Impact of Periodontal Treatment on Serum Levels of Hepcidin and Hemoglobin
NCT ID: NCT02641210
Last Updated: 2015-12-29
Study Results
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Basic Information
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COMPLETED
PHASE4
63 participants
INTERVENTIONAL
2015-01-31
2015-10-31
Brief Summary
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Detailed Description
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The study was approved by the Ethics Committee on Human Research of the Federal University of Maranhão, São Luís, MA, Brazil under the protocol number 23115-010215 / 2011-16. All participants signed the consent form.
The sample size was defined on the basis of previous studies on the association between chronic periodontitis and systemic inflammatory markers.
All participants received an oral hygiene kit, attended a motivational speech with instructions on tooth brushing and flossing, and they were later referred for dental care.
At first visit, the medical record was checked for selecting volunteers without pre-diagnosed systemic diseases, in addition the general and periodontal clinical examination were performed, the urine collector was delivered, and drug intake \[Albendazole 400 mg as a single dose\]. After 15 days, subjects who met the initial selection criteria were sent for blood and urine collection for evaluation of biochemical markers. According to the results of laboratory tests, subjects were maintained or excluded after verification of those diagnosed with systemic diseases not previously identified.
The anamnesis and periodontal examination were carried out by a single trained examiner.It was collected the current and past medical and dental history, family history, social data, medications, possible changes of the menstrual flow, measurement of blood pressure, weight, height, and body mass index.
Oral clinical examination was also performed to diagnose the periodontal status of the participants. Then they were referred for dental care, according to their treatment needs.
After the therapy used, new clinical examination of the oral health of all participants was conducted 90 days after treatment. In the same period, new blood collection was performed for reassessment of biochemical markers.
The periodontal clinical examination used a periodontal probe type Williams in six sites per tooth (mesiobuccal, mid-buccal, it -vestibular, distolingual, medium-lingual, mesiolingual), performed by a single observer, dental surgeon, specialist in periodontics and previously trained. The intra-examiner concordance coefficient was 0.81 for probing depth and 0.77 for clinical attachment level. The following clinical parameters were evaluated: Probing depth (PD), gingival recession (GR), clinical attachment level (CAL), Visible Plaque Index (VPI), Bleeding on probing (BOP). This same examination at baseline was repeated 90 days after the initial examination and included the same clinical periodontal parameters.
Individuals who had at least two teeth with probing depth ≥ 5 mm and clinical attachment level ≥ 6 mm, associated with the presence of bleeding on probing, in the same site, 30 seconds after the first insertion probe, were diagnosed with periodontitis.
Blood samples (20ml) were collected in Ethylenediaminetetraacetic acid (EDTA) tubes after 12 hours fasting. The remainder of the EDTA-anticoagulated blood was centrifuged for 10 minutes at 3000 rpm to separate the plasma, aliquoted and stored at -70 until further analysis of the IL-6 concentrations.
The following laboratory tests were performed: total cholesterol, fasting glucose, triglycerides, albumin, glutamate oxalate transaminase, creatinine, uric acid, erythrocyte sedimentation rate (ESR), CRP, IL-6, Hepcidin, Serum Iron, Ferritin, Transferrin saturation, Blood parameters (hemoglobin, hematocrit, mean corpuscular volume - MCV, MCH), and urinalysis for abnormal elements and sediment (EAS).
Serum was obtained by addition of venous blood into a tube containing an activator of coagulation. After centrifugation for 15 minutes at 1800 rpm, the serum was separated. Serum was aliquoted piece for colorimetric evaluation of ferritin by chemiluminescence technique; serum iron and Ferrozine technique and transferrin saturation index, Goodwin's modified technique. The nephelometric was used for C-reactive protein of dosages and serum was stored at -70 °C remaining for analysis of hepcidin.
IL-6 and hepcidin were evaluated by the technique of immunoassay using ELISA kit, according to the manufacturer's instructions. Readings were made by automatic microplate reader and the absorbance was read at a wavelength of 450 nm in the spectrophotometer.
For statistical analysis, the investigators used a statistical software. Initially, there was a descriptive analysis through frequency measures, mean and standard deviation, median and interquartile range. Categorical variables were compared among groups using the chi-square test. The normal distribution of numerical variables was assessed Shapiro-Wilk test. The inferential analysis was made to assess the impact of the periodontal treatment on blood count variables, inflammatory markers, iron and periodontal parameters, used the paired Student's t test or the Wilcoxon test, and comparing the corresponding absolute delta between groups using the Mann-Whitney test. The significance level was set at 5%.
Conditions
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Keywords
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Study Design
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NON_RANDOMIZED
PARALLEL
TREATMENT
NONE
Study Groups
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Periodontal Treatment
The experimental group underwent nonsurgical periodontal therapy, performed by a single professional who performed the scaling and root planing procedures under local anesthesia using an ultrasonic device and Gracey and mini Gracey curettes, with Robson polishing brush and prophylactic paste. This therapy was performed in two sessions at seven day intervals, with no time limit, according to the needs of each periodontal condition. In each session, subjects received oral hygiene instruction (OHI) for use of toothbrushes for the modified Bass technique, dental floss and other complementary means (interdental brush, single tuft brush, electric toothbrush, etc.) when necessary. Supportive periodontal therapy was performed in 30, 60 and 90 days. Albendazole administration.
Periodontal Treatment
Periodontal Treatment using Gracey curettes and ultrasonic device.
Albendazole
All participants took Albendazole 400 mg before the intervention.
No Periodontal Treatment
Individuals in the control group underwent only the polishing of tooth surfaces with Robson brush and prophylactic paste fine-grained and topical fluoride application. After 90 days, they were reassessed with the same parameters of clinical examination of the baseline.
No interventions assigned to this group
Interventions
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Periodontal Treatment
Periodontal Treatment using Gracey curettes and ultrasonic device.
Albendazole
All participants took Albendazole 400 mg before the intervention.
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* Aged 30-65 years
* Without other chronic systemic diseases except periodontitis
* At least 20 teeth
Exclusion Criteria
* Congestive heart failure
* Chronic kidney disease
* Malignant neoplasms
* Acquired immunodeficiency syndrome
* Hypertension
* Pregnant women
* Nursing mothers
* Immunosuppressed by medication
* Women with changes in menstrual flow
* Smokers or ex-smokers for less than 10 years
* Usage history of NSAIDs or nonsteroidal and antibiotics within 3 months prior to the study and during the search
* Iron replacement in patients to treat anemia and carrying out subgingival scaling and periodontal surgery in 6 months prior to investigation.
30 Years
65 Years
ALL
Yes
Sponsors
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Federal University of Maranhao
OTHER
Responsible Party
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Sandra Augusta de Moura Leite
Professor in Federal University of Maranhao
Other Identifiers
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23115-010215/2011-16
Identifier Type: -
Identifier Source: org_study_id