Effectiveness of Non-surgical Periodontal Treatment on HbA1c Levels in a Patient With Type 2 Diabetes Mellitus

NCT ID: NCT04051866

Last Updated: 2023-09-14

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

WITHDRAWN

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2022-12-02

Study Completion Date

2023-12-15

Brief Summary

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This study evaluates the effectiveness of an intervention, non-surgical periodontal treatment (SPR), in patients with poorly controlled type 2 diabetes mellitus and moderate-severe periodontal disease aimed at reducing HbA1c levels at 12 months compared with the usual practice in Primary Health Care.

Detailed Description

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Design: Pragmatic cluster randomized clinical trial with 12 months follow-up. Unit of randomization: dentist. Setting: Primary Health Care Centers in one Spanish region (Madrid) Population: Patients ≥ 35 years of age with moderate-severe periodontal disease and diagnosed with type 2 diabetes with por control (HbA1c \> 7,5). N=288 patients (144 in each arm) will be recruited by dentist before randomization.

Intervention: Both groups will receive education on oral hygiene measures. The experimental group will receive the non-surgical periodontal treatment at the beginning of the study and the control group at the end of the study.

Conditions

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Chronic Periodontitis Diabetes Mellitus, Type 2

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The sample size has been calculated to estimate a difference of at least 0.4% units between groups in the change of HbA1c at 12 months.

By means of a list of the patients assigned in the usual practice to each participating dentist, who meets the inclusion criteria, and they will be contacted in the resulting order after carrying out a randomization of each list.

Once it has been confirmed that it meets the inclusion criteria and accepted the participation in it, a simple random assignment, with balanced groups, will be used, automatically implemented in the electronic data collection notebook.

The intervention can not be masked, however the main result is measured through an analytical parameter (HbA1c), minimizing the possibility of information bias.

To reduce the possible variability due to the different observers, a training and calibration session will be developed.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Intervention can't be masked. Statistician conducting the analysis will not know to which study arm a given patient has been assigned.

Study Groups

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Control

Usual care (provided in Primary Health Care Centres) Oral hygiene instructions

Group Type OTHER

Oral hygiene instructions

Intervention Type OTHER

Education for individual health regarding peridontal disease and its association with diabetes, as well as oral hygiene instructions that include the modified Bass technique, use of interproximal brushes and dental floss

Intervention

Usual care (provided in Primary Health Care Centres) Non-surgical periodontal treatment: Scaling and root planing (SRP) Oral hygiene instructions

Group Type EXPERIMENTAL

Non-surgical periodontal treatment: Scaling and root planing (SRP)

Intervention Type PROCEDURE

Removal of dental plaque and dental calculus from the surface of a tooth, from the surface of a tooth apical to the gingival margin accumulated in periodontal pockets, or from the surface coronal to the gingival margin.

Oral hygiene instructions

Intervention Type OTHER

Education for individual health regarding peridontal disease and its association with diabetes, as well as oral hygiene instructions that include the modified Bass technique, use of interproximal brushes and dental floss

Interventions

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Non-surgical periodontal treatment: Scaling and root planing (SRP)

Removal of dental plaque and dental calculus from the surface of a tooth, from the surface of a tooth apical to the gingival margin accumulated in periodontal pockets, or from the surface coronal to the gingival margin.

Intervention Type PROCEDURE

Oral hygiene instructions

Education for individual health regarding peridontal disease and its association with diabetes, as well as oral hygiene instructions that include the modified Bass technique, use of interproximal brushes and dental floss

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of type 2 diabetes (code CIAP-2 T90)
* With at least one determination of HbA1c in the last 3 months HbA1c\> 7.5%
* No changes in hypoglycemic or insulin treatment in the last 3 months.
* With generalized moderate-severe chronic periodontal disease.
* Presence of at least 16 natural teeth.
* Informed consent.

Exclusion Criteria

* Patients with basic systemic diseases with oral involvement (autoimmune diseases of oral involvement: oral lichen planus, lupus, pemphigus, pemphigoid)
* Limited life expectancy.
* Urgent diabetic complications in the 30 days prior to the study.
* They need extensive oral treatment: fistulous trajectories, cellulitis, pulpitis or other oral infections.
* Pregnant, with desire for pregnancy in the 12 months of study or breastfeeding.
* That they have received periodontal treatment in the last 6 months.
* That they have received antibiotic and / or anti-inflammatory regimen continued at least in the last 4 weeks prior to the study (except low doses of acetylsalicylic acid).
* In treatment with corticosteroids or immunosuppressive drugs.
* On dialysis or risk of bleeding (anticoagulant treatment).
* Dependent on alcohol.
* Patients who require antibiotic prophylaxis for the realization of SPR.
* Patients with uncontrolled systemic diseases (with the exception of diabetes): cardiovascular, lung, liver, kidney disease in advanced stages or neoplasms.
Minimum Eligible Age

35 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Gerencia de Atención Primaria, Madrid

OTHER_GOV

Sponsor Role lead

Responsible Party

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Juan Ignacio Ropero Pires

Dentist. Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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María Trinidad García Vázquez, Dentist, PhD

Role: PRINCIPAL_INVESTIGATOR

Gerencia de Atención Primaria

Locations

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Gerencia de Atención Primaria

Madrid, , Spain

Site Status

Countries

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Spain

Other Identifiers

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CCI 20/18

Identifier Type: -

Identifier Source: org_study_id

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