The Influence of Smoking on Oral Neutrophils and Matrix Metalloproteinase-8 in Periodontitis Patients, Before and After Nonsurgical Treatment
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Enrollment
- 40
- Primary Endpoint
- Oral neutrophils
Study Overview
Brief Summary
Objective: The aim of this study was to evaluate and compare the oral neutrophil numbers (ONN) in saliva, the level of matrix metalloproteinase-8 (MMP-8) in gingival crevicular fluid (GCF) and the periodontal parameters in smokers and non-smokers with periodontitis, before and after nonsurgical periodontal treatment (NSPT).
Materials and method: 40 periodontitis patients including 20 smokers and 20 non-smokers were enrolled in this study. All patients were received the NSPT included instructing oral hygiene, scaling and root planning. Clinical parameters (plaque index (PlI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD) and clinical attachment loss (CAL)), ONN and GCF MMP-8 level were assessed before (baseline) and after NSPT 1 month and 3 months.
Detailed Description
After periodontal examination and medical history evaluation, all patients received oral hygiene instructions. The modified-Bass tooth brushing technique, as well as the use of dental floss and interproximal brushes (if needed) were showed to the patients. They were educated to brush their teeth at least twice a day. All patients were given a dentifrice and toothbrush. Patient motivation to quit smoking was also provided.
At the first visit, supragingival scaling with ultrasonic scalers (Cavitron Jet Plus (Densply Sirona, Mississauga, Canada) were provided to all patients. Occlusion adjustments were also performed in the case of indications.
After one week, the baseline (T0) parameters were recorded. The following samples were collected: (1) saliva, (2) gingival cervical fluid (GCF), and (3) clinical periodontal parameters. A doctor who collected the samples was blinded about the smoking status.
Subsequently, scaling and root planning (SRP) by ultrasonic scalers (Cavitron Jet Plus (Densply Sirona, Mississauga, Canada) and Gracey curettes (Hu-Friedy, Chicago, USA), under local anesthesia, were performed by a periodontist, who was also blinded about the smoking status. The number of SRP visits was determined by patient disease conditions.
Following the completion of NSPT, all subjects were recalled after one month and three months for re-evaluation. The collection of (1) saliva, (2) gingival cervical fluid (GCF), and (3) clinical periodontal parameters were performed. Based on the patients' periodontal status, supragingival scaling and polishing were given.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Triple (Care Provider, Investigator, Outcomes Assessor)
Eligibility Criteria
- Ages
- 30 Years to 60 Years (Adult)
- Sex
- Male
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Male patients
- •Aged from 30 to 60 years old
- •Systemically healthy
- •Having at least 20 teeth
- •Diagnosed with moderate to severe periodontitis according to american academy of periodontology 2015: gingival bleeding at examination, ≥5mm periodontal pocket depth (PPD), bone resorption on x-ray film ≥16% or >3mm root length
- •Having at least two sites at anterior teeth with PPD from 5 to 7 mm
- •For group 1, subjects who never smoke
- •For group 2, subjects who had smoked more than 10 cigarettes per day for at least the past 10 years
Exclusion Criteria
- •Patients with acute or chronic medical disorders
- •Patients under any medication for the past 3 months
- •Patients who had undergone periodontal therapy in the last 12 months
- •Patients with oral lesions such as ulcers, aphthous ulcers, glossitis or multi tooth decays
Outcomes
Primary Outcomes
Oral neutrophils
Time Frame: After Nonsurgical periodontal treatment three months (T3)
The number of neutrophils in saliva
Matrix metalloproteinase-8 (MMP-8)
Time Frame: After Nonsurgical periodontal treatment three months (T3)
The level of matrix metalloproteinase-8 (MMP-8) in gingival crevicular fluid
Secondary Outcomes
- Probing pocket depth (PPD)(After Nonsurgical periodontal treatment three months (T3))
- Plaque Index (PlI)(After Nonsurgical periodontal treatment three months (T3))
- Clinical attachment loss (CAL)(After Nonsurgical periodontal treatment three months (T3))
- Gingival Index (GI)(After Nonsurgical periodontal treatment three months (T3))
Investigators
Nguyen Thu Thuy
Associate Dean of Faculty of Odonto-stomatology
University of Medicine and Pharmacy at Ho Chi Minh City