Emdogain Minimally Invasive Surgical Technique

Straumann® Emdogain® Application In Conjunction With Minimally Invasive Surgical Technique For Periodontal Disease Treatment: A Split-Mouth Design Study

The aim of this controlled study is to assess the clinical outcomes and patient reported outcomes of using minimally invasive surgical procedure with Straumann Emdogain as an adjunct (test treatment) or without Straumann Emdogain (control treatment).

Study Overview

• Status: Completed
• Conditions: Periodontitis
• Intervention / Treatment: Procedure: Scaling and root planing; Device: Emdogain application; Procedure: Scaling and root planing without Emdogain

Detailed Description

The aim of the study will be achieved through the following primary and secondary objectives. The primary objective is to evaluate the regenerative potential of Straumann Emdogain by comparing the change in clinical attachment level from baseline to 12 months between the test and control arms. The regenerative potential of Straumann Emdogain will also be assessed by comparing the changes in gingival margins, changes in average probing pocket depth, changes in full mouth plaque score, changes in bleeding on probing, and changes in root dentin hypersensitivity from baseline to 12 months between the test and control arms.

• Study Type: Interventional
• Enrollment (Actual): 51
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • Quebec
    • Montreal, Quebec, Canada, H3B 3A7
      • Clinique Paro Excellence
• Germany
  • Mainz, Germany, 55131
    • Universitätsmedizin der Johannes Gutenberg Universität Mainz
• United States
  • Alabama
    • Cullman, Alabama, United States, 35055
      • Periodontal and Implant Associates, Inc.
  • Colorado
    • Aurora, Colorado, United States, 80012-3202
      • Periodontics and Implant Dentistry

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 21 years to 85 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Subjects must have voluntarily signed the informed consent form before any study related procedures
• Subjects must be males or females who are 18-85 years of age
• Subjects must have moderate to severe chronic, generalized periodontitis with pockets of 5 mm - 8mm probing depth in at least 2 pockets per contralateral quadrants in one arch (study teeth)
• Subjects must be committed to the study and the required follow-up visits
• Subjects must be in good general health as assessed by the Investigator

Exclusion Criteria:

• Subjects taking or intending to take any medications during the duration of the study that will potentially affect healing and inflammation
• Subjects who are currently heavy smokers (defined >10 cigarettes per day or >1 cigar per day) or who use chewing tobacco
• Subjects being treated with systemic antibiotics or subjects that were treated with systemic antibiotics within 3 months prior to treatment in this study
• Subjects with uncontrolled diabetes
• Subjects that are immunocompromised or immunosuppressed
• Subjects that cannot provide informed consent
• Subjects with drug or alcohol abuse
• Subjects that have undergone periodontal root planing or periodontal surgery in the last 6 months
• Subjects that are pregnant
• Subjects with necrotizing periodontitis or periodontitis related to systemic disease
• Teeth with pockets with probing depth ≥ 9 mm will not classify as study teeth
• Teeth with pockets or defects with furcation involvement will not classify as study teeth
• Teeth with mobility degree > 1 without splint will not classify as study teeth
• Subjects with test and control sites in the two quadrants on adjacent teeth
• Patients with compromised health conditions such as diabetes, systemic diseases, high dose steroid therapy, bone metabolic diseases, radiation or immune-oppressive therapy, and infections or vascular impairment at the surgical site
• Subjects with conditions or circumstances, in the opinion of the Investigator , which would prevent completion of study participation or interfere with analysis of study results

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Test (with Emdogain); Scaling and root planing with Emdogain	Procedure: Scaling and root planing; Using minimally invasive surgical procedure (scaling and root planing) with Emdogain application to treat one contra-lateral quadrant in subject's jaw.; Device: Emdogain application; Using minimally invasive surgical procedure (scaling and root planing) with Emdogain application to treat one contra-lateral quadrant in subject's jaw
Other: Control (without Emdogain); Scaling and root planing without Emdogain	Procedure: Scaling and root planing without Emdogain; Using minimally invasive surgical procedure (scaling and root planing) without Emdogain application to treat one contra-lateral quadrant in subject's jaw.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Clinical Attachment Levels (CAL)	CAL will be measured in millimeters on the study teeth at 6 locations. Outcome is mean change of CAL from baseline measurements at surgery to 12-months post-surgery, taken from the deepest pocket of a patient's test and control teeth measured at baseline. Analysis will compare the mean change of CAL for test and control treatment arms.	Baseline and 12 Month Follow-Up Visit

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Gingival Margin (GM)	GM will be measured in millimeters on the study teeth at 6 locations. Outcome is mean change of GM from baseline at surgery to 12-months-post surgery, taken from the deepest pocket of a patient's test and control teeth measured at baseline. Analysis will compare the mean change of GM for test and control treatment arms.	Baseline and 12 Month Follow-Up Visit
Change in Pocket Probing Depth (PPD)	PPD will be measured in millimeters on the study teeth in 6 locations. Outcome is mean change of PPD from baseline at surgery to 12-months post-surgery, taken from the deepest pocket of a patient's test and control teeth at baseline. Analysis will compare the mean change of PPD for test and control treatment arms.	Baseline and 12 Month Follow-Up Visit
Change in Full Mouth Plaque Score (FMPS)	FMPS will be calculated based on the number of tooth surfaces with plaque over the total number of tooth surfaces x 100. The value is presented as a percent. The difference in FMPS between 12 months and baseline will be determined.	Baseline and 12 Month Follow-Up Visit
Change in Bleeding on Probing (BoP)	For the categorical variable BoP, the frequency of bleeding (present or absent) will be counted (absolute and in percent) over all measured sites around the identified study teeth for each treatment group. The results will be compared between the 12-month follow-up and baseline.	Baseline and 12 Month Follow-Up Visit
Change in Root Dentin Hypersensitivity	Presence of root dentin hypersensitivity will be recorded as "none" (no reaction from the subject), "mild" (sensible with no pain), "moderate" (sensible with slight pain), or "severe" (sensible with pain that persists for a while) after a conventional air blast is applied to the study tooth. Changes in the frequency of categories will be determined and compared between the two treatment arms. An improvement is defined as a decreased reaction (for example, severe to mild), a deterioration is defined as increased reaction (for example, none to moderate), and unchanged is no change to reaction (for example, mild to mild).	Baseline and 12 Month Follow-Up Visit
Change in Post-surgical Pain	Post-surgical pain will be measured on a 100 millimeter visual analog scale. The range is 0 (no pain) to 99 (nearly maximum pain). The lower the value, the better the outcome. The subjects will be instructed to mark their level of pain on a line for both the test quadrant and the control quadrant. The average change in pain level will be determined and compared between the two arms.	1-2 days post surgery, 1 week post surgery, and 2 weeks post surgery

Collaborators and Investigators

• Sponsor: Institut Straumann AG
• Investigators: Principal Investigator: Pamela K McClain, DDS, Periodontics and Implant Dentistry; Principal Investigator: Veronique Benhamou, DDS, Clinique Paro Excellence; Principal Investigator: Jennifer H Doobrow, DMD, Periodontal & Implant Associates

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2015
• Primary Completion (Actual): June 1, 2018
• Study Completion (Actual): August 30, 2019

Study Registration Dates

• First Submitted: September 14, 2015
• First Submitted That Met QC Criteria: September 14, 2015
• First Posted (Estimate): September 16, 2015

Study Record Updates

• Last Update Posted (Actual): October 17, 2019
• Last Update Submitted That Met QC Criteria: October 16, 2019
• Last Verified: October 1, 2019

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Stomatognathic Diseases; Periodontal Diseases; Mouth Diseases; Periodontitis
• Other Study ID Numbers: CR 01/15

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No