Intervention Study of Two Protocols for Non-surgical Treatment of Chronic Periodontitis
Approaches to Pocket/Root Debridement for Periodontal Infection Control - a Study on Effectiveness.
Treatment directed towards the control of periodontal infections is to about 90% non-surgical procedures. There is evidence from a large number of randomized controlled studies that the efficacy in terms of clinical outcomes of a full-mouth ultrasonic debridement approach (FMUD) is comparable to that of traditional section-wise scaling and root planing (SRP). A hypothesis for the current effectiveness study is that comparable clinical effects will be obtained with the FMUD approach as with conventional section-wise SRP, but with significantly more favourable patient-centred and health-economic outcomes.
This randomized study involves about 100 professionals (dental hygienists) and more than 850 patients at 40 dental clinics in the Vastra Gotaland Region, Sweden. The project not only evaluate treatment effects in terms of pertinent clinical outcomes, it also has a strong focus on patient-centered measures - patient-reported experience measures (PREM) and patient-reported outcome measures (PROM) - as well as health-economics.
Přehled studie
Postavení
Podmínky
Detailní popis
All patients with chronic periodontitis (age 30 years and older) attending the selected Public Dental clinics in VG are eligible. The patients should have at least 8 teeth with pathological pockets (probing pocket depth ≥5 mm and bleeding on probing). Only patients providing signed informed consent are included.
Reported data in the study by Wennström et al. (J Clin Periodontol 2005) were used for power calculation. Thus, a total sample of 834 patients will provide a power of 95% at a significance level of p<0.05 to detect a difference of 5% in proportion of sites with "pocket closure" i.e. PPD ≤4 mm and BoP negative (primary efficacy variable) between treatment groups. For a power of 80% a total sample of 506 patients is required.
Typ studie
Zápis (Očekávaný)
Fáze
- Nelze použít
Kontakty a umístění
Studijní místa
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Gothenburg, Švédsko, SE 405 30
- Dept of periodontology, Institute of odontology, The Sahlgrenska academy at University of Gothenburg
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Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Inclusion Criteria:
- chronic periodontitis
- at least 6 teeth with approximal probing pocket depth ≥5 mm and bleeding on probing
Exclusion Criteria:
- subgingival instrumentation within 6 months prior to screening examination
- compromised medical conditions requiring prophylactic antibiotic coverage
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Singl
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
|---|---|
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Aktivní komparátor: Full-mouth ultrasonic debridement
Motivation and instruction in proper oral hygiene.
Before initiation of the subgingival debridement the patient must show sufficient self-performed infection control (full-mouth plaque score <30%).
One session of full-mouth ultrasonic pocket/root debridement using a piezoceramic ultrasonic instrument.
A follow-up visit after 2-4 weeks is scheduled for oral hygiene control and re-motivation/re-instruction if indicated.
At 3 and 6 months re-evaluation is performed and re-instrumentation of all sites showing a remaining probing pocket depth of ≥5 mm carried out.
Final evaluation at 18 months.
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Motivation and instruction in proper oral hygiene.
Before initiation of the subgingival debridement the patient must show sufficient self-performed infection control (full-mouth plaque score <30%).
One session of full-mouth ultrasonic pocket/root debridement using a piezoceramic ultrasonic instrument.
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Aktivní komparátor: Section-wise scaling and root planing
Conventional treatment approach comprising motivation, oral hygiene instructions and section-wise scaling and root planing at required number of consecutive appointments with 1-2 week interval.
Follow-up 2-4 weeks after the last session of SRP for oral hygiene control and re-instruction if indicated.
At 3 and 6 months re-evaluation is performed and re-instrumentation of all sites showing a remaining pocket depth of ≥5 mm carried out.
Final evaluation at 18 months.
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Conventional treatment approach comprising motivation, oral hygiene instructions and section-wise scaling and root planing at required number of consecutive appointments with 1-2 week interval.
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Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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"Periodontal pocket closure"
Časové okno: Up to 18 months
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Frequency of sites with probing pocket depth (PPD) ≤4 mm and no bleeding
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Up to 18 months
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Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Probing pocket depth
Časové okno: Up to 18 months
|
Reduction in mean Probing pocket depth
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Up to 18 months
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Bleeding on pocket probing (BoP)
Časové okno: Up to 18 months
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Reduction in frequency of bleeding on pocket probing (BoP)
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Up to 18 months
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Patient-reported outcome measures (PROM)
Časové okno: Up to 18 months
|
Questionnaire
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Up to 18 months
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Patient-reported experience measures (PREM)
Časové okno: Up to 18 months
|
Questionnaire
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Up to 18 months
|
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Investment for treatment
Časové okno: Up to 18 months
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Individual investment for treatment - Direct and subsidiary costs
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Up to 18 months
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Další výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Plaque score
Časové okno: Up to 18 months
|
Percentage of tooth surfaces with bacterial deposits
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Up to 18 months
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Treatment time
Časové okno: Up to 18 months
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Treatment time in minutes for mechanical instrumentation and oral hygiene instructions respectively
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Up to 18 months
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Spolupracovníci a vyšetřovatelé
Sponzor
Spolupracovníci
Vyšetřovatelé
- Vrchní vyšetřovatel: Jan L Wennstrom, Dept of periodontology, Sahlgrenska academy, University of Gothenburg, Sweden
- Ředitel studie: Maria Welander, Dept of periodontology, Sahlgrenska academy, University of Gothenburg, Sweden
- Ředitel studie: Kajsa H Abrahamsson, Dept of periodontology, Sahlgrenska academy, University of Gothenburg, Sweden
Publikace a užitečné odkazy
Obecné publikace
- Tomasi C, Liss A, Welander M, Alian AY, Abrahamsson KH, Wennstrom JL. A randomized multi-centre study on the effectiveness of non-surgical periodontal therapy in general practice. J Clin Periodontol. 2022 Nov;49(11):1092-1105. doi: 10.1111/jcpe.13703. Epub 2022 Jul 27.
- Liss A, Wennstrom JL, Welander M, Tomasi C, Petzold M, Abrahamsson KH. Patient-reported experiences and outcomes following two different approaches for non-surgical periodontal treatment: a randomized field study. BMC Oral Health. 2021 Dec 15;21(1):645. doi: 10.1186/s12903-021-02001-4.
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia
Primární dokončení (Aktuální)
Dokončení studie (Očekávaný)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Odhad)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
Další identifikační čísla studie
- VGR 2013-2
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