Periodontitis
Conditions
Keywords
Enamel Matrix Derivative, Periodontitis, Non-surgical periodontal therapy
Brief summary
The aim of the study is to investigate the effect of enamel matrix derivative in addition to scaling and root planing in comparison to scaling and root planing only in periodontitis patients that have already undergone initial periodontal therapy and are in periodontal maintenance.
Detailed description
Enamel matrix derivative (EMD) have already been widely applied as a regenerative bio-modulator in periodontal surgery and have been demonstrated to enhance periodontal regeneration. Recently, also its flapless, non-surgical application has been shown to have beneficial effects when applied during initial therapy of periodontitis. The present study is designed as a single-blinded randomized controlled clinical trial. We plan to include a total of 50 periodontitis patients that have already undergone initial periodontal therapy, but still show remaining sites with increased periodontal probing depth (PPD). Patients will be randomly allocated at a 1:1 ratio to either scaling and root planing (SRP) in combination with EMD application into the affected pockets (test group, n=25) or to SRP only (control group, n=25). Before treatment, as well as after 3, 6 and 12 months, we plan to assess site-specific periodontal parameters as well as whole-mouth oral hygiene indices. Furthermore, we intend to evaluate gingival crevicular fluid, as well as parameters representing periodontal disease activity.
Interventions
DEVICEEmdogain® FL
Emdogain® FL is an enamel matrix derivative intended for subgingival and topical application in conjunction with scaling and root planing procedures to provide regeneration of tooth support lost due to periodontal disease. Emdogain® FL has been shown to be effective in residual pockets with probing depths from 5mm to 9mm with no furcation involvement in patients with adequate plaque control. Emdogain® FL has also been shown to enhance the early healing of periodontal soft tissue wounds resulting from the instrumentation of periodontal pockets.
OTHERScaling and root planing
Scaling and root planing procedures as part of non-surgical periodontal therapy involves mechanical removal of dental plaque and calculus using curettes and sonic scalers.
Sponsors
Medical University of Vienna
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
25 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Periodontitis stage III * Patients that have completed initial periodontal therapy, and have remaining periodontal pockets of ≥6mm up to 9mm PPD * Given written informed consent form for participation in the study
Exclusion criteria
* Systemic antibiotics within the previous 3 months * Pregnant or breastfeeding women * Any current or past clinically significant pathology/disease (comorbidity) that, in the opinion of the periodontists, might confound the results or poses an additional risk to the subject during participation in the study, such as renal insufficiency, malignancy, rheumatoid osteoarthritis, human immunodeficiency syndrome. * Patients with at least one tooth of mobility grade 0 or 1 and/or furcation involvement grade 0 or I according to Hamp
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Periodontal probing depth (PPD) | At baseline | Distance from the gingival margin to the base of the pocket with a calibrated periodontal probe |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| PESA, PISA (mm2) | At baseline, after 3, 6 and 12 months | PESA:Periodontal Epithelial Surface Area PISA: periodontal inflamed surface area |
| GCF markers for periodontal regeneration | At baseline, after 3, 6 and 12 months | GCF: Gingival crevicular fluid |
| Periodontal bacteria | At baseline, after 3, 6 and 12 months | Microbiologic evaluation of GCF via polymerase chain reaction (PCR) DNA probe test kit |
| CAL (mm) | At baseline, after 3, 6 and 12 months | CAL (Clinical attachment level): the probing depth and the distance from the gingival margin to the CEJ API: Approximal plaque index PBI: Papillary Bleeding Index PESA:Periodontal Epithelial Surface Area PISA: periodontal inflamed surface area GCF: Gingival crevicular fluid |
| API, PBI (%) | At baseline, after 3, 6 and 12 months | API: Approximal plaque index PBI: Papillary Bleeding Index |
Countries
Austria
Outcome results
None listed