Effectiveness of Adjunctive Therapy of Emdogain®FL in Non-surgical Periodontal Treatment

NCT ID: NCT06070181

Last Updated: 2024-10-31

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

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-03-01

Study Completion Date

2026-08-01

Brief Summary

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The goal of this clinical trial is to assess the safety and effectiveness of adjunctive Emdogain® therapy in non-surgical periodontal treatment for patients with stage 3 and 4 periodontitis.

The main questions it aims to answer are:

* Will adjunctive treatment with Emdogain® result in a greater reduction in Bleeding on Probing and probing pocket depth compared to non-surgical periodontal treatment alone? • Will adjunctive treatment with Emdogain® lead to a greater mean Radiographic attachment level (rAL) gain per quadrant compared to non-surgical periodontal treatment alone?
* Will adjunctive treatment with Emdogain® result in a lower proportion of treated teeth requiring surgery (PPD ≥6mm) at 12 months after treatment?

Participants in the study will undergo the following tasks:

* Screening and randomization
* Receival of non-surgical periodontal treatment in all quadrants and in two quadrants adjunctive Emdogain®
* 6-month follow-up assessment
* 12-month follow-up assessment

Clinical and radiological assesment will be performed in two quadrants treated with adjunctive Emdogain® therapy and two quadrants treated with non-surgical periodontal treatment alone. This comparison will help determine the effects of adjunctive therapy with Emdogain®.

The study aims to provide insights into the safety and efficacy of adjunctive Emdogain® therapy in non-surgical periodontal treatment, specifically in patients with stage 3 and 4 periodontitis.

Detailed Description

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Phase 1: Screening After written informed consent has been obtained, the patient is entered in the screening and enrolment log and in the patient identification log and receives a patient identification number. An evaluation is then carried out by a periodontist with a dental hygienist to determine whether the patient meets the study inclusion criteria and none of the exclusion criteria and study specific information will be collected. For excluded patients, the reason(s) for exclusion shall be documented.

Phase 2: Treatment After providing informed consent, screening completion and after examination by a periodontist, study treatment will be performed only once the Plaque Index (PI) of each screened patient will be \<20%. This means that randomization and the scaling phase (study treatment) will be only initiated when each individual patient was compliant with the oral hygiene instructions and the PI (as measured with Staining rondells red Directa, 4 surface plaque index, 1 rinsing 10 sec with 50 ml of water) was recorded to be \<20%.

Randomization to test or control-quadrants will be performed using statistical software after full mouth scaling and root planing has taken place. Out of the four quadrants / patient, two quadrants will be randomised to be treated according to standard care with adjunctive Emdogain® FL. The remaining two quadrants will be treated as controls (standard care; no adjunctive Emdogain® FL).

Following randomization, root planing and scaling will be performed by a calibrated dental hygienist in all quadrants under local anaesthesia (with xylocaine adrenaline 2%). First, an ultrasonic scaler (EMS) will be used and then manual scaling with LM-curettes will be performed. The hygienist will scale each root surface until the root surface is judged to be free of tartar. As part of standard care, this decision is made by the calibrated dental hygienist based on tactile experience.

Pockets of 5mm to 9mm (PPD) will be treated in the study (both Test and Control treatment). Test treatment: Emdogain® FL will be added to standard treatment i. e. Test quadrants. PrefGel® will be applied on the root surface for 2 minutes, then rinsed away with sterile saline solution for 30 seconds. The surface will be lightly dried using gauze and airblow and then Emdogain® will be applied. The Emdogain® FL application will be performed by the dental hygienist under the supervision of a periodontist. Control treatment: pockets of 5mm to 9mm (PPD) will receive standard treatment (no addition of Emdogain® FL) i. e. Control quadrants.

Additional teeth with PPD outside the range of 5mm to 9mm (PPD) may be present both in Test and/or Control quadrants. Such teeth will be treated using standard care (no Emdogain®) but they will not be included in study evaluations.

The patient will then be asked to rinse daily with an antiseptic mouth rinse twice a day (FLUX-CHX chlorhexidine 0.12% solution) until 14 days following the treatment. Antibiotics (e.g. penicillin V) may also be used in the presence of suppuration. The patient will be instructed not to brush in the treated area for 7 days following the treatment. Then only gentle brushing on buccal and lingual tooth surfaces using the roll stroke method will be recommended. The patients will be instructed not to perform any sulcular or interdental brushing before 2 weeks following the treatment.

Followed by individually planed healing controls and oral hygiene controls. (the number of visits/follow-ups will be recorded and presented.

Phase 3: 6 months follow up Examination will be carried out by a periodontist (blinded) at the six months follow up visit. Examination consists of periodontal assessments i. e. PI, BoP and PPD.

Phase 4: 12 months follow up Examination will be carried out by a periodontist (blinded) at the 12 months follow up visit. Examination consists of periodontal assessments (PI, BoP, PPD) and X-rays.

Conditions

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Periodontitis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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Control- no adjunctive treatment

One arm is the control: two quadrants per each patient treated with non-surgical periodontal treatment alone. NO adjunctive treatment with emdogain. The two quadrants are randomized.

Group Type OTHER

Non-surgical periodontal treatment

Intervention Type PROCEDURE

No additional/adjunctive treatment with Emdogain

Test-adjunctive treatment with Emdogain

The experimental arm is the two quadrants per patient assigned to be treated vid adjunctive Emdogain.

Group Type EXPERIMENTAL

Enamel matrix derivate

Intervention Type DEVICE

'Applying Enamel matrix derivate in the periodontal pockets after completing the non-surgical periodontal treatment

Non-surgical periodontal treatment

Intervention Type PROCEDURE

No additional/adjunctive treatment with Emdogain

Interventions

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Enamel matrix derivate

'Applying Enamel matrix derivate in the periodontal pockets after completing the non-surgical periodontal treatment

Intervention Type DEVICE

Non-surgical periodontal treatment

No additional/adjunctive treatment with Emdogain

Intervention Type PROCEDURE

Other Intervention Names

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Emdogain Control- no adjunctive treatment

Eligibility Criteria

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Inclusion Criteria

Patients must meet all of the following criteria for inclusion in the study:

* Over 18 years old
* Stage 3 or 4 periodontitis
* Residual pockets with probing depths from 5mm to 9mm with no furcation involvement and adequate plaque control

Exclusion Criteria

* Antibiotic treatment in last 3 months
* Subgingival scaling and root planning performed in last 12 months
* Patients for which the use of Emdogain® is contraindicated i. e. patients with uncontrolled diabetes or other uncontrolled systemic diseases, disorders or treatments that compromise wound healing, chronic high dose steroid therapy, bone metabolic diseases, radiation or other immuno-suppressive therapy and infections or vascular impairment at the surgical site.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Region Jönköping County

OTHER_GOV

Sponsor Role collaborator

Ostergotland County Council, Sweden

OTHER

Sponsor Role lead

Responsible Party

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Shariel Sayardoust

Associate professor and Senior Consultant in Periodontology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Shariel Sayardoust, PhD, DDS

Role: PRINCIPAL_INVESTIGATOR

Ostergotland County Council, Sweden

Locations

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Centre for Oral Rhabilitation

Linköping, Region Östergötland, Sweden

Site Status RECRUITING

Countries

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Sweden

Central Contacts

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Shariel Sayardoust, PhD, DDS

Role: CONTACT

+46 (0) 736564648

Carin Starkhammar Johansson, PhD, DDS

Role: CONTACT

Other Identifiers

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EMDFL2023

Identifier Type: -

Identifier Source: org_study_id

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