Mechanisms and Treatment Response of Aggressive Periodontitis in Children
NCT ID: NCT01330719
Last Updated: 2024-03-12
Study Results
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Basic Information
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COMPLETED
NA
514 participants
INTERVENTIONAL
2006-12-31
2022-12-02
Brief Summary
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Detailed Description
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If the patient has gum disease: At the initial examination, some samples will be collected: the natural fluid that comes from the gums and the bacteria that are present there will be collected by inserting a piece of paper and a filter strip in the spaces between teeth and gums; blood samples may also be taken by a phlebotomist to evaluate some inflammatory signs of disease and possible genetic markers (about 5 teaspoons at each visit); and a cheek swab may be taken by gently rubbing a little brush into the inside of the cheeks. Patients also may be asked to spit into a container we provide. Tissues from gums that are usually discarded may also be collected during treatment. When patients return for re-evaluation of their gums, all these samples may be collected again at 3, 6, 12, 18 and 24 months after the initial therapy. After 24 months, only clinical examinations may be performed, up to 3 more visits within the following 3 years.
If the patient does not have gum disease: If gums are healthy and the patient does not need treatment, they will be seen every 6 months for examination and cleanings, then sample collections may also be taken at these visits up to 24 months. These sample collections are done to be studied by genetic tests, which will tell us if there are specific genetic markers (inherited markers) associated with this disease, and also other laboratory testing, which will help the researchers identify how the body responds to bacteria. These markers will also be evaluated in family members (parents, grandparents or siblings), when possible, to check for the likelihood of these members developing this disease.
Regardless of the patient's gum condition, investigators will also evaluate current and past dental x-rays to determine if there were signs of this disease in the past.
Investigators may also take photos of the teeth and gums.
Conditions
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Study Design
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NON_RANDOMIZED
PARALLEL
PREVENTION
NONE
Study Groups
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Diseased periodontal treatment
Scaling and root planing along with systemic antibiotics (Amoxicillin 500 mg and Metronidazole 250 mg tid 7 days).
Diseased periodontal treatment
Treatment includes scaling and root planing with systemic antibiotics, Amoxicillin 500 mg and Metronidazole 250 mg tid 7 days. At certain intervals after the scaling and root planing, your gums will be reevaluated. You will receive further surgical gum therapy only if your gums haven't shown improvement after first treatment on the reevaluation appointments. If surgery is needed, a bone substituting material may be necessary to "fill" the spaces where bone has been destroyed by the disease. Extraction of teeth might also be part of gum treatment if the disease is very severe. Re-treatment with antibiotics also may be necessary depending on the response after treatment. You are usually re-examined and receive additional cleanings every 3 to 6 months to ensure the disease does not come back.
Conventional periodontal treatment
Standard periodontal prophylaxis
Conventional periodontal treatment
Scaling and gum measurement will be taken to compare to the treated group.- If it is determined that you do not have this disease, a conventional cleaning is done, usually every 6 months. This is all part of normal clinical care.
Interventions
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Diseased periodontal treatment
Treatment includes scaling and root planing with systemic antibiotics, Amoxicillin 500 mg and Metronidazole 250 mg tid 7 days. At certain intervals after the scaling and root planing, your gums will be reevaluated. You will receive further surgical gum therapy only if your gums haven't shown improvement after first treatment on the reevaluation appointments. If surgery is needed, a bone substituting material may be necessary to "fill" the spaces where bone has been destroyed by the disease. Extraction of teeth might also be part of gum treatment if the disease is very severe. Re-treatment with antibiotics also may be necessary depending on the response after treatment. You are usually re-examined and receive additional cleanings every 3 to 6 months to ensure the disease does not come back.
Conventional periodontal treatment
Scaling and gum measurement will be taken to compare to the treated group.- If it is determined that you do not have this disease, a conventional cleaning is done, usually every 6 months. This is all part of normal clinical care.
Eligibility Criteria
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Inclusion Criteria
* In good general health as evidenced by medical history
* Diagnosed with localized aggressive periodontitis (LAP), defined by the presence of attachment loss ≥ 2mm and detected bone loss on at least two sites, involving first molars and/or incisors, or
* Periodontally healthy (defined by absence of clinical signs of periodontitis) related or not to LAP participants
Inclusion parent /grandparent:
* Male or female, up to age 90 years
* Parent or grandparent of an enrolled participant with LAP
Exclusion child/adolescent:
* Diagnosed with any systemic diseases or conditions that could influence the progression and/or clinical characteristics of periodontal disease (i.e., immunosuppression, diabetes, neutropenia or blood disorders).
* Patients that have taken antibiotics within the last 3 months\* or require antibiotic prophylaxis prior to initial visit.
* Patients that are currently taking medications that could influence the characteristics or response to periodontal treatment (example: immune-suppressive drugs, such as cyclosporine or steroids).
* Smokers (≥10 cigarettes a day for over 6 months)
* Pregnant/lactating women as pregnancy causes gingival changes that could confound study results.
* Any psychiatric conditions that will inhibit participants from proper understanding of study procedures as determined by the PI/clinician investigator.
* Patients may still enroll but will be scheduled for initial visit 3 months later
Exclusion parent/grandparent:
* Patients that have taken antibiotics within the last 3 months\* or require antibiotic prophylaxis prior to initial visit.
* Pregnant/lactating women as pregnancy causes gingival changes that could confound study results.
* Any psychiatric conditions that will inhibit participants from proper understanding of study procedures as determined by the PI/clinician investigator.
5 Years
90 Years
ALL
Yes
Sponsors
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National Institute of Dental and Craniofacial Research (NIDCR)
NIH
University of Florida
OTHER
Responsible Party
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Principal Investigators
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Ikramuddin Aukhil
Role: PRINCIPAL_INVESTIGATOR
University of Florida
Locations
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Acorn Dental Clinic
Brooker, Florida, United States
Broward College
Fort Lauderdale, Florida, United States
Dental Clinical Research Unit, University of Florida
Gainesville, Florida, United States
Azalea Dental Clinic
Gainesville, Florida, United States
UF Hialeah Dental Clinic
Hialeah, Florida, United States
Duval County Department of Health
Jacksonville, Florida, United States
UF Naples Pediatric Dental Clinic
Naples, Florida, United States
Gadsden County Health Department--Quincy Dental Clinic
Quincy, Florida, United States
Leon County Health Department
Tallahassee, Florida, United States
University of Kentucky
Lexington, Kentucky, United States
Countries
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References
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Albandar JM. Epidemiology and risk factors of periodontal diseases. Dent Clin North Am. 2005 Jul;49(3):517-32, v-vi. doi: 10.1016/j.cden.2005.03.003.
Albandar JM, Tinoco EM. Global epidemiology of periodontal diseases in children and young persons. Periodontol 2000. 2002;29:153-76. doi: 10.1034/j.1600-0757.2002.290108.x. No abstract available.
Albandar JM. Juvenile periodontitis--pattern of progression and relationship to clinical periodontal parameters. Community Dent Oral Epidemiol. 1993 Aug;21(4):185-9. doi: 10.1111/j.1600-0528.1993.tb00753.x.
Sweeney EA, Alcoforado GA, Nyman S, Slots J. Prevalence and microbiology of localized prepubertal periodontitis. Oral Microbiol Immunol. 1987 Jun;2(2):65-70. doi: 10.1111/j.1399-302x.1987.tb00292.x.
Zambon JJ, Christersson LA, Slots J. Actinobacillus actinomycetemcomitans in human periodontal disease. Prevalence in patient groups and distribution of biotypes and serotypes within families. J Periodontol. 1983 Dec;54(12):707-11. doi: 10.1902/jop.1983.54.12.707.
Page RC, Baab DA. A new look at the etiology and pathogenesis of early-onset periodontitis. Cementopathia revisited. J Periodontol. 1985 Dec;56(12):748-51. doi: 10.1902/jop.1985.56.12.748.
Agarwal S, Suzuki JB, Riccelli AE. Role of cytokines in the modulation of neutrophil chemotaxis in localized juvenile periodontitis. J Periodontal Res. 1994 Mar;29(2):127-37. doi: 10.1111/j.1600-0765.1994.tb01101.x.
Christersson LA, Slots J, Rosling BG, Genco RJ. Microbiological and clinical effects of surgical treatment of localized juvenile periodontitis. J Clin Periodontol. 1985 Jul;12(6):465-76. doi: 10.1111/j.1600-051x.1985.tb01382.x.
Shaddox L, Wiedey J, Bimstein E, Magnuson I, Clare-Salzler M, Aukhil I, Wallet SM. Hyper-responsive phenotype in localized aggressive periodontitis. J Dent Res. 2010 Feb;89(2):143-8. doi: 10.1177/0022034509353397. Epub 2009 Dec 30.
Koutouzis T, Haber D, Shaddox L, Aukhil I, Wallet SM. Autoreactivity of serum immunoglobulin to periodontal tissue components: a pilot study. J Periodontol. 2009 Apr;80(4):625-33. doi: 10.1902/jop.2009.080422.
Alfant B, Shaddox LM, Tobler J, Magnusson I, Aukhil I, Walker C. Matrix metalloproteinase levels in children with aggressive periodontitis. J Periodontol. 2008 May;79(5):819-26. doi: 10.1902/jop.2008.070513.
Shaddox LM, Wiedey J, Calderon NL, Magnusson I, Bimstein E, Bidwell JA, Zapert EF, Aukhil I, Wallet SM. Local inflammatory markers and systemic endotoxin in aggressive periodontitis. J Dent Res. 2011 Sep;90(9):1140-4. doi: 10.1177/0022034511413928. Epub 2011 Jul 5.
Shaddox LM, Huang H, Lin T, Hou W, Harrison PL, Aukhil I, Walker CB, Klepac-Ceraj V, Paster BJ. Microbiological characterization in children with aggressive periodontitis. J Dent Res. 2012 Oct;91(10):927-33. doi: 10.1177/0022034512456039. Epub 2012 Aug 3.
Beliveau D, Magnusson I, Bidwell JA, Zapert EF, Aukhil I, Wallet SM, Shaddox LM. Benefits of early systemic antibiotics in localized aggressive periodontitis: a retrospective study. J Clin Periodontol. 2012 Nov;39(11):1075-81. doi: 10.1111/jcpe.12001. Epub 2012 Aug 29.
Goncalves PF, Huang H, McAninley S, Alfant B, Harrison P, Aukhil I, Walker C, Shaddox LM. Periodontal treatment reduces matrix metalloproteinase levels in localized aggressive periodontitis. J Periodontol. 2013 Dec;84(12):1801-8. doi: 10.1902/jop.2013.130002. Epub 2013 Mar 28.
Branco-de-Almeida LS, Cruz-Almeida Y, Gonzalez-Marrero Y, Kudsi R, de Oliveira ICV, Dolia B, Huang H, Aukhil I, Harrison P, Shaddox LM. Treatment of localized aggressive periodontitis alters local host immunoinflammatory profiles: A long-term evaluation. J Clin Periodontol. 2021 Feb;48(2):237-248. doi: 10.1111/jcpe.13404. Epub 2020 Dec 16.
Velsko IM, Harrison P, Chalmers N, Barb J, Huang H, Aukhil I, Shaddox L. Grade C molar-incisor pattern periodontitis subgingival microbial profile before and after treatment. J Oral Microbiol. 2020 Sep 13;12(1):1814674. doi: 10.1080/20002297.2020.1814674.
Harris TH, Wallace MR, Huang H, Li H, Shaddox LM. Associations of P2RX7 Functional Diplotypes with Localized Aggressive Periodontitis. JDR Clin Trans Res. 2019 Oct;4(4):342-351. doi: 10.1177/2380084419863789. Epub 2019 Jul 18.
Shaddox LM, Mullersman AF, Huang H, Wallet SM, Langaee T, Aukhil I. Epigenetic regulation of inflammation in localized aggressive periodontitis. Clin Epigenetics. 2017 Sep 2;9:94. doi: 10.1186/s13148-017-0385-8. eCollection 2017.
Branco-de-Almeida LS, Cruz-Almeida Y, Gonzalez-Marrero Y, Huang H, Aukhil I, Harrison P, Wallet SM, Shaddox LM. Local and Plasma Biomarker Profiles in Localized Aggressive Periodontitis. JDR Clin Trans Res. 2017 Jul;2(3):258-268. doi: 10.1177/2380084417701898. Epub 2017 Apr 14.
Burgess D, Huang H, Harrison P, Aukhil I, Shaddox L. Aggregatibacter actinomycetemcomitans in African Americans with Localized Aggressive Periodontitis. JDR Clin Trans Res. 2017 Jul;2(3):249-257. doi: 10.1177/2380084417695543. Epub 2017 Mar 1.
Burgess DK, Huang H, Harrison P, Kompotiati T, Aukhil I, Shaddox LM. Non-Surgical Therapy Reduces Presence of JP2 Clone in Localized Aggressive Periodontitis. J Periodontol. 2017 Dec;88(12):1263-1270. doi: 10.1902/jop.2017.170285. Epub 2017 Aug 18.
Miller KA, Branco-de-Almeida LS, Wolf S, Hovencamp N, Treloar T, Harrison P, Aukhil I, Gong Y, Shaddox LM. Long-term clinical response to treatment and maintenance of localized aggressive periodontitis: a cohort study. J Clin Periodontol. 2017 Feb;44(2):158-168. doi: 10.1111/jcpe.12640. Epub 2016 Dec 27.
Shaddox LM, Spencer WP, Velsko IM, Al-Kassab H, Huang H, Calderon N, Aukhil I, Wallet SM. Localized aggressive periodontitis immune response to healthy and diseased subgingival plaque. J Clin Periodontol. 2016 Sep;43(9):746-53. doi: 10.1111/jcpe.12560. Epub 2016 Jul 15.
Allin N, Cruz-Almeida Y, Velsko I, Vovk A, Hovemcamp N, Harrison P, Huang H, Aukhil I, Wallet SM, Shaddox LM. Inflammatory Response Influences Treatment of Localized Aggressive Periodontitis. J Dent Res. 2016 Jun;95(6):635-41. doi: 10.1177/0022034516631973. Epub 2016 Feb 25.
Merchant SN, Vovk A, Kalash D, Hovencamp N, Aukhil I, Harrison P, Zapert E, Bidwell J, Varnado P, Shaddox LM. Localized aggressive periodontitis treatment response in primary and permanent dentitions. J Periodontol. 2014 Dec;85(12):1722-9. doi: 10.1902/jop.2014.140171.
Goncalves PF, Klepac-Ceraj V, Huang H, Paster BJ, Aukhil I, Wallet SM, Shaddox LM. Correlation of Aggregatibacter actinomycetemcomitans detection with clinical/immunoinflammatory profile of localized aggressive periodontitis using a 16S rRNA microarray method: a cross-sectional study. PLoS One. 2013 Dec 23;8(12):e85066. doi: 10.1371/journal.pone.0085066. eCollection 2013.
Shaddox LM, Goncalves PF, Vovk A, Allin N, Huang H, Hou W, Aukhil I, Wallet SM. LPS-induced inflammatory response after therapy of aggressive periodontitis. J Dent Res. 2013 Aug;92(8):702-8. doi: 10.1177/0022034513495242. Epub 2013 Jun 20.
Other Identifiers
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IRB201400349-N
Identifier Type: -
Identifier Source: org_study_id
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