MedPath

Treatment of Periodontitis in Obese Individuals

Phase 4
Completed
Conditions
Periodontitis
Obese
Obesity, Morbid
Interventions
Combination Product: One-stage full-mouth disinfection with chlorhexidine
Registration Number
NCT03103204
Lead Sponsor
University of Taubate
Brief Summary

Obesity and gum diseases are highly prevalent in all parts of the world. Obesity can negatively influence severity and progression rates of gum diseases. Presence of fat in the body determines a general systemic state of inflammation. On the other hand, when gum diseases are successfully treated systemic and local inflammation decrease. In addition reductions in glycemic blood levels are also observed after treatment. Periodontitis is one type of gum disease that is associated with bone loss. It could be treated within 24 hours by using a protocol, which combines dental debridement and mouthwash. This treatment protocol, named "one-stage full-mouth disinfection" works well in individuals of normal weight. However, there is no information whether it is effective in obese individuals or not. Also, it should be clarified if obesity influences response to periodontal treatment. This study hypothesized that obesity impair response to periodontal treatment. Therefore, the effects of the protocol "one-stage full-mouth disinfection" will be evaluated in obese individuals and normal weight controls. This evaluation will be based on the monitoring of several clinical, microbiological and biochemical parameters throughout 9 months. Participants will answer validated questionnaires to evaluate if treatment of gum disease would be able to improve individual's quality of life. Study population will be composed of 90 to 100 obese individuals (males or females; \> 18 years of age; smokers or non smokers; \> 12 natural teeth). Participants will be classified into 5 groups according to their body mass index in normal weight (n = 15 to 20); overweight (n = 15 to 20); obesity I (n = 15 to 20); obesity II (n = 15 to 20); obesity III (n = 15 to 20). Examinations will be performed before treatment and also 3, 6 and 9 months after treatment. This study will contribute to the knowledge on how obese individuals respond to this specific treatment protocol. Also, having normal weight individuals as controls the present study will contribute to a better understanding about obesity, in its different severities, influence on periodontal treatment.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
96
Inclusion Criteria
  • Moderate to advanced generalized chronic periodontitis
  • Body mass index: > 18.5 kg/m2
  • Minimum of 12 natural teeth
  • Smokers, non-smokers or former-smokers
Exclusion Criteria
  • Systemic diseases (diabetes, renal diseases, rheumatic diseases, osteoporosis and cardiovascular diseases)
  • Pregnant and lactating women
  • HIV/ AIDS
  • periodontal treatment in the last year (before baseline appointment)
  • Medication: Immunosuppressive drugs, antibiotics in the past three months (before baseline appointment) )
  • orthodontic appliance

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Normal weight full-mouth disinfectionOne-stage full-mouth disinfection with chlorhexidine* Normal weight (body mass index 18.5 - 24.9 kg/m2) individuals with chronic periodontitis * Full-mouth manual scaling and root planing within 24 hours * tongue cleaning with chlorhexidine gel 1% for 1 minute * tonsils disinfection with chlorhexidine spray 0.2% * rinsing with 15mL of 0.2% chlorhexidine solution for 30 seconds before and after dental scaling * subgingival irrigation of all periodontal pockets with 1% chlorhexidine solution * daily rinsing with 0.2% chlorhexidine solution (15mL/30 seconds/2 times a day
Overweight full-mouth disinfectionOne-stage full-mouth disinfection with chlorhexidine* Overweight (body mass index 25.0 - 29.9 kg/m2) individuals with chronic periodontitis * Full-mouth manual scaling and root planing within 24 hours * tongue cleaning with chlorhexidine gel 1% for 1 minute * tonsils disinfection with chlorhexidine spray 0.2% * rinsing with 15mL of 0.2% chlorhexidine solution for 30 seconds before and after dental scaling * subgingival irrigation of all periodontal pockets with with 1% chlorhexidine solution * daily rinsing with 0.2% chlorhexidine solution (15mL/30 seconds/2 times a day
Obesity III full-mouth disinfectionOne-stage full-mouth disinfection with chlorhexidine* Obesity III (body mass index ≥ 40.0 kg/m2) individuals with chronic periodontitis * Full-mouth manual scaling and root planing within 24 hours * tongue cleaning with chlorhexidine gel 1% for 1 minute * tonsils disinfection with chlorhexidine spray 0.2% * rinsing with 15mL of 0.2% chlorhexidine solution for 30 seconds before and after dental scaling * subgingival irrigation of all periodontal pockets with with 1% chlorhexidine solution * daily rinsing with 0.2% chlorhexidine solution (15mL/30 seconds/2 times a day
Obesity I full-mouth disinfectionOne-stage full-mouth disinfection with chlorhexidine* Obesity I (body mass index 30.0 - 34.9 kg/m2) individuals with chronic periodontitis * Full-mouth manual scaling and root planing within 24 hours * tongue cleaning with chlorhexidine gel 1% for 1 minute * tonsils disinfection with chlorhexidine spray 0.2% * rinsing with 15mL of 0.2% chlorhexidine solution for 30 seconds before and after dental scaling * subgingival irrigation of all periodontal pockets with with 1% chlorhexidine solution * daily rinsing with 0.2% chlorhexidine solution (15mL/30 seconds/2 times a day
Obesity II full-mouth disinfectionOne-stage full-mouth disinfection with chlorhexidine* Obesity II (body mass index 35.0 - 39.9 kg/m2) individuals with chronic periodontitis * Full-mouth manual scaling and root planing within 24 hours * tongue cleaning with chlorhexidine gel 1% for 1 minute * tonsils disinfection with chlorhexidine spray 0.2% * rinsing with 15mL of 0.2% chlorhexidine solution for 30 seconds before and after dental scaling * subgingival irrigation of all periodontal pockets with with 1% chlorhexidine solution * daily rinsing with 0.2% chlorhexidine solution (15mL/30 seconds/2 times a day
Primary Outcome Measures
NameTimeMethod
Periodontal clinical efficacyChanges in clinical attachment measurements from baseline to 6 months

Improvements in clinical attachment level (mm) overtime and comparisons among groups at 6 months after treatment

Secondary Outcome Measures
NameTimeMethod
Oral safety and tolerabilityChanges in salivary nitrite levels from baseline to 6 months

Maintenance of salivary nitrite levels overtime and comparisons among groups at 6 months after treatment

Impact on quality of lifeChanges in scores (Likert scale ranging from 0 to 56 points) of Oral impacts on daily performance questionnaire from baseline to 6 months

Improvements in Oral impacts on daily performance questionnaire scores overtime and comparisons among groups at 6 months after treatment

Antimicrobial efficacyChanges in bacterial levels from baseline to 6 months

Reductions in Treponema denticola, Porphyromonas gingivalis, Tannerella forsythia, Aggregatibacter actinomycetemcomitans levels overtime and comparisons among groups at 6 months after treatment

Trial Locations

Locations (1)

University of Taubate

🇧🇷

Taubate, Sao Paulo, Brazil

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