Periodontitis
Conditions
Keywords
periodontitis, smoking, neutrophil, matrix metalloproteinase-8, nonsurgical treatment
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.
Interventions
PROCEDURENonsurgical periodontal treatment
Oral hygiene instructions, scaling and root planning.
Sponsors
University of Medicine and Pharmacy at Ho Chi Minh City
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
MALE
Age
30 Years to 60 Years
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Oral neutrophils | At baseline (T0) | The number of neutrophils in saliva |
| Matrix metalloproteinase-8 (MMP-8) | At baseline (T0). | The level of matrix metalloproteinase-8 (MMP-8) in gingival crevicular fluid |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Gingival Index (GI) | At baseline (T0). | Gingival Index (Silness and Loe, 1967) |
| Plaque Index (PlI) | At baseline (T0). | Plaque Index (Silness and Loe, 1967) |
| Probing pocket depth (PPD) | At baseline (T0). | The distance from the gingival margin to pocket base |
| Clinical attachment loss (CAL) | At baseline (T0). | The distance from the cementoenamel junction (CEJ) to the gingival margin |
Outcome results
None listed