Mechanisms and Treatment Response of Aggressive Periodontitis in Children

NCT ID: NCT01330719

Last Updated: 2024-03-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

514 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-12-31

Study Completion Date

2022-12-02

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Although of low prevalence, aggressive periodontitis is a rapid destructive form of periodontal disease that initiates at a young age, leading to premature loss of first molars and incisors. Little is known on the mechanisms of this disease. It is imperative to understand mechanisms of disease to establish proper treatment. We have established a controlled study in a comparable population presenting similar aggressive disease characteristics to evaluate the mechanisms of this disease. It is the goal of this study to determine immunological and microbiological mechanisms responsible for the rapid tissue destruction in children with localized aggressive periodontitis and how traditional periodontal intervention affects these mechanisms. Important knowledge gained with this proposal will aid in defining specific treatment approaches to better control disease progression and prevent disease initiation in susceptible individuals.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

There a multiple appointments throughout the study which can vary depending upon if a patient has the disease present or not.

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

See the medical conditions and disease areas that this research is targeting or investigating.

Aggressive Periodontitis

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Diseased periodontal treatment

Scaling and root planing along with systemic antibiotics (Amoxicillin 500 mg and Metronidazole 250 mg tid 7 days).

Group Type EXPERIMENTAL

Diseased periodontal treatment

Intervention Type PROCEDURE

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

Group Type ACTIVE_COMPARATOR

Conventional periodontal treatment

Intervention Type PROCEDURE

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

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

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.

Intervention Type PROCEDURE

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.

Intervention Type PROCEDURE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Male or female, aged 5 to 25
* 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.
Minimum Eligible Age

5 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

National Institute of Dental and Craniofacial Research (NIDCR)

NIH

Sponsor Role collaborator

University of Florida

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Ikramuddin Aukhil

Role: PRINCIPAL_INVESTIGATOR

University of Florida

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Acorn Dental Clinic

Brooker, Florida, United States

Site Status

Broward College

Fort Lauderdale, Florida, United States

Site Status

Dental Clinical Research Unit, University of Florida

Gainesville, Florida, United States

Site Status

Azalea Dental Clinic

Gainesville, Florida, United States

Site Status

UF Hialeah Dental Clinic

Hialeah, Florida, United States

Site Status

Duval County Department of Health

Jacksonville, Florida, United States

Site Status

UF Naples Pediatric Dental Clinic

Naples, Florida, United States

Site Status

Gadsden County Health Department--Quincy Dental Clinic

Quincy, Florida, United States

Site Status

Leon County Health Department

Tallahassee, Florida, United States

Site Status

University of Kentucky

Lexington, Kentucky, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

References

Explore related publications, articles, or registry entries linked to this study.

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.

Reference Type BACKGROUND
PMID: 15978239 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 12102707 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 8370252 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 10870470 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 6358452 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 3866058 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 8158501 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 3894435 (View on PubMed)

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.

Reference Type RESULT
PMID: 20042739 (View on PubMed)

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.

Reference Type RESULT
PMID: 19335083 (View on PubMed)

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.

Reference Type RESULT
PMID: 18454660 (View on PubMed)

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.

Reference Type RESULT
PMID: 21730256 (View on PubMed)

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.

Reference Type RESULT
PMID: 22863892 (View on PubMed)

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.

Reference Type RESULT
PMID: 22931240 (View on PubMed)

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.

Reference Type RESULT
PMID: 23537121 (View on PubMed)

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.

Reference Type DERIVED
PMID: 33205510 (View on PubMed)

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.

Reference Type DERIVED
PMID: 33062199 (View on PubMed)

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.

Reference Type DERIVED
PMID: 31319038 (View on PubMed)

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.

Reference Type DERIVED
PMID: 28883894 (View on PubMed)

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.

Reference Type DERIVED
PMID: 28879248 (View on PubMed)

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.

Reference Type DERIVED
PMID: 28879247 (View on PubMed)

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.

Reference Type DERIVED
PMID: 28820321 (View on PubMed)

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.

Reference Type DERIVED
PMID: 27767222 (View on PubMed)

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.

Reference Type DERIVED
PMID: 27037664 (View on PubMed)

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.

Reference Type DERIVED
PMID: 26917438 (View on PubMed)

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.

Reference Type DERIVED
PMID: 25186780 (View on PubMed)

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.

Reference Type DERIVED
PMID: 24376864 (View on PubMed)

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.

Reference Type DERIVED
PMID: 23788609 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

R01DE019456

Identifier Type: NIH

Identifier Source: secondary_id

View Link

IRB201400349-N

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.