Ignite Creation Date:
2024-10-25 @ 8:06 PM
Last Modification Date:
2024-10-26 @ 3:42 PM
Study NCT ID:
NCT06627192
Status:
NOT_YET_RECRUITING
Last Update Posted:
None
First Post:
2024-08-26
Brief Title:
Effect of Non-surgical Periodontal Therapy in Hypertensive Patients With Assessment of Endocan and TNF-α Levels in GCF
Sponsor:
None
Organization:
None
Study Overview
Official Title:
Effect of Non-surgical Periodontal Therapy in Hypertensive Patients With Assessment of Endocan and TNF-a Levels in Gingival Crevicular Fluid Case Control Study
Status:
NOT_YET_RECRUITING
Status Verified Date:
2024-10
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
No
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
There is a strong crossway relationship between periodontitis and hypertension Hypertension is the most prevalent of cardiovascular diseases and its prevalence is increased by the presence of periodontitis Periodontal attachment loss is higher in hypertension patients when compared to healthy subjects Both are examples of non-communicable diseases NCDs also known as chronic inflammatory diseases they tend to be of long duration and are the result of a combination of genetic physiological and environmental factors The lack of an appropriate balance between these factors results in cellular changes as well as the levels of cytokines with subsequent changes in clinical manifestations of periodontal diseases Both periodontitis and hypertension are associated with inflammation and an increase in specific proinflammatory cytokines
Aim of the study To investigate the correlation between the clinical parameters and the levels of Endocan and TNF-α in gingival crevicular fluid GCF before and after non-surgical periodontal therapy NSPT in stage II periodontitis patients with hypertension in comparison to non-hypertensive patients
Aim of the study To investigate the correlation between the clinical parameters and the levels of Endocan and TNF-α in gingival crevicular fluid GCF before and after non-surgical periodontal therapy NSPT in stage II periodontitis patients with hypertension in comparison to non-hypertensive patients
Detailed Description:
Clinical assessment of specific clinical parameters plaque index gingival index probing depth clinical attachment level CAL as primary outcome Biochemical assessment of Endocan and TNF-α levels in GCF by Enzyme Linked Immunosorbent Assay ELISA as well as measurement of blood pressure at baseline and after 3 months as secondary outcomes
Study procedures
Details of the interventions testing and follow up
Group Case I
This group will include 20 patients diagnosed with stage II periodontitis and controlled hypertension They will receive NSPT and oral hygiene measures will be instructed following treatment
Group Control II
This group will include 20 patients diagnosed with stage II periodontitis and no hypertension They will receive NSPT and oral hygiene measures will be instructed following treatment
Study protocol and surgical steps
Before enrollment a detailed case history will be recorded A calibrated standard aneroid sphygmomanometer The average of 3 blood pressure values systolic blood pressure SBP and diastolic blood pressure DBP will be taken at 1 minute interval this will be used in data analyses
For all patients who are suitable for the study the following clinical evaluation parameters will be measured
Plaque index PI Gingival index GI Probing depth PD Bleeding on probing BOP Clinical attachment level CAL Standardized periapical radiograph
Note Full mouth assessment will be done and then the deepest site will be evaluated for the GCF sample
Baseline GCF samples will be taken the day after patients were clinically evaluated to prevent contamination with blood related to the probing of inflamed areas
The sample areas will be insulated with cotton rolls to prevent saliva contamination and all supragingival plaque will be eliminated The paper strips will be placed into the periodontal pocket and then permitted to remain for 30 seconds
All patients will undergo full mouth NSPT this will be done using ultrasonic and hand instruments
The patients will receive oral hygiene instructions including tooth brushing using modified bass technique All patients will be provided with toothbrush soft toothpaste signal and interdental cleaning with dental floss or interdental brush
Two weeks follow-up to ensure that appropriate oral hygiene instructions are followed The clinical parameter to be assessed will be PI and BOP patients with PI 2 and BOP 10 will be eliminated from the study
Then clinical evaluation collection of samples and measuring of SBP and DBP will be performed at 3 months after NSPT in both groups
The Outcomes Assessment
Clinical assessment Biochemical assessment Blood pressure measurement
For clinical assessment the following clinical parameters including PI GI PD BOP and CAL will be recorded for each individual at 1 site at baseline and 3 months postoperatively Clinical parameters of PI and BOP will be assessed at 2 weeks 4 weeks and 6 weeks follow ups to ensure proper oral hygiene Regarding biochemical analysis GCF samples will be collected preoperative and 3 months after NSPT Blood pressure measurements will be taken before and after 3 months of NSPT
Clinical Assessment The following clinical parameters will be taken using UNC15 Probe at baseline and 3 months postoperative
Plaque index
no plaque
plaque recognized only by running a probe across the tooth surface
plaque visible to the naked eye
abundance of soft matter
Gingival index
Normal gingiva
Mild inflammation - slight edema No bleeding on probing
Moderate inflammation -redness edema and glazing Bleeding on probing
Severe inflammation - marked redness and edema Ulceration Tendency for spontaneous bleeding
Probing depth
Will be measured from the gingival margin to the depth of the pocket at four points mesio-facial mid-facial disto-facial and mid-lingual to the nearest millimeter using UNC-15 periodontal probe The average of the three facial points will be recorded as the facial probing depth FPD while the mid-lingual point will be recorded as the lingual probing depth
Clinical attachment level CALWill be measured from the CEJ to the depth of the periodontal pocket
b Biochemical Assessment
Biochemical assessment will be done at the deepest pocket at baseline and 3 months after non-surgical periodontal therapy Endocan and TNF-α levels will be determined using commercial human Endocan ESM-1 and TNF-α ELISA Kits Measurements will be performed according to the manufacturers instructions
c Blood Pressure measurement Systolic and diastolic Blood pressure measurement will be done according to 2020 International Society of Hypertension Global Hypertension Practice Guidelines
IX Statistical Analysis The obtained results will be collected tabulated and subjected to appropriate statistical analysis
Study procedures
Details of the interventions testing and follow up
Group Case I
This group will include 20 patients diagnosed with stage II periodontitis and controlled hypertension They will receive NSPT and oral hygiene measures will be instructed following treatment
Group Control II
This group will include 20 patients diagnosed with stage II periodontitis and no hypertension They will receive NSPT and oral hygiene measures will be instructed following treatment
Study protocol and surgical steps
Before enrollment a detailed case history will be recorded A calibrated standard aneroid sphygmomanometer The average of 3 blood pressure values systolic blood pressure SBP and diastolic blood pressure DBP will be taken at 1 minute interval this will be used in data analyses
For all patients who are suitable for the study the following clinical evaluation parameters will be measured
Plaque index PI Gingival index GI Probing depth PD Bleeding on probing BOP Clinical attachment level CAL Standardized periapical radiograph
Note Full mouth assessment will be done and then the deepest site will be evaluated for the GCF sample
Baseline GCF samples will be taken the day after patients were clinically evaluated to prevent contamination with blood related to the probing of inflamed areas
The sample areas will be insulated with cotton rolls to prevent saliva contamination and all supragingival plaque will be eliminated The paper strips will be placed into the periodontal pocket and then permitted to remain for 30 seconds
All patients will undergo full mouth NSPT this will be done using ultrasonic and hand instruments
The patients will receive oral hygiene instructions including tooth brushing using modified bass technique All patients will be provided with toothbrush soft toothpaste signal and interdental cleaning with dental floss or interdental brush
Two weeks follow-up to ensure that appropriate oral hygiene instructions are followed The clinical parameter to be assessed will be PI and BOP patients with PI 2 and BOP 10 will be eliminated from the study
Then clinical evaluation collection of samples and measuring of SBP and DBP will be performed at 3 months after NSPT in both groups
The Outcomes Assessment
Clinical assessment Biochemical assessment Blood pressure measurement
For clinical assessment the following clinical parameters including PI GI PD BOP and CAL will be recorded for each individual at 1 site at baseline and 3 months postoperatively Clinical parameters of PI and BOP will be assessed at 2 weeks 4 weeks and 6 weeks follow ups to ensure proper oral hygiene Regarding biochemical analysis GCF samples will be collected preoperative and 3 months after NSPT Blood pressure measurements will be taken before and after 3 months of NSPT
Clinical Assessment The following clinical parameters will be taken using UNC15 Probe at baseline and 3 months postoperative
Plaque index
no plaque
plaque recognized only by running a probe across the tooth surface
plaque visible to the naked eye
abundance of soft matter
Gingival index
Normal gingiva
Mild inflammation - slight edema No bleeding on probing
Moderate inflammation -redness edema and glazing Bleeding on probing
Severe inflammation - marked redness and edema Ulceration Tendency for spontaneous bleeding
Probing depth
Will be measured from the gingival margin to the depth of the pocket at four points mesio-facial mid-facial disto-facial and mid-lingual to the nearest millimeter using UNC-15 periodontal probe The average of the three facial points will be recorded as the facial probing depth FPD while the mid-lingual point will be recorded as the lingual probing depth
Clinical attachment level CALWill be measured from the CEJ to the depth of the periodontal pocket
b Biochemical Assessment
Biochemical assessment will be done at the deepest pocket at baseline and 3 months after non-surgical periodontal therapy Endocan and TNF-α levels will be determined using commercial human Endocan ESM-1 and TNF-α ELISA Kits Measurements will be performed according to the manufacturers instructions
c Blood Pressure measurement Systolic and diastolic Blood pressure measurement will be done according to 2020 International Society of Hypertension Global Hypertension Practice Guidelines
IX Statistical Analysis The obtained results will be collected tabulated and subjected to appropriate statistical analysis
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None