the conventional physiotherapy group, and all will receive three weeks of structured treatment. Results will be evaluated using techniques that will measure plantar pressure with Algometry, Foot Function Index (FFI) scores, and the Foot Health Status Questionnaire (FHSQ). Differences before and after treatment will be tested within the group using paired t-tests, and others will be examined between the groups with independent t-tests.

the study is about intervention to patient with frozen shoulder to help patients improve function and shoulder disability , reduce pain and improve range of motion, the main aim of this study is to find out which treatment intervention SSMP , MWM and sham mobilization give effective results

The goal of this clinical trial is to compare the efficacy of preoperative administration of alpha-chemo-trypsin, ibuprofen, and acetaminophen in managing post-endodontic pain in patients with symptomatic irreversible pulpitis. The main question it aims to answer is: What is the efficacy of preoperative administration of alpha-chemo-trypsin, ibuprofen, and acetaminophen in managing post-endodontic pain in patients with symptomatic irreversible pulpitis? Participants will undergo root canal treatment after premedication. Researchers will compare \[alpha-chemo-trypsin, ibuprofen, and acetaminophen\] to see the intensity of post-endodontic pain.

The goal of this randomized controlled trial is to compare the effectiveness of immersive virtual reality combined with conventional therapy to the effectiveness of non-immersive virtual reality combined with conventional therapy in enhancing upper limb function in subacute hemiplegic stroke patients.