Periodontitis
Conditions
Brief summary
This study aims to investigate the clinical and microbiological efficacy of Lactobacillus reuteri as an adjunctive therapy to non-surgical periodontal treatment of chronic periodontitis with type 2 diabetes.
Detailed description
Periodontitis and diabetes affect the course and outcome of each other. Many studies have shown that for patients with periodontitis, concomitant diabetes can aggravate the destruction of periodontal tissue and accelerate the progression of periodontitis, which is an important risk factor for periodontitis. Affected by diabetes, patients with poor glycemic control have worse periodontal status, and the prognosis of periodontitis treatment is more suspicious. Conversely, periodontitis also affects diabetic status, and periodontitis is associated with dysglycemia, increased insulin resistance, and increased risk of diabetic complications. After periodontal therapy, it is expected to reduce the level of systemic inflammation and ultimately improve glycemic control and overall prognosis of diabetes. However, the treatment of periodontitis with diabetes is still a challenge, and how to improve the prognosis of patients with periodontitis with type 2 diabetes remains to be studied. BioGaia Prodentis is a probiotic chewable tablet containing Lactobacillus reuteri (combination of L. reuteri DSM 17938 and L. reuteri ATCC 5289). Studies have shown that the use of the probiotics has an additional effect on periodontal therapy. However, in the periodontitis patients with type 2 diabetes, whether the use of this probiotic can improve the effect of periodontal therapy, few relevant research have published.
Interventions
DIETARY_SUPPLEMENTProbiotics
The participant would receive non-surgical periodontal treatment, after which the participant uses probiotics (BioGaia Prodentis, L. reuteri DSM 17938+L. reuteri ATCC 5289, 0.8g, qn) for another 30 days.
DIETARY_SUPPLEMENTControl
The participant does not use probiotics after non-surgical periodontal treatment.
Sponsors
The Dental Hospital of Zhejiang University School of Medicine
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
35 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
1. age between 35 to 70 years, 2. type 2 diabetes with treatment ≥ 6-month, with HbA1c≤7.5%, 3. generalized periodontitis (Stage III or IV), 4. no less than 15 teeth
Exclusion criteria
1. smoking, or quit smoking for less than 5 years; 2. Suffering from other known systemic diseases that can affect the progression of periodontitis (immune abnormalities, osteoporosis, history of head and neck radiotherapy, etc.); 3. Received periodontal treatment within 6 months; 4. Have taken antibiotics, non-steroidal anti-inflammatory drugs, immunosuppressants, hormones and other drugs that affect periodontal within 3 months; 5. Have taken probiotics within 6 months; 6. Prophylactic use of antibiotics is required; 7. Pregnant and lactating women;
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Probing depth | change from baseline to day 90 | measured at six sites of each implant (mesio-labial/buccal, mid-labial/buccal, disto-labial/buccal, mesio-palatal/lingual, mid-palatal/lingual, and disto-palatal/lingual) using a periodontal probe (UNC15) |
| Microorganism | change from baseline to day 90 | measured by 16s rDNA in subgingival plaque and faces |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Bleeding of Probing | day 0, 30, 90, 150 | bleeding after periodontal probing |
| Fasting Blood Glucose | day 0, 30, 90, 150 | Fasting Blood Glucose in blood |
| Gingival index | day 0, 30, 90, 150 | assessed at four sites of each implant (mesio-labial/buccal, mid-labial/buccal, disto-labial/buccal, and palatal/lingual) according to the index of Loe and Silness |
| IL-1β、IL-6、TNF-α | day 0, 30, 90, 150 | IL-1β、IL-6、TNF-α by ELISA in GCF |
| HbA1c | day 0, 30, 90, 150 | HbA1c in blood |
| Gingival Recession | day 0, 30, 90, 150 | The distance from the implant margin to the gingival margin was measured with a periodontal probe |
Outcome results
None listed