Effect of Omega 3 as an Immunomodulator Adjunct to Periodontal Debridement
NCT ID: NCT04389931
Last Updated: 2020-05-21
Study Results
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Basic Information
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COMPLETED
NA
18 participants
INTERVENTIONAL
2016-03-31
2016-10-31
Brief Summary
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Detailed Description
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Randomization: Only the main investigator, who made the randomization by using the Epidat 4.0 program, had knowledge about the content of the containers and the group to which each patient belonged in the study, therefore, was in charge of labeling the containers, achieving in this way that collaborators and participants in the investigation did not know their content until after the study was finished. Standardization and calibration: The data was collected using instruments and supplies with the same commercial brands, in a single chair, under the same lighting and by a single examiner in the case of clinical data and another examiner for microbiological variables. The complete process of PCR was performed by a biochemist belonging to the microbiology laboratory, Santiago campus of the UNAB. An interexaminer calibration was performed, where the only clinical examiner was calibrated by a specialist in periodontics, recording the data obtained in a calibration sheet. For this, a minimum of 10 subjects were evaluated, in which a site of one tooth belonging to each quadrant was randomly selected. Periodontopathogens: The presence of periodontopathogens was considered when exposing the agarose gel of the electrophoresis to ultraviolet light, a band at the site of the 197 base pairs (bp) was observed in the lane possessing the patient's subgingival bioflora sample of Pg, 316 base pairs for Td, 745 for Tf and 167 for Fn. Data collection and instrument: Prior to the data collection, all subjects belonging to the study were asked for a panoramic radiograph for diagnostic purposes. Subsequently, the periodontal examination was performed registering the clinical variables described above in a clinical record. Obtaining microbiological samples: The microbiological examination was performed before SRP on both groups. The collection of microbiological samples was based on a protocol that is used at the University of Chile. Using sterile paper cones number 40, a sample of subgingival biofilm was taken from the site with the highest CAL, within those with PD ≥ 5mm, and an oral hygiene instruction was performed. Before the collection of subgingival biofilm, the area was cleaned with a sterile gauze to eliminate the supragingival biofilm. Then, with a tweezer, a paper cone was taken, and its tip was placed in the sulcus of the study site for 20 seconds, to ensure the absorption of the crevicular fluid and subgingival biofilm. Each biological sample obtained was suspended in an Eppendorf tube with 1 ml of distilled water and transported in a refrigerator at a temperature of 4°C approximately, within a time not exceeding 3 hours, to be then temporarily stored at -80°C, until its transfer and subsequent extraction of deoxyribonucleic acid (DNA) and PCR technique processing. The time between sampling and DNA extraction did not exceed 48 hours, to avoid deterioration of the biological material. Periodontal Treatment: Once the preliminary collection of all the variables was completed, non-surgical periodontal treatment was carried out, beginning with supra and subgingival full-mouth decontamination, using an electric piezo (DTE®, Guilin Woodpecker Medical Instrument Co., Ltd., Guilin, Guangxi , People's Republic of China), followed by root planning at sites presenting PD ≥ 5mm and CAL≥ 4mm, using Gracey curettes (Hu-Friedy® Manufacturing Inc., Chicago, Illinois (IL), USA). This therapy was performed in all patients, both in the intervention and control group, under full mouth treatment protocol, in 1 or 2 work sessions, lasting from 1 to 2 hours, achieving treatment within 24 hours. Omega 3 or placebo administration: At the end of the last treatment session, the Omega 3 (Omega 3, Galenic Pharmacy) or a placebo (Lactose, Galenic Pharmacy) was administered, depending on the group, intervention or control respectively, to which the patient belonged. For both therapies, the administration regimen was 2 tablets of 1g orally per day, for 90 consecutive days.To maintain the double-blind, the containers used for the Omega 3 and placebo presented the same characteristics regarding size and color. About the Omega 3 tablets and placebo, these were visually identical. Subsequently, at the first, third and six month after the end of the nonsurgical treatment, a new collection of all the clinical variables measured at the beginning of the study was performed, while the microbiological variables were measured again at the third month after treatment, from the same site used in the first sampling.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
TRIPLE
Study Groups
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Periodontal treatment, lactose tab
Periodontal treatment (scaling and root planning) and two tablets containing lactose once a day for 90 days immediately after the scaling and root planning.
Lactose tab
Two tablets containing lactose Procedure: Periodontal treatment Scaling and root planning
Periodontal treatment, Omega 3
Periodontal treatment (scaling and root planning) and two tablets containing 1g of Omega 3 once a day for 90 days immediately after the scaling and root planning.
Omega 3
Two tablets containing 1g Omega 3. Procedure:Periodontal treatment Scaling and root planning
Interventions
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Lactose tab
Two tablets containing lactose Procedure: Periodontal treatment Scaling and root planning
Omega 3
Two tablets containing 1g Omega 3. Procedure:Periodontal treatment Scaling and root planning
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* Patients American Society of Anesthesiologists (ASA) I or ASA II compatible with local anesthesia procedures.
* Present at least 10 natural teeth, excluding semi-erupted third molars.
* Present at least 6 sites with a probing depth (PD) ≥ 5mm and clinical attachment loss (CAL) ≥ 4mm
Exclusion Criteria
* Patients who use any medication associated with gingival disorders such as: Anticonvulsants (Phenytoin), Calcium channel blockers (Nifedipine), Immunosuppressive drugs (Cyclosporins).
* Patients with systemic diseases that affect the immunoinflammatory response.
* Patients under treatment with antacids on a regular basis due to chronic gastritis and / or self-medication with antacids.
* Patients under treatment with drugs such as: warfarin, digoxin and acetylsalicylic acid.
* Previous history of allergy to local anesthetics.
* Patients presenting orthodontic appliances.
* Patients who have received antibiotic treatment in the last 3 months.
* Patients who have received periodontal treatment.
* Pregnancy.
* Carriers of valvular prostheses or failures in heart valves, with endocarditis risk.
* Patients who are physically and intellectually incapacitated to participate, according to chilean law number 20,584, title II, paragraph 8, article 28.
* Heavy smoking patients, which is smoking more than 10 cigarettes per day.
* Patients allergic to Omega 3 or seafood or its derivatives: fish, shellfish, algae, etc.
* Patients with lactose intolerance.
39 Years
70 Years
ALL
Yes
Sponsors
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Universidad Nacional Andres Bello
OTHER
Responsible Party
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Mariely Navarrete
Associate Professor, Faculty of Dentistry Andres Bello University, Viña del Mar campus
Principal Investigators
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Mariely A Navarrete, MSc
Role: STUDY_DIRECTOR
Universidad Nacional Andres Bello
Mariely A Navarrete Riffo, MSc
Role: PRINCIPAL_INVESTIGATOR
Universidad Nacional Andres Bello
Locations
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Universidad Nacional Andres Bello
Viña del Mar, Región de Valparaíso, Chile
Countries
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References
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Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Periodontol. 2018 Jun;89 Suppl 1:S159-S172. doi: 10.1002/JPER.18-0006.
Meissner K, Bingel U, Colloca L, Wager TD, Watson A, Flaten MA. The placebo effect: advances from different methodological approaches. J Neurosci. 2011 Nov 9;31(45):16117-24. doi: 10.1523/JNEUROSCI.4099-11.2011.
Suchy FJ, Brannon PM, Carpenter TO, Fernandez JR, Gilsanz V, Gould JB, Hall K, Hui SL, Lupton J, Mennella J, Miller NJ, Osganian SK, Sellmeyer DE, Wolf MA. National Institutes of Health Consensus Development Conference: lactose intolerance and health. Ann Intern Med. 2010 Jun 15;152(12):792-6. doi: 10.7326/0003-4819-152-12-201006150-00248. Epub 2010 Apr 19. No abstract available.
Jellema P, Schellevis FG, van der Windt DA, Kneepkens CM, van der Horst HE. Lactose malabsorption and intolerance: a systematic review on the diagnostic value of gastrointestinal symptoms and self-reported milk intolerance. QJM. 2010 Aug;103(8):555-72. doi: 10.1093/qjmed/hcq082. Epub 2010 Jun 3.
Lang NP, Tonetti MS. Periodontal risk assessment (PRA) for patients in supportive periodontal therapy (SPT). Oral Health Prev Dent. 2003;1(1):7-16.
Van Dyke TE, Hasturk H, Kantarci A, Freire MO, Nguyen D, Dalli J, Serhan CN. Proresolving nanomedicines activate bone regeneration in periodontitis. J Dent Res. 2015 Jan;94(1):148-56. doi: 10.1177/0022034514557331. Epub 2014 Nov 11.
Deore GD, Gurav AN, Patil R, Shete AR, Naiktari RS, Inamdar SP. Omega 3 fatty acids as a host modulator in chronic periodontitis patients: a randomised, double-blind, palcebo-controlled, clinical trial. J Periodontal Implant Sci. 2014 Feb;44(1):25-32. doi: 10.5051/jpis.2014.44.1.25. Epub 2014 Feb 26.
Other Identifiers
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047
Identifier Type: -
Identifier Source: org_study_id
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