<?xml version="1.0" encoding="utf-8"?>
<!DOCTYPE trials [
<!ELEMENT trials (trial+)>

<!ELEMENT trial (main,contacts,countries,criteria,health_condition_code,health_condition_keyword,intervention_code,
          intervention_keyword,primary_outcome,secondary_outcome,secondary_sponsor,secondary_ids,source_support,ethics_reviews)>

<!ELEMENT main (trial_id,utrn?,reg_name,date_registration,primary_sponsor,public_title,acronym?,scientific_title,scientific_acronym?,
          date_enrolment,type_enrolment,target_size,recruitment_status,url?,study_type,study_design,phase,hc_freetext?,i_freetext?,results_actual_enrolment,results_date_completed,results_url_link,results_summary,           results_date_posted,results_date_first_publication,results_baseline_char,results_participant_flow,results_adverse_events,results_outcome_measures,results_url_protocol,results_IPD_plan, results_IPD_description)>
<!ELEMENT trial_id (#PCDATA)>
<!ELEMENT utrn (#PCDATA)>
<!ELEMENT reg_name (#PCDATA)>
<!ELEMENT date_registration (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT primary_sponsor (#PCDATA)>
<!ELEMENT public_title (#PCDATA)>
<!ELEMENT acronym (#PCDATA)>
<!ELEMENT scientific_title (#PCDATA)>
<!ELEMENT scientific_acronym (#PCDATA)>
<!ELEMENT date_enrolment (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT type_enrolment (#PCDATA)>
<!ELEMENT target_size (#PCDATA)>
<!ELEMENT recruitment_status (#PCDATA)><!-- Pending,Recruiting,Suspended,Complete,Other -->
<!ELEMENT url (#PCDATA)>
<!ELEMENT study_type (#PCDATA)><!-- interventional,observational -->
<!ELEMENT study_design (#PCDATA)>
<!ELEMENT phase (#PCDATA)>
<!ELEMENT hc_freetext (#PCDATA)>
<!ELEMENT i_freetext (#PCDATA)>
<!ELEMENT results_actual_enrolment (#PCDATA)>
<!ELEMENT results_date_completed (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT results_url_link (#PCDATA)>
<!ELEMENT results_summary (#PCDATA)>
<!ELEMENT results_date_posted (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT results_date_first_publication (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT results_baseline_char (#PCDATA)>
<!ELEMENT results_participant_flow (#PCDATA)>
<!ELEMENT results_adverse_events (#PCDATA)>
<!ELEMENT results_outcome_measures (#PCDATA)>
<!ELEMENT results_url_protocol (#PCDATA)>
<!ELEMENT results_IPD_plan (#PCDATA)>
<!ELEMENT results_IPD_description (#PCDATA)>


<!ELEMENT contacts (contact+)>
<!ELEMENT contact (type,firstname,middlename,lastname,address,city,country1,zip,telephone,email,affiliation)>
<!ELEMENT type (#PCDATA)><!-- Public,Scientific -->
<!ELEMENT firstname (#PCDATA)>
<!ELEMENT middlename (#PCDATA)>
<!ELEMENT lastname (#PCDATA)>
<!ELEMENT address (#PCDATA)>
<!ELEMENT city (#PCDATA)>
<!ELEMENT country1 (#PCDATA)>
<!ELEMENT zip (#PCDATA)>
<!ELEMENT telephone (#PCDATA)>
<!ELEMENT email (#PCDATA)>
<!ELEMENT affiliation (#PCDATA)>

<!ELEMENT countries (country2+)>
<!ELEMENT country2 (#PCDATA)>

<!ELEMENT criteria (inclusion_criteria,agemin,agemax,gender,exclusion_criteria)>
<!ELEMENT inclusion_criteria (#PCDATA)>
<!ELEMENT agemin (#PCDATA)>
<!ELEMENT agemax (#PCDATA)>
<!ELEMENT gender (#PCDATA)>
<!ELEMENT exclusion_criteria (#PCDATA)>

<!ELEMENT health_condition_code (hc_code+)>
<!ELEMENT hc_code (#PCDATA)>

<!ELEMENT health_condition_keyword (hc_keyword+)>
<!ELEMENT hc_keyword (#PCDATA)>

<!ELEMENT intervention_code (i_code+)>
<!ELEMENT i_code (#PCDATA)>

<!ELEMENT intervention_keyword (i_keyword+)>
<!ELEMENT i_keyword (#PCDATA)>

<!ELEMENT primary_outcome (prim_outcome+)>
<!ELEMENT prim_outcome (#PCDATA)>

<!ELEMENT secondary_outcome (sec_outcome+)>
<!ELEMENT sec_outcome (#PCDATA)>

<!ELEMENT secondary_sponsor (sponsor_name+)>
<!ELEMENT sponsor_name (#PCDATA)>

<!ELEMENT secondary_ids (secondary_id+)>
<!ELEMENT secondary_id (sec_id,issuing_authority)>
<!ELEMENT sec_id (#PCDATA)>
<!ELEMENT issuing_authority (#PCDATA)>

<!ELEMENT source_support (source_name+)>
<!ELEMENT source_name (#PCDATA)>

<!ELEMENT ethics_reviews (ethics_review+)>
<!ELEMENT ethics_review (status,approval_date,contact_name,contact_address,contact_phone,contact_email)>
<!ELEMENT status (#PCDATA)><!-- Not approved,Approved,NA -->
<!ELEMENT approval_date (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT contact_name (#PCDATA)>
<!ELEMENT contact_address (#PCDATA)>
<!ELEMENT contact_phone (#PCDATA)>
<!ELEMENT contact_email (#PCDATA)>
]>
<trials>
  <trial>
    <main>
      <trial_id>IRCT20260620069891N1</trial_id>
      <utrn></utrn>
      <reg_name>IRCT</reg_name>
      <date_registration>2026-08-31</date_registration>
      <primary_sponsor>Mashhad University of Medical Sciences</primary_sponsor>
      <public_title>Comparing Aloe Vera-Tea Tree Herbal Mouthwash with Chlorhexidine on Reducing Gum Inflammation in Orthodontic Patients</public_title>
      <acronym></acronym>
      <scientific_title>The Effect of Aloe Vera-Tea tree Mouthwash Compared with Chlorhexidine on Gingivitis Reduction in Orthodontic Patients: A Randomized Clinical Trial</scientific_title>
      <scientific_acronym></scientific_acronym>
      <date_enrolment>2026-11-22</date_enrolment>
      <type_enrolment>anticipated</type_enrolment>
      <target_size>60</target_size>
      <recruitment_status>Pending</recruitment_status>
      <url>https://irct.ir/trial/92074</url>
      <study_type>interventional</study_type>
      <study_design>Randomization: Randomized, Blinding: Double blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment, Randomization description: 1. Randomization Method
In this study, balanced permuted block randomization with a block size of six is used to allocate participants into intervention and control groups.

2. Unit of Randomization
The unit of randomization is individual.

3. Stratification
No stratification is applied in the randomization process.

4. Randomization Tools
Sequence Generation Instrument: Statistical software is utilized to generate the block random sequence.
Allocation Concealment Instrument: Sequentially Numbered, Opaque, Sealed Envelopes (SNOSE), impermeable to light, are utilized.
5. Random Sequence Generation
The random sequence is generated prior to the start of sampling by an independent researcher/statistician who has no role in clinical examinations, data collection, or patient treatment.
Given the total sample size of 60 participants and a block size of six, 10 blocks of six are calibrated.
Within each 6-element block, three codes for the intervention group (A) and three codes for the control group (B) are randomly arranged in various combinations to maintain a 1:1 allocation ratio throughout the study.
6. Allocation Concealment and Blinding
To implement allocation concealment and prevent bias among the investigator and participants regarding the upcoming group allocation:

Allocation codes generated by the independent researcher are placed inside sealed, light-impermeable, opaque envelopes marked sequentially with serial numbers from 1 to 60.
The envelopes remain strictly sealed until participant enrollment.
Only after comprehensive participant evaluation, verification of inclusion and exclusion criteria, and obtaining written informed consent, the envelope corresponding to the entry sequence is opened to assign the specific mouthwash.
Due to the double-blind nature of the study, the mouthwash containers are made identical in appearance, volume, color, and packaging, labeled solely with codes A and B. Consequently, outcome assessors (clinical index examiners), and the data analyst remain blinded to the assigned interventions until the completion of data analysis, Blinding description: To achieve effective blinding, an independent individual outside the research team packages both mouthwashes (0.2% Chlorhexidine and the Aloe Vera-Tea Tree combination) in identical, unlabelled bottles that carry only randomized identification codes. An independent researcher generates the random sequence and places allocation details in sealed opaque envelopes.
The breakdown of blinding for all involved parties is as follows:

1. Principal Investigator and Healthcare Personnel (Dentists and Clinical staff):
The principal investigator and the clinical personnel responsible for patient care—including baseline scaling, root planing, and oral hygiene instruction—are kept unaware of the treatment group assignments. Because an independent third party handles the distribution of the coded bottles, the clinical staff cannot influence patient management based on treatment status.

2. Data Collectors and Outcome Assessors:
The clinical evaluator who measures outcome variables—specifically the Gingival Index (GI), Plaque Index (PI), Sulcus Bleeding Index (SBI), and Lobene Stain Index—is completely blinded to patient group allocation. Examinations and data entry proceed strictly without any knowledge of the mouthwash type used by the participant.

3. Data Analyst and Manuscript Drafters:
The biostatistician receives and analyzes the dataset using anonymized group codes (e.g., Group A and Group B). Similarly, the authors drafting the manuscript remain blinded to the true identity of the study groups until all statistical analyses are finalized and the dataset is unblinded.

4. Data Safety and Monitoring Board (DSMB):
If the safety monitoring committee reviews any adverse events or interim data, the information is provided strictly in a coded format to ensure an unbiased safety evaluation.</study_design>
      <phase>0 (exploratory trials)</phase>
      <hc_freetext>Gingivitis.</hc_freetext>
      <i_freetext>Intervention 1: Intervention group: Aloe vera-Tea tree mouthwash. Intervention 2: Control group: 0.2% chlorhexidine mouthwash.</i_freetext>
      <results_actual_enrolment></results_actual_enrolment>
      <results_date_completed></results_date_completed>
      <results_url_link></results_url_link>
      <results_summary></results_summary>
      <results_date_posted></results_date_posted>
      <results_date_first_publication></results_date_first_publication>
      <results_baseline_char></results_baseline_char>
      <results_participant_flow></results_participant_flow>
      <results_adverse_events></results_adverse_events>
      <results_outcome_measures></results_outcome_measures>
      <results_url_protocol></results_url_protocol>
      <results_IPD_plan>No - There is not a plan to make this available</results_IPD_plan>
      <results_IPD_description>Justification or reason for not sharing IPD is There is no further information.</results_IPD_description>
    </main>
    <contacts>
      <contact>
        <type>public</type>
        <firstname>Sina Ghasempour</firstname>
        <middlename></middlename>
        <lastname></lastname>
        <address>No. 28, Mohandes 14 St., Ershad 8 St.</address>
        <city>Mashhad</city>
        <country1>Iran (Islamic Republic of)</country1>
        <zip>9185816541</zip>
        <telephone>+98 51 3760 5268</telephone>
        <email>Sinaqs2020@gmail.com</email>
        <affiliation>Mashhad University of Medical Sciences</affiliation>
      </contact>
      <contact>
        <type>scientific</type>
        <firstname>Sina Ghasempour</firstname>
        <middlename></middlename>
        <lastname></lastname>
        <address>No. 28, Mohandes 14 St., Ershad 8 St.</address>
        <city>Mashhad</city>
        <country1>Iran (Islamic Republic of)</country1>
        <zip>9185816541</zip>
        <telephone>+98 51 3760 5268</telephone>
        <email>Sinaqs2020@gmail.com</email>
        <affiliation>Mashhad University of Medical Sciences</affiliation>
      </contact>
    </contacts>
    <countries>
      <country2>Iran (Islamic Republic of)</country2>
    </countries>
    <criteria>
      <inclusion_criteria>Presence of full fixed orthodontic appliances
Presence of at least 20 natural teeth in the oral cavity
Moderate baseline Gingival Index (mean GI ≥ 1.0)
Informed consent (and parental consent for participants under 18 years of age)</inclusion_criteria>
      <agemin>15 years</agemin>
      <agemax>35 years</agemax>
      <gender>Both</gender>
      <exclusion_criteria>Presence of systemic diseases
Advanced periodontal disease
Pregnancy or lactation
History of hypersensitivity/allergy to chlorhexidine, tea tree oil, or aloe vera
Smoking or hookah (waterpipe) use
Use of antibiotics or anti-inflammatory drugs within the past month, or requiring antibiotic prophylaxis
Systemic conditions affecting periodontal health (e.g., uncontrolled diabetes, leukemia)
Regular use of other mouthwashes/mouthrinses in the past month
Non-compliance with study protocols and instructions</exclusion_criteria>
    </criteria>
    <health_condition_code>
      <hc_code>K05.1</hc_code>
    </health_condition_code>
    <health_condition_keyword>
      <hc_keyword>Chronic gingivitis</hc_keyword>
    </health_condition_keyword>
    <intervention_code>
      <i_code>Treatment - Drugs</i_code>
      <i_code>Treatment - Drugs</i_code>
    </intervention_code>
    <intervention_keyword>
      <i_keyword>Intervention group: Aloe vera-Tea tree mouthwash</i_keyword>
      <i_keyword>Control group: 0.2% chlorhexidine mouthwash</i_keyword>
    </intervention_keyword>
    <primary_outcome>
      <prim_outcome>Gingivitis. Timepoint: Baseline: Before the start of the intervention (after initial scaling and hygiene instruction) – First assessment: 2 weeks after mouthwash use – Second assessment: 4 weeks after mouthwash use. Method of measurement: Gingival Index (GI): Measurement and assessment of the severity of gingival inflammation (the primary tool for determining sample size and evaluating gingivitis). Sulcus Bleeding Index (SBI): Evaluated and recorded based on the method developed by Mühlemann and Son.</prim_outcome>
    </primary_outcome>
    <secondary_outcome>
      <sec_outcome></sec_outcome>
    </secondary_outcome>
    <secondary_sponsor>
      <sponsor_name></sponsor_name>
    </secondary_sponsor>
    <secondary_ids>
      <secondary_id>
        <sec_id></sec_id>
        <issuing_authority></issuing_authority>
      </secondary_id>
    </secondary_ids>
    <source_support>
      <source_name>Mashhad University of Medical Sciences</source_name>
    </source_support>
    <ethics_reviews>
      <ethics_review>
        <status>Approved</status>
        <approval_date>2026-05-02</approval_date>
        <contact_name>Ethics committee of Mashhad University of Medical Sciences</contact_name>
        <contact_address>Ghoreyshi Building, Daneshgah Street Mashhad Razavi Khorasan Iran (Islamic Republic of)</contact_address>
        <contact_phone></contact_phone>
        <contact_email></contact_email>
      </ethics_review>
    </ethics_reviews>
  </trial>
</trials>
