Bacteremia in Periodontal Patients
11 août 2014 mis à jour par: University of Taubate
Influence of Pre-procedural Oral Rinse in the Induced Bacteremia by Periodontal Instrumentation: a Randomized Clinical Trial
Bacteremia represents the presence of live germs in the blood stream.
Patients with gum disease show damaged tissues and seem to be more susceptible to bacteremia.
In fact, daily activities such as mastication can induce bacteremia in these patients.
Dental procedures related to bleeding also induce bacteremia.
However, there are many questions that should be clarified.
Among them, clinical strategies that are able to reduce the levels of germs in blood should be determined.
This desirable effect could be particularly important for some patients, for example, for those at higher risk for endocarditis.
Therefore, this study tested if 0.12% chlorhexidine solution used as a single mouth rinse before dental instrumentation could reduce the levels of bacteria in the blood.
In addition, the occurrence and magnitude of bacteremia in patients with gum disease were investigated by two different laboratorial techniques.
After receiving verbal and written explanations and after signed the informed consent form, 80 systemically healthy volunteers diagnosed with gum disease having dental plaque and tartar were randomly allocated in one the following groups: a) mouth-rinse use and dental instrumentation and b) dental instrumentation with no mouth rinse.
In a preliminary visit volunteers underwent a complete periodontal examination which included clinical measurements (inflammatory and debris accumulation indicators), microbial (tongue and dental plaque samples collected with paper points), saliva (to determine volume and biological indicators) and gingival crevicular fluid sampling (to monitor gingival inflammation profile).
In the next visit, dental instrumentation was performed under local anesthesia, after the mouth rinse single use in the most diseased periodontal teeth/quadrant.
Blood samples were collected before any dental procedure, 2 and 6 minutes after dental instrumentation.
Oral hygiene instructions and periodontal treatment were performed in additional visits according to individual needs.
Finally, the relation between bacteremia and several indicators of periodontal status was investigated.
Aperçu de l'étude
Statut
Complété
Les conditions
Intervention / Traitement
Type d'étude
Interventionnel
Inscription (Réel)
80
Phase
- Phase 4
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Lieux d'étude
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-
SP
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Taubate, SP, Brésil, 12020330
- Nucleus of periodontal research of University of Taubate
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Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
18 ans à 45 ans (Adulte)
Accepte les volontaires sains
Non
Sexes éligibles pour l'étude
Tout
La description
Inclusion Criteria:
- mild to moderate plaque related gingivitis (gingivitis group)
- mild to moderate periodontitis (periodontitis group)
- at least 20 natural teeth
- with no recognized systemic risk related to bacteremia
- no need for antibiotic prophylaxis before dental procedures
Exclusion Criteria:
- systemic diseases or other conditions that could influence the periodontal status;
- alcohol or other drugs abuse;
- orthodontic devices;
- extended prosthetic fixed devices, removable partial dentures or overhanging restorations;
- pregnancy or breast-feeding;
- history of sensitivity or suspected allergies following the use of chlorhexidine;
- antibiotics and/or anti-inflammatory drug use in the three months prior to the beginning of the study;
- regular use of chemotherapeutic antiplaque/antigingivitis products;
- any furcation lesions;
- periodontal treatment performed within six months prior to study initiation;
- unwillingness to return for follow-up.
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: La prévention
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Quadruple
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: gingivitis mouth rinse
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Before local oral anesthesia and periodontal instrumentation individuals performed a single oral rinse (15mL of 0.12% chlorhexidine gluconate for 30 seconds).
Debridement procedures were carried out with manual Gracey and McCall curettes and Hirschfield files.
Individuals only received local oral anesthesia before periodontal instrumentation.
Debridement procedures were carried out with manual Gracey and McCall curettes and Hirschfield files.
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|
Expérimental: periodontitis mouth rinse
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Before local oral anesthesia and periodontal instrumentation individuals performed a single oral rinse (15mL of 0.12% chlorhexidine gluconate for 30 seconds).
Debridement procedures were carried out with manual Gracey and McCall curettes and Hirschfield files.
Individuals only received local oral anesthesia before periodontal instrumentation.
Debridement procedures were carried out with manual Gracey and McCall curettes and Hirschfield files.
|
|
Comparateur actif: gingivitis no mouth rinse
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Individuals only received local oral anesthesia before periodontal instrumentation.
Debridement procedures were carried out with manual Gracey and McCall curettes and Hirschfield files.
|
|
Comparateur actif: periodontitis no mouth rinse
|
Individuals only received local oral anesthesia before periodontal instrumentation.
Debridement procedures were carried out with manual Gracey and McCall curettes and Hirschfield files.
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Changes on viable bacterial levels in blood
Délai: 2 and 6 minutes
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To check a possible antimicrobial effect after a single mouth rinse use, the levels of viable anaerobic and aerobic bacterial cels were compared between 0 and 2 minutes, 0 and 6 minutes and between 2 and 6 minutes.
Blood samples were collected and spread out onto agar plates to determine total levels of aerobic and anaerobic bacteria.
Bacterial levels at 2 and 6 minutes were compared between volunteers who performed the pre-procedural rinse and who not.
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2 and 6 minutes
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Changes on levels of bacterial DNA in blood
Délai: 2 and 6 months
|
To check a possible antimicrobial effect after a single mouth rinse use, the levels of bacterial DNA in blood samples were compared between 0 and 2 minutes, 0 and 6 minutes and between 2 and 6 minutes.
Blood samples were collected and analyzed by real time PCR (polymerase chain reaction) to determine total bacterial load and levels of target periodontal pathogens.
Bacterial levels at 2 and 6 minutes were compared between volunteers who performed the pre-procedural rinse and who not.
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2 and 6 months
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Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Parrainer
Collaborateurs
Les enquêteurs
- Chercheur principal: Jose R Cortelli, PhD, University of Taubate
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude
1 août 2013
Achèvement primaire (Réel)
1 décembre 2013
Achèvement de l'étude (Réel)
1 décembre 2013
Dates d'inscription aux études
Première soumission
8 août 2014
Première soumission répondant aux critères de contrôle qualité
11 août 2014
Première publication (Estimation)
13 août 2014
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
13 août 2014
Dernière mise à jour soumise répondant aux critères de contrôle qualité
11 août 2014
Dernière vérification
1 août 2014
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
- Processus pathologiques
- Infections
- Syndrome de réponse inflammatoire systémique
- Inflammation
- Maladies stomatognathiques
- Maladies parodontales
- Maladies de la bouche
- Infections bactériennes
- Infections bactériennes et mycoses
- État septique
- Maladies gingivales
- Parodontite
- Gingivite
- Bactériémie
- Agents anti-infectieux locaux
- Agents anti-infectieux
- Agents dermatologiques
- Désinfectants
- Chlorhexidine
- Gluconate de chlorhexidine
Autres numéros d'identification d'étude
- BPP
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