Periodontitis, Metabolic Syndrome
Conditions
Brief summary
A 6-month, parallel-arm, investigator-masked, randomized clinical trial was conducted in patients with MetS and severe periodontitis. Participants were randomly assigned to an Intensive Periodontal Treatment group (IPT; scaling and root planing and azithromycin capsules 500mg/24h/3days) or to a Minimal Periodontal Treatment group (MPT; professional plaque removal and placebo capsules). Blood and subgingival microbiological samples were collected at baseline, 3 and 6 months after therapy. The primary outcome was between-group difference in C-reactive protein (CRP). Secondary outcomes included HbA1c, lipids, α-1 antitrypsin, fibrinogen levels and subgingival microbiota assessment.
Interventions
PROCEDUREScaling and root planning
Patients received non-surgical periodontal therapy in the form of full-mouth scaling and root planing (SRP), in two sessions, 1 week apart, with the use of an ultrasonic scaler (Minipiezon Electromedical Systems EMS, Nyon, Switzerland) and hand instruments, under local anaesthesia.
PROCEDURESupragingival Prophylaxis
Supragingival removal of all deposits (plaque and calculus) with an ultrasonic scaler in two sessions, 1 week apart.
Sponsors
Colgate Palmolive
Universidad Complutense de Madrid
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
35 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Diagnosis of Metabolic Syndrome according to the IDF definition * at least 16 teeth * at least eight sites with probing pocket depth (PPD) ≥ 6 mm and four sites with clinical attachment loss ≥ 5 mm, distributed in at least two different quadrants (Koromantzos et al. 2012).
Exclusion criteria
* They are not medically controlled for obesity and cardiovascular risk factors at the start of the study. For ethical reasons, patient inclusion must be delayed at least 3 months when begins a pharmacological treatment. * They had history of kidney disease with Cr\>1.2, CKD-EPI\< 70 mil/min, or proteinuria \> 300 mg/24 hours or 0.3 mg/grCr in isolated sample. * They had history of chronic lung disease, or acute disease during the previous 3 months. * They had history of stroke during the previous 3 months, myocardial infarction or revascularization during the previous 6 months, or recent angor pectoris history. * They had history of known peripheral artery disease, or chronic heart failure. * They had surgical treatment during the previous 3 months. * They had any disease that conditions compliance along the study, such as alcoholism or psychiatric disorder. * They had a history of systemic antibiotic usage over the previous 3 months. * They had non-surgical periodontal treatment during the previous 6 months; or surgical periodontal treatment over the previous 12 months.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in C-reactive protein | Baseline, 3 months and 6 months | Main outcome variable is the change in concentration of C-reactive protein between baseline and 6 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Probing Pocket Depth | Baseline, 3 months and 6 months | Examination of probing pocket depth will be determined with a periodontal probe and expressed in mm |
| Change in Plaque Index | Baseline, 3 months and 6 months | Examination of plaque index |
| Change in Bleeding on Probing | Baseline, 3 months and 6 months | Examination of bleeding on probing |
| Change in the presence of selected periodontal pathogens | Baseline, 3 months and 6 months | Selected periodontal pathogens: Aggregatibacter actinomycetemcomitans, Tannerella forsythia, P.gingivalis, Prevotella intermedia/nigrescens, Parvimonas micra, Campylobacter rectus and Fusobacterium nucleatum |
| Change in Clinical Attachment Level | Baseline, 3 months and 6 months | Examination of clinical attachment level will be determined with a periodontal probe and expressed in mm |
| Change in the proportions of selected periodontal pathogens | Baseline, 3 months and 6 months | Selected periodontal pathogens: Aggregatibacter actinomycetemcomitans, Tannerella forsythia, P.gingivalis, Prevotella intermedia/nigrescens, Parvimonas micra, Campylobacter rectus and Fusobacterium nucleatum |
| Change in the concentration of Inflammatory mediators (IL-1β, IL-6, IL-8 and TNF-α) in plasma and gingival crevicular fluid | Baseline, 3 months and 6 months | The inflammatory mediators will be determined by Luminex |
| Change in the % of Glycated haemoglobin | Baseline, 3 months and 6 months | Analysis of glycated haemoglobin was determined in the Lab of the University Hospital |
| Change in the total counts of selected periodontal pathogens | Baseline, 3 months and 6 months | By means of anaerobic culture. Selected periodontal pathogens: Aggregatibacter actinomycetemcomitans, Tannerella forsythia, P.gingivalis, Prevotella intermedia/nigrescens, Parvimonas micra, Campylobacter rectus and Fusobacterium nucleatum |
Outcome results
None listed