Prevalence of Porphyromonas Gingivalis Fimbrial Subunit Genotype in Smokers and Nonsmokers After Periodontal Therapy

NCT ID: NCT02879903

Last Updated: 2016-08-30

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

EARLY_PHASE1

Total Enrollment

32 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-08-31

Study Completion Date

2016-12-31

Brief Summary

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The aims of the present study will be identify 5 types of fimbrial subunit genotype strains in smokers and nonsmokers with periodontitis, before and after periodontal therapy. Third two periodontitis patients will be selected to these study, 16 nonsmokers and 16 smokers. Clinical and microbiological parameters were evaluated at baseline and 3 months after periodontal treatment: Plaque Index, Bleeding On Probe, Probing Depth, Gingival Recession and Clinical Attachment Level. The prevalence of P. gingivalis and fimbrial subunit gene strains will be determined by Polymerase Chain Reaction.

Detailed Description

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Porphyromonas gingivalis is one of the most prevalent periodontopathogens present in red complex that is considered to be infectious agent causing several types of periodontal diseases. P. gingivalis has ability to invade gingival epithelial cells and can survive for extended periods of time. Fimbriae have been characterized to be key factors in adhesion, invasion, and colonization. Fimbriae are also responsible for invasion of membrane vesicles into host cells. Long fimbriae (FimA), also known as major fimbriae, are long, peritrichous, filamentous components. They have a role in initial attachment and organization of biofilms, as they act as adhesins that mediate invasion and colonization of host cells contributing to P. gingivalis virulence.

Fimbrillin (FimA; structural subunit protein of fimbriae) is classified into 5 variants (types I to V) based on their nucleotide sequences. P. gingivalis strains possessing type II fimA are correlated with P. gingivalis-positive patients, and its occurrence was significantly increased with the more severe forms of periodontitis. Previous studies evaluated the differences among the prevalence of fimA genotypes and periodontal health status in adults. P. gingivalis was detected in 36.8% of the healthy subjects and in 87.1% periodontitis patients. Among the P. gingivalis-positive healthy adults, the most prevalent fimA type was type I (76.1%), followed by type V (29.7%). In contrast, a majority of the periodontitis patients carried type II fimA organisms (66.1%), followed by type IV (28.9%). These findings indicate that there are both disease-associated and non-disease-associated strains of P. gingivalis, and that their infectious traits influencing periodontal health status could be differentiated based on the clonal variation of fimA genes.

Tobacco consumption is a risk factor for periodontal disease. Several studies have been reported that smoker habit is associated with greater clinical attachment loss, recession and tooth loss and reduced bone height and density. However, controversial report has been discussed about the differences between smokers and non-smokers periodontopathogens. P. gingivalis have been report 52.2% prevalence in non-smokers and 66.7% in smokers (pocket depth 3-5 mm) , and are associated with high levels in sites with periodontitis.

The mechanism that tobacco affects the periodontal tissue is related with nicotine that has been associated with various cellular changes that may contribute to the initiation and subsequent progression of periodontal disease. It is promote local effect like the reduction of the gingival blood flow, what can be due to long-term effects on the inflammatory lesions, higher incidence of gingival recession and others clinical parameters in smokers is correlated with cytotoxic and vasoactive substances present in tobacco, including nicotine, carbon monoxide and reactive oxidant substances and systemic effect is that smoking is responsible for 90% of cases of lung cancer, type deadliest cancer for men and women smokers, as well as being associated with various lung diseases. Furthermore, they promote oxidative stress and alterations in the immunoinflammatory responses, reducing functional activity of leucocytes, macrophages, lymphocytes and other immune cells, impaired wound healing and microbial recognition.

Nonsurgical therapy using scaling and root planning is the most usual periodontal therapy, well-recognized by the improvement in clinical and microbiological parameters. Fewer studies evaluated longitudinal clinical and microbiological status of smokers undergoing periodontal maintenance therapy and controversial results were found with absence of difference in disease progression in comparison with nonsmokers. P. gingivalis has been reduced after periodontal treatment. Previous report related reduction of 93 % to P.gingivalis for non-smokers and 88 % for smokers after periodontal treatment.

Conditions

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Chronic Periodontitis

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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biofilm tobacco effect

Group smokers - patients will receive periodontal treatment and biofilm will be collected.

Group Type EXPERIMENTAL

Periodontal treatment

Intervention Type PROCEDURE

An experienced periodontist will be performed clinical periodontal parameters, including Plaque Index, Bleeding On Probe, Pocket Probing Depth, Gingival Recession, Clinical Attachment Level using a periodontal probe, at six sites per tooth at all teeth, excluding third molars.

Quadrant scaling and root planning will be weekly performed on each patient under local anesthesia using periodontal curettes and ultrasonic scalers. The maintenance therapy will be included professional plaque control and Scaling and root planing in recurrent periodontal pockets.

Microbiological collect

Intervention Type PROCEDURE

Biofilm will be collected with the paper point to analyse presence of Porphyromonas gingivalis fimbrial subunit gene type I, II, III, IV and V.

Questionnaire

Intervention Type PROCEDURE

Age will be expressed in years Sex -female and male, will be expressed in percentage. Time of cigarette consumption - will be expressed in years

biofilm non smoker effect

Group Non Smokers - patients will receive periodontal treatment and biofilm will be collected.

Group Type EXPERIMENTAL

Periodontal treatment

Intervention Type PROCEDURE

An experienced periodontist will be performed clinical periodontal parameters, including Plaque Index, Bleeding On Probe, Pocket Probing Depth, Gingival Recession, Clinical Attachment Level using a periodontal probe, at six sites per tooth at all teeth, excluding third molars.

Quadrant scaling and root planning will be weekly performed on each patient under local anesthesia using periodontal curettes and ultrasonic scalers. The maintenance therapy will be included professional plaque control and Scaling and root planing in recurrent periodontal pockets.

Microbiological collect

Intervention Type PROCEDURE

Biofilm will be collected with the paper point to analyse presence of Porphyromonas gingivalis fimbrial subunit gene type I, II, III, IV and V.

Questionnaire

Intervention Type PROCEDURE

Age will be expressed in years Sex -female and male, will be expressed in percentage. Time of cigarette consumption - will be expressed in years

Interventions

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Periodontal treatment

An experienced periodontist will be performed clinical periodontal parameters, including Plaque Index, Bleeding On Probe, Pocket Probing Depth, Gingival Recession, Clinical Attachment Level using a periodontal probe, at six sites per tooth at all teeth, excluding third molars.

Quadrant scaling and root planning will be weekly performed on each patient under local anesthesia using periodontal curettes and ultrasonic scalers. The maintenance therapy will be included professional plaque control and Scaling and root planing in recurrent periodontal pockets.

Intervention Type PROCEDURE

Microbiological collect

Biofilm will be collected with the paper point to analyse presence of Porphyromonas gingivalis fimbrial subunit gene type I, II, III, IV and V.

Intervention Type PROCEDURE

Questionnaire

Age will be expressed in years Sex -female and male, will be expressed in percentage. Time of cigarette consumption - will be expressed in years

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

Clinical diagnosis of chronic periodontitis Consumption of 10 or more cigarettes/day.

Exclusion Criteria

Diabetes mellitus Osteoporosis Pregnant and lactating females Immune suppressive medication Phenytoin Cyclosporine Calcium channel blockers Immunotherapy or diagnosed as HIV+
Minimum Eligible Age

27 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Universidade Federal Fluminense

OTHER

Sponsor Role lead

Responsible Party

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Gabriela Alessandra da Cruz Galhardo Camargo

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

References

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Lin X, Wu J, Xie H. Porphyromonas gingivalis minor fimbriae are required for cell-cell interactions. Infect Immun. 2006 Oct;74(10):6011-5. doi: 10.1128/IAI.00797-06.

Reference Type RESULT
PMID: 16988281 (View on PubMed)

Zhao L, Wu YF, Meng S, Yang H, OuYang YL, Zhou XD. Prevalence of fimA genotypes of Porphyromonas gingivalis and periodontal health status in Chinese adults. J Periodontal Res. 2007 Dec;42(6):511-7. doi: 10.1111/j.1600-0765.2007.00975.x.

Reference Type RESULT
PMID: 17956463 (View on PubMed)

Amano A, Kuboniwa M, Nakagawa I, Akiyama S, Morisaki I, Hamada S. Prevalence of specific genotypes of Porphyromonas gingivalis fimA and periodontal health status. J Dent Res. 2000 Sep;79(9):1664-8. doi: 10.1177/00220345000790090501.

Reference Type RESULT
PMID: 11023261 (View on PubMed)

Zeller I, Hutcherson JA, Lamont RJ, Demuth DR, Gumus P, Nizam N, Buduneli N, Scott DA. Altered antigenic profiling and infectivity of Porphyromonas gingivalis in smokers and non-smokers with periodontitis. J Periodontol. 2014 Jun;85(6):837-44. doi: 10.1902/jop.2013.130336. Epub 2013 Oct 23.

Reference Type RESULT
PMID: 24147843 (View on PubMed)

Other Identifiers

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CAAE: 53022216.0.0000.5626

Identifier Type: -

Identifier Source: org_study_id

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