Effects of AMP Application After Non-surgical Periodontal Therapy on Treatment of Periodontitis

Phase 4

Completed

Interventions: Drug: minocycline hydrochloride ointment
Other: SRP
Drug: Oral biological antimicrobial gel

Brief Summary: Chronic periodontitis is an infectious disease of periodontal support tissues caused by bacterial biofilm, which leads to inflammation and destruction of periodontal support tissues ultimately resulting in tooth loss.In the clinic, patients with Stage III and Grade B periodontitis are difficult to gain desired outcomes on account of deep periodontal pockets, complicated anatomy, the removal of subgingival dental biofilms, and control of residual inflammation. A large number of studies have indicated that the effectiveness of local application of antibiotics as an adjunct to scaling and root planning (SRP), such as the antimicrobial and minocycline hydrochloride could affect bacterial metabolism and inhibit bioﬁlm attachment particularly in terms of pocket depth reduction and attachment level gain. However, the use of wide-spectrum antibiotics may cause some inevitable side effects including drug resistance, pathogens and probiotics were eliminated leading to diversity of microbiota diminished, and toothstaining. To solve the problems of antibiotics in the clinic, antimicrobial peptides (AMPs) may be considered as an alternative to conventional antibiotics drugs.In this randomized clinical trial, we aimed to evaluate the effects of AMPs as an addition to SRP on clinical parameters and microbiological biofilms in patients with Stage III and Grade B periodontitis.

Recruitment & Eligibility

Inclusion Criteria

At least 18 years old
Previously untreated Stage III and Grade B periodontitis by clinically and radiologically。In 2018, EEP and AAP sorted out periodontitis into four classifications (Stage I to IV) based on several variables including clinical attachment loss, amount and percentage of bone loss, probing depth, presence and extent of angular bony defects and furcation involvement, tooth mobility, and tooth loss due to periodontitis, and three levels (grade A: low risk, grade B: moderate risk, grade C: high risk of progression) according to the rate of disease progression.
A minimum of 20 natural teeth in the mouth, and more than 4 molars.

Exclusion Criteria

Acute oral lesions or necrotizing ulcerative periodontitis,
Having received antibiotics within 6 months or the need for antibiotic coverage during experiment,
Being allergic to minocycline,
No orthodontic treatment,
A history of systemic diseases,
Pregnancy,
Smoker

Arm && Interventions

Group	Intervention	Description
Perio Group	minocycline hydrochloride ointment	scaling and root planning and subgingival application of minocycline hydrochloride ointment
SRP Group	SRP	scaling and root planning
AMP Group	Oral biological antimicrobial gel	scaling and root planning and subgingival application of antimicrobial peptide gel

Primary Outcome Measures

Name	Time	Method
Periodontal Probing Depth	Change from Baseline Periodontal probing depth at 90 days	from the gingival margin to the bottom of the periodontal pocket were assessed using a Williams periodontal probe((Hu-Friedy)
Attachment Level Were Assessed Using a Williams Periodontal Probe((Hu-Friedy)	Change from Baseline Attachment level at 90 days	from the cementoenamel junction, crown margin or restoration to the bottom of the pocket
Bleeding Index Were Assessed Using a Williams Periodontal Probe((Hu-Friedy) ,the Rating Method Was Assessed Using the Criteria of Mazza.	Change from Bleeding index at 90 days	Bleeding index : 0 = normal appearance of the gingiva and no bleeding on sulcus probing. 1. = normal appearance of the gingiva but bleeding on probing of the sulcus. 2. = bleeding on probing and gingival color change without swelling. 3. = bleeding on probing, gingival color change with mild swelling. 4. = bleeding on probing with marked gingival swelling, with or without color change. 5. = bleeding on probing, L Spontaneous bleeding, gingival color change with marked swelling, with or without ulceration.