Antibacterial Photodynamic Therapy in the Management of Peri-implantitis

NCT ID: NCT06017817

Last Updated: 2024-10-18

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

RECRUITING

Clinical Phase

NA

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-05-13

Study Completion Date

2026-12-31

Brief Summary

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This early-stage study is designed to determine the efficacy of the Lumoral method in periimplantitis. Improved supragingival plaque control can help to also sustain subgingival plaque management in the long term. In addition, the device might have a photobiomodulation effect on periodontal tissues, thus impacting osseointegration.

Detailed Description

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Clinical signs of inflammation in peri-implantitis include bleeding on probing, suppuration, increased probing depth, and radiographic signs of bone loss. Currently, the best treatment options for peri-implantitis include non-surgical methods of biofilm removal in the supra-mucosal area around implants, and comprehensive guidance on self-performed infection control procedures. With more advanced peri-implantitis, anti-infective surgical treatment protocol would be needed.

Matrix metalloproteinase 8 (MMP-8) has been found to be elevated in association with oral infections, such as periodontitis and peri-implantitis. The level of active MMP-8 (aMMP-8) can detect to determine tissue health and to assess inflammation, and can easily be measured during a regular dental appointment with a chairside test.

The Lumoral Treatment is a CE-marked medical device developed to provide a potent, targeted antibacterial action on dental plaque in a home environment. The method mechanism of action is antibacterial photodynamic therapy (aPDT). The method is used by swishing a mouth rinse, which has a strong adherence to dental plaque. The plaque-adhered photoactive mouth rinse can be activated by a simple-to-use light applicator. Preliminary results have shown a promising anti-inflammatory response in addition to plaque reduction.

Conditions

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Peri-Implantitis Plaque, Dental

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

80 subjects in total are recruited to this study: 40 subjects in the non-surgical treatment (NST), of which 20 participants in the NST Study group (NST-1) and 20 participants in the NST Control group (NST-2), and 40 subjects in the surgical treatment (ST), of which 20 participants in the ST Study group (ST-1) and 20 participants in the ST Control group (ST-2).
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators
The first assessments will be made before randomization.

After the randomization, there is no masking.

Study Groups

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Non-surgical treatment, Study group (NST-1)

Lumoral Treatment; Standard, non-surgical anti-infective treatment by scaling and root planing (SRP); and Standard oral hygiene instructions for electric toothbrushing, interdental brush, and dental floss use.

Group Type EXPERIMENTAL

Lumoral Treatment

Intervention Type DEVICE

Anti-infective photodynamic therapy for plaque-induced oral conditions

Standard oral hygiene instructions

Intervention Type PROCEDURE

Standard oral hygiene instructions for electric toothbrushing, interdental brush, and dental floss use

Scaling and root planing (SRP

Intervention Type PROCEDURE

non-surgical anti-infective treatment by scaling and root planing

Non-surgical treatment, Control group (NST-2)

Standard, non-surgical anti-infective treatment by scaling and root planing (SRP); and Standard oral hygiene instructions for electric toothbrushing, interdental brush, and dental floss use.

Group Type ACTIVE_COMPARATOR

Standard oral hygiene instructions

Intervention Type PROCEDURE

Standard oral hygiene instructions for electric toothbrushing, interdental brush, and dental floss use

Scaling and root planing (SRP

Intervention Type PROCEDURE

non-surgical anti-infective treatment by scaling and root planing

Surgical treatment, Study group (ST-1)

Lumoral Treatment; Surgical anti-infective peri-implantitis treatment; and Standard oral hygiene instructions for electric toothbrushing, interdental brush, and dental floss use.

Group Type EXPERIMENTAL

Lumoral Treatment

Intervention Type DEVICE

Anti-infective photodynamic therapy for plaque-induced oral conditions

Standard oral hygiene instructions

Intervention Type PROCEDURE

Standard oral hygiene instructions for electric toothbrushing, interdental brush, and dental floss use

surgical anti-infective peri-implantitis treatment

Intervention Type PROCEDURE

surgical anti-infective peri-implantitis treatment

Surgical treatment, Control group (ST-2)

Surgical anti-infective peri-implantitis treatment; and Standard oral hygiene instructions for electric toothbrushing, interdental brush, and dental floss use.

Group Type ACTIVE_COMPARATOR

Standard oral hygiene instructions

Intervention Type PROCEDURE

Standard oral hygiene instructions for electric toothbrushing, interdental brush, and dental floss use

surgical anti-infective peri-implantitis treatment

Intervention Type PROCEDURE

surgical anti-infective peri-implantitis treatment

Interventions

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Lumoral Treatment

Anti-infective photodynamic therapy for plaque-induced oral conditions

Intervention Type DEVICE

Standard oral hygiene instructions

Standard oral hygiene instructions for electric toothbrushing, interdental brush, and dental floss use

Intervention Type PROCEDURE

Scaling and root planing (SRP

non-surgical anti-infective treatment by scaling and root planing

Intervention Type PROCEDURE

surgical anti-infective peri-implantitis treatment

surgical anti-infective peri-implantitis treatment

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* PPD ≥6 mm and marginal bone loss \>3 mm
* Dental implants collected and clinically characterized according to Lähteenmäki et al. CEDR-22
* Agreement to participate in the study and to sign a written consent form
* Able to co-operate with the treatment protocol and avoid any other oral hygiene measures outside of the study protocol

Exclusion Criteria

* Presence of any physical limitation or restriction that might restrict Lumoral use
* Unwilling to participate in the study
* Pregnancy or lactation
* Active smoking
* Medicated diabetes mellitus (DM)
* Any systemic disease (e.g., wound healing dysfunctions) that could alter the progression of peri-implantitis
* Use of antibiotics and doxycycline, chlorhexidine, and bisphosphonates, within 4 weeks week prior to study participation
* Peri-implant and periodontal treatment within 3 months prior to study participation
* Removable major prosthesis or major orthodontic appliance
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Helsinki

OTHER

Sponsor Role collaborator

Nilminie Rathnayake

INDUSTRY

Sponsor Role lead

Responsible Party

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Nilminie Rathnayake

Principal Investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Nilminie Rathnayake, Assoc Prof

Role: PRINCIPAL_INVESTIGATOR

University of Helsinki

Locations

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Södertandläkarna AB

Stockholm, , Sweden

Site Status RECRUITING

Countries

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Sweden

Central Contacts

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Mikko Kylmänen

Role: CONTACT

+358407245934

Facility Contacts

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Nilminie Rathnayake, Periodontist

Role: primary

References

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Berglundh T, Jepsen S, Stadlinger B, Terheyden H. Peri-implantitis and its prevention. Clin Oral Implants Res. 2019 Feb;30(2):150-155. doi: 10.1111/clr.13401. Epub 2019 Feb 3.

Reference Type BACKGROUND
PMID: 30636066 (View on PubMed)

Jepsen S, Berglundh T, Genco R, Aass AM, Demirel K, Derks J, Figuero E, Giovannoli JL, Goldstein M, Lambert F, Ortiz-Vigon A, Polyzois I, Salvi GE, Schwarz F, Serino G, Tomasi C, Zitzmann NU. Primary prevention of peri-implantitis: managing peri-implant mucositis. J Clin Periodontol. 2015 Apr;42 Suppl 16:S152-7. doi: 10.1111/jcpe.12369.

Reference Type BACKGROUND
PMID: 25626479 (View on PubMed)

Kassebaum NJ, Bernabe E, Dahiya M, Bhandari B, Murray CJ, Marcenes W. Global burden of severe periodontitis in 1990-2010: a systematic review and meta-regression. J Dent Res. 2014 Nov;93(11):1045-53. doi: 10.1177/0022034514552491. Epub 2014 Sep 26.

Reference Type BACKGROUND
PMID: 25261053 (View on PubMed)

Kassebaum NJ, Smith AGC, Bernabe E, Fleming TD, Reynolds AE, Vos T, Murray CJL, Marcenes W; GBD 2015 Oral Health Collaborators. Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990-2015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors. J Dent Res. 2017 Apr;96(4):380-387. doi: 10.1177/0022034517693566.

Reference Type BACKGROUND
PMID: 28792274 (View on PubMed)

Lang NP, Suvan JE, Tonetti MS. Risk factor assessment tools for the prevention of periodontitis progression a systematic review. J Clin Periodontol. 2015 Apr;42 Suppl 16:S59-70. doi: 10.1111/jcpe.12350.

Reference Type BACKGROUND
PMID: 25496279 (View on PubMed)

Lahteenmaki H, Patila T, Raisanen IT, Kankuri E, Tervahartiala T, Sorsa T. Repeated Home-Applied Dual-Light Antibacterial Photodynamic Therapy Can Reduce Plaque Burden, Inflammation, and aMMP-8 in Peri-Implant Disease-A Pilot Study. Curr Issues Mol Biol. 2022 Mar 8;44(3):1273-1283. doi: 10.3390/cimb44030085.

Reference Type BACKGROUND
PMID: 35723308 (View on PubMed)

Nikinmaa S, Moilanen N, Sorsa T, Rantala J, Alapulli H, Kotiranta A, Auvinen P, Kankuri E, Meurman JH, Patila T. Indocyanine Green-Assisted and LED-Light-Activated Antibacterial Photodynamic Therapy Reduces Dental Plaque. Dent J (Basel). 2021 May 3;9(5):52. doi: 10.3390/dj9050052.

Reference Type BACKGROUND
PMID: 34063662 (View on PubMed)

Slade GD. Derivation and validation of a short-form oral health impact profile. Community Dent Oral Epidemiol. 1997 Aug;25(4):284-90. doi: 10.1111/j.1600-0528.1997.tb00941.x.

Reference Type BACKGROUND
PMID: 9332805 (View on PubMed)

Related Links

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https://doi.org/10.1007/s41547-019-00056-9

Alaijah, F., Morsi, A., Nasher, R. et al. Photobiomodulation therapy in the treatment of periodontal disease: a literature review. Laser Dent Sci 3, 147-153 (2019)

https://doi.org/10.1590/S1806-83242014.50000004

Gomes SC, Romagna R, Rossi V, Corvello PC, Melchiors-Angst PD. Supragingival treatment as an aid to reduce subgingival needs: a 450-day investigation Braz. oral res. 28 (1) 2014

https://www.fda.gov/media/75892/download

Levine JI. Medications that increase photosensitivity. FDA document Dec 1990.

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0232775

Nikinmaa S, Alapulli H, Auvinen P, et al. (2020) Dual-light photodynamic therapy administered daily provides a sustained antibacterial effect on biofilm and prevents Streptococcus mutans adaptation. PLoS ONE 15(5)

https://doi.org/10.1016/j.parkreldis.2017.02.026

Pereira PAB, Aho VTE, Paulin L, et al., (2017) Oral and nasal microbiota in Parkinson's disease. Parkinsonism and Related Disorders 38: 61-67

Other Identifiers

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HEALTHIER

Identifier Type: -

Identifier Source: org_study_id

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