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Acute Phase Response & Periodontal Treatment

Not Applicable
Completed
Conditions
Periodontal Diseases
Interventions
Procedure: Scaling & Root Planing
Registration Number
NCT02460926
Lead Sponsor
University of Pisa
Brief Summary

This study has compared quadrant scaling and root planing (Q-SRP) versus intensive treatment performed within 24 hours (FM-SRP) in terms of acute phase responses following treatment of periodontal disease. The primary aim was to compare the differences in CRP acute increase following FM-SRP versus Q-SRP therapy (24 hours after therapy). Secondary outcomes included changes in a broad array of inflammatory and endothelial injury markers between groups. Patients were randomly assigned to either FM-SRP and Q-SRP. Data indicated that non-surgical periodontal therapy performed within 24 hours induced greater perturbations of systemic inflammation compared to conventional treatment.

Detailed Description

Aim. A moderate acute-phase response occurs 24 hours following full-mouth non-surgical treatment (FM-SRP). Aim of this study will be to compare quadrant scaling (Q-SRP) versus FM-SRP in terms of systemic acute (24 hours) and medium-term (3 months) inflammation.

Material \& Methods. 38 periodontitis-affected subjects will be randomly allocated to FM-SRP or Q-SRP after a baseline visit. Periodontal and anthropometric parameters, such as systolic and diastolic bood pressure, BMI and temperature, will be collected at baseline and 3 months. Serum samples will be drawn at baseline, 1, 7 and 90 days after treatment. High sensitivity assays for a broad array of inflammatory (PCR, IL-6, TNF-alpha) and endothelial assays will be performed.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
38
Inclusion Criteria
  • Patients presenting with probing pocket depths (PPD) ≥5 mm,
  • bleeding on probing on at least 25% of their total sites
  • documented radiographic alveolar bone loss
Exclusion Criteria
  • age earlier than 18 and older than 70 years;
  • pregnant or lactating females;
  • females using contraceptive methods;
  • reported diagnosis of any systemic illnesses including cardiovascular, renal and liver diseases;
  • any pharmacological treatment within the 3 months before the beginning of the study;
  • PT in the previous 6 months.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Scaling & Root Planing - Full MouthScaling & Root PlaningPeriodontal treatment (PT), consisting in both supra- and sub-gingival mechanical instrumentation of the root surface (scaling and root planing), was performed by a single periodontist . Treatment was provided using both hand and ultrasonic instrumentation with fine tips. Local anaesthesia was used when needed and no time constraints were enforced. FM-SRP patients received treatment within 24 hrs in two separate sessions, one side of the mouth for each session: two quadrants were instrumented in an afternoon session, whereas the other two were instrumented the following morning
Scaling & Root Planing - QuadrantScaling & Root PlaningPeriodontal treatment (PT), consisting in both supra- and sub-gingival mechanical instrumentation of the root surface (scaling and root planing), was performed by a single periodontist . Treatment was provided using both hand and ultrasonic instrumentation with fine tips. Local anaesthesia was used when needed and no time constraints were enforced. Q-SRP patients received four quadrants sessions of PT with an interval of 1 week between sessions
Primary Outcome Measures
NameTimeMethod
C reactive Protein24 Hours
Secondary Outcome Measures
NameTimeMethod
Full Mouth Plaque Score90 days

presence/absence of dental plaque in percentual values

Full Mouth Bleeding Score90 days

presence/absence of sites bleeding on probing in percentual values

periodontal pocket depth (PPD)90 days

mean in site \> 4mm

clinical attachment level (CAL)90 days

mean in mm

Interleukin - 624 Hours, 7 days, 90 days
number of pockets > 4 mm90 days

number of pockets \> 4 mm

C reactive Protein7 days, 90 days
Tumor Necrosis Factor - alpha24 Hours, 7 days, 90 days
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