Comparisons Of Different Antiplaque Agents On Gingivitis In Orthodontic Patients

Not Applicable

Completed

• Conditions: Gingivitis
• Interventions: Drug: Placebo; Drug: combination gel (chlorhexidine and metronidazole); Drug: Chlorhexidine Gluconate; Drug: Metronidazole

• Registration Number: NCT06305546
• Lead Sponsor: Anam Sattar

Brief Summary

Fixed orthodontic treatment affects the periodontium by allowing plaque accumulation on teeth if the oral ecosystem is unfavorable which initially causes gingivitis to progress into periodontitis, and later enamel demineralization occurs. Yáñez-Vico et al observed that regular modifications per checkups were painful and unpleasant for the patient thus the patients undergoing fixed orthodontic treatments compromised their oral hygiene. This creates plaque retention sites which can lead to developing white spot lesions, caries, and periodontitis

Detailed Description

Metal brackets were used on the teeth such as incisors, canines, and premolars as well as bands on the 1st molars to treat all patients with the same kind of orthodontic appliances. Metal Brackets were bonded by the principal investigator with the direct bonding technique by using light cure adhesives. General oral hygiene instructions were given by the clinician to each participant in the study.

Participants were divided into four groups through computer-generated software. Group A participants used 1% metronidazole gel, Group B participants used 0.25% chlorhexidine gel. Group C participants used a combination gel (1% Metronidazole and 0.25% Chlorhexidine). Group D participants used a placebo gel. All participants were instructed to follow oral hygiene measures such as brushing twice a day with a soft brush with fluoridated toothpaste, and use of floss or interdental brushes. For two weeks, all individuals from groups A, B, C, and D were instructed to use pea-sized gel on their gingiva two times a day. To ensure patient compliance, the investigators assigned patients with log sheets to fill daily on whether they used the gel consistently every day twice a day for 2 weeks. Patients were also instructed to return the container of gel on the day of follow-up.

OUTCOMES:

The primary outcome included the measurement of indices during study time from baseline (T0) to 2weeks (T1), 4 weeks (T2), 8 weeks (T3) and 12 weeks(T4) . The investigators have evaluated Gingival Index and Bleeding Index by probing and assessing the gingiva and Orthodontic Plaque index by plaque disclosing tablets, and examined six standard sites on incisors, canine, and premolars as described by Gettinger et al. Banded first molars were not included because banding itself can compromise periodontal health. The study sites were assessed by using CPITN probe. Six proximal line angles were investigated for gingivitis on the selected teeth: Right maxillary second premolar, mesiobuccal line angle; right maxillary canine, distobuccal line angle; left maxillary central incisor, distopalatal line angle; right mandibular central incisor, distolingual line angle; left mandibular canine, distobuccal line angle; left mandibular second premolar, mesiobuccal line angle.

If any of the study teeth were missing, then the corresponding tooth on the opposite side was evaluated.

Patients were only included in the trial if they have Gingival index, Orthodontic plaque index scores ≥2 and Bleeding index ≥ 1 on any three or more than three of the six teeth that were examined in the study. The total combined GI and BI indexes were computed by averaging the measured values at T0, T1, T2, T3 and T4 . For OPI, the score was calculated by counting the number of teeth with plaque accumulation at each time interval.

Study Timeline

• Study Start: 2023-04-01
• Primary Completion: 2023-10-31
• Study Completion: 2023-10-31
• Study First Submitted: 2023-12-05
• Status Verified: 2024-03
• Study First Submitted QC: 2024-03-10
• Last Update Submitted: 2024-03-11
• Study First Posted: 2024-03-12
• Last Update Posted: 2024-03-13

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 80

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
GROUP D	Placebo	-
GROUP C	combination gel (chlorhexidine and metronidazole)	-
group A	Chlorhexidine Gluconate	-
GROUP B	Metronidazole	-

Primary Outcome Measures

Name	Time	Method
gingival index	12 weeks	Gingival index Score 0: no inflammation Score 1: Mild inflammation of gingiva. No bleeding on probing. Score2: Moderate inflammation, Red, edematous and shiny gingiva, bleeding on probing.; Score 3: Severe inflammation, Red, edematous and ulcerated gingiva. There is spontaneous bleeding
bleeding index	12 weeks	Bleeding Index Score 0: absence of bleeding after 30 seconds Score 1: presence of bleeding after 30 seconds Score 2: immediate bleeding
orthodontic plaque index	12 weeks	Orthodontic Plaque Index 0: No plaque deposits on the tooth surfaces surrounding the bracket base; 1. Plaque deposits on one tooth surface at the bracket base; 2. Plaque deposits on two tooth surfaces at the bracket base; 3. Plaque deposits on three tooth surfaces at the bracket base; 4. Plaque deposits on four tooth surfaces at the bracket base

Trial Locations

Locations (1)

Dow University of Health Sciences; 🇵🇰 Karachi, Sindh, Pakistan