Role of Stress Reduction Protocol on Outcome of Periodontal Therapy

NCT ID: NCT02487862

Last Updated: 2015-11-24

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

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-02-28

Study Completion Date

2015-12-31

Brief Summary

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Psychological conditions, particularly psychosocial stress, have been implicated as risk indicators for periodontal disease. Minimal evidence in literature exists to assess the effect of stress reduction therapy (SRT) in the outcome of non-surgical periodontal therapy (NSPT). Hence, the present study was aimed at exploring the possibility of employing SRT in stressed subjects (assessed using questionnaire data and serum cortisol level) as an adjunctive intervention in the management of periodontal diseases.

Detailed Description

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Periodontitis is a multifactorial disease where microbial dental biofilms are considered to be a key etiological agent for the initiation \& progression of the inflammatory process. Apart from the microbial biofilms, several other risk factors have been associated with increased susceptibility, progression and severity of periodontal diseases such as systemic diseases, genetic polymorphisms, socio-economic or educational status, tobacco smoking, oral hygiene level and psychological stress.

With respect to other possible factors influencing chronic periodontitis, more direct evidence has emerged that stress, depression and anxiety contribute to the development of periodontitis in odds ratio of 1:2. Further, it has been shown that subjects with stress are more prone to develop periodontal disease than subjects without stress. It is speculated that chronic stress contribute to the development of periodontitis by having a net negative effect on the immunological response of body or by health related risk behaviors such as smoking, over eating and lessen compliance with the preventive behavior or even both. In addition, it has been found that patients experiencing stress were slower in recovery from periodontal treatment compared to subjects who are not experiencing stress.

Interestingly, the impact of stress on the pathogenesis and periodontal treatment outcomes depends upon the individuals coping ability. Literature evidence shows that emotional-focused coping individuals (defensive coping, resigned coping, distractive coping which are advantageous in the short term) have more advanced disease and poor response to non-surgical periodontal treatment when compared to problem focused coping (i.e. active coping). Hence, assessment of a patient's stress level, their coping ability and stress management might be of value in understanding psychological effects on periodontal health and its disease process, which will be helpful in future preventive care. Considering these facts, we hypothesize that if stress is causally related to the worsening of parameters in a chronic periodontitis patient, its alleviation might result in an additive response to the conventional periodontal therapy. However, till date, there are no intervention studies on possibility of employing psychological intervention (stress reduction therapy) as adjunctive measure in the treatment of periodontitis subjects with unfavorable psychological background. Hence, considering this hypothesis, the present study is conducted which is first of its kind, to explore and evaluate, if intervention focused on stress management enhancement training may serve as adjunctive role in non-surgical treatment of periodontal diseases by monitoring the improvements in periodontal condition through clinical parameters and correlating with stress marker like salivary cortisol levels and Derogatis stress profile (DSP) scores.

Conditions

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Combat and Operational Stress Reaction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Screening

Participants were screened for the inclusion and exclusion criteria to select the study group. No intervention has been done.

Group Type NO_INTERVENTION

No interventions assigned to this group

catagerizing the study population

The selected participants where assigned into respective groups

Group Type PLACEBO_COMPARATOR

Stress Reduction Protocol

Intervention Type BEHAVIORAL

Stress Reduction Protocol

Stress Reduction Protocol

Participants were evaluated for the outcome of the intervention.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Stress Reduction Protocol

Stress Reduction Protocol

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* patients within the age group of 30 to 55 years,
* systemically healthy stressed \& unstressed individuals with chronic periodontitis and
* who were co-operative and willing to attend follow up visits

Exclusion Criteria

* patients on corticosteroids and antipsychotic drug therapy,
* who had received any periodontal therapy,
* surgical or non- surgical within the past six months of baseline examination,
* Smokers,
* no prior history of non-surgical periodontal therapy within 6 months,
* with less than 20 permanent teeth remaining,
* history of psychiatric treatment within past 6 months,
* known systemic diseases and conditions.
Minimum Eligible Age

30 Years

Maximum Eligible Age

55 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

Yes

Sponsors

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Krishnadevaraya College of Dental Sciences & Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Karthikeyan BV, MDS

Role: STUDY_DIRECTOR

Krishnadevaraya College of Dental Sciences

Locations

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Krishnadevaraya College of dental sciences

Banglore, Karnataka, India

Site Status RECRUITING

Countries

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India

Central Contacts

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Karthikeyan BV, MDS

Role: CONTACT

+919449545157

Facility Contacts

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Karthikeyan BV, MDS

Role: primary

+919449545157

References

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Kiecolt-Glaser JK, Preacher KJ, MacCallum RC, Atkinson C, Malarkey WB, Glaser R. Chronic stress and age-related increases in the proinflammatory cytokine IL-6. Proc Natl Acad Sci U S A. 2003 Jul 22;100(15):9090-5. doi: 10.1073/pnas.1531903100. Epub 2003 Jul 2.

Reference Type RESULT
PMID: 12840146 (View on PubMed)

Related Links

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Other Identifiers

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KCDS

Identifier Type: -

Identifier Source: org_study_id