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Interleukin-34 Level in Periodontal Disease

Primary Purpose

Periodontal Disease Stage 2

Status
Recruiting
Phase
Not Applicable
Locations
Egypt
Study Type
Interventional
Intervention
Non surgical periodontal therapy
Sponsored by
Ain Shams University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Periodontal Disease Stage 2

Eligibility Criteria

20 Years - 50 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria: Patients with stage II Periodontitis. Both genders aged from 20-50 years Minimum 20 natural teeth excluding third molars Good compliance with the plaque control instructions following initial therapy. Availability for follow-up and maintenance program. Exclusion Criteria: .•Smokers Pregnant and lactating females. Systemic diseases that could affect the outcome of the therapy (According to Cornell Medical Index-Health Questionnaire). Patients taking antibiotics, anti-inflammatory, and immunosuppressive therapy during the preceding 3 months before the start of the trial and during the study. Patients who have undergone any periodontal therapy in the last 6 months Vulnerable groups of patients e.g. (handicapped patients).

Sites / Locations

  • Faculty of Dentistry-Ain Shams UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

No Intervention

Active Comparator

Arm Label

Healthy individuals

Stage II periodontitis patients

Arm Description

No intervention

Non-surgical periodontal therapy by ultrasonic and universal curettes

Outcomes

Primary Outcome Measures

1- To measure the IL - 34 levels in ng/L in GCF before &after Non-Surgical Periodontal Therapy of stage II periodontitis patients and compare it to healthy individuals
1- To measure the IL - 34 levels in ng/L in GCF before &after Non-Surgical Periodontal Therapy of stage II periodontitis patients and compare it to healthy individuals

Secondary Outcome Measures

To evaluate Plaque index before & after Non-Surgical Periodontal Therapy of stage II periodontitis patients
To evaluate Plaque index (0-3 score) before & after Non-Surgical Periodontal Therapy of stage II periodontitis patients
To evaluate Gingival index before & after Non-Surgical Periodontal Therapy of stage II periodontitis patients
To evaluate Gingival index (0-3 score) before & after Non-Surgical Periodontal Therapy of stage II periodontitis patients
To evaluate Probing depth before & after Non-Surgical Periodontal Therapy of stage II periodontitis patients
To evaluate Probing depth in mm before & after Non-Surgical Periodontal Therapy of stage II periodontitis patients
To evaluate Clinical attachment level before & after Non-Surgical Periodontal Therapy of stage II periodontitis patients
To evaluate Clinical attachment level in mm before & after Non-Surgical Periodontal Therapy of stage II periodontitis patients

Full Information

First Posted
May 12, 2023
Last Updated
July 25, 2023
Sponsor
Ain Shams University
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1. Study Identification

Unique Protocol Identification Number
NCT05962567
Brief Title
Interleukin-34 Level in Periodontal Disease
Official Title
Effect of Non-surgical Periodontal Therapy on Interleukin-34 Level in Gingival Crevicular Fluid in Patients With Periodontal Disease (Controlled Clinical Trial)
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Recruiting
Study Start Date
January 1, 2023 (Actual)
Primary Completion Date
August 1, 2023 (Anticipated)
Study Completion Date
September 1, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Ain Shams University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Aim of the study: To investigate changes in the levels of Interleukin 34 (IL-34) in the Gingival crevicular fluid(GCF) of patients with stage II periodontitis patients before and after nonsurgical periodontal therapy and compare it with healthy individuals To correlate changes in Gingival crevicular fluid level of Interleukin 34 with changes in periodontal parameters after nonsurgical periodontal therapy
Detailed Description
Periodontal disease is a chronic disease of various inflammatory diseases where the early symptoms are gingival redness, swelling, and bleeding. As the disease progresses, periodontal pockets, clinical attachment loss (CAL) as well as alveolar bone resorption may occur. If left untreated, periodontal disease can lead to loss of teeth which directly affects patient's mastication. A new system of periodontal classification has been adopted, in which the types of disease that were previously identified as "chronic" or "aggressive" Armitage, 1999 are now classified under one category ("periodontitis") and re-diagnosed on the basis of many variants (staging and grading system). The stage is based on the severity of the disease and the complexity of the disease management (in terms of loss of clinical attachment between teeth (CAL), radiographic bone loss, and tooth loss), complexity, and size and distribution. Grading provides additional information about the biological features of the disease, including history-based analysis of the progression rate of periodontitis; progression risk assessment; analysis of possible adverse effects of treatment; and risk assessment that the disease or its treatment may adversely affect the patient's normal life. Periodontitis is described in four stages ranging from Stage I: Initial periodontitis (CAL 1-2mm), Stage II: Moderate periodontitis (CAL 3-4 mm), Stage III: Severe periodontitis with potential for additional tooth loss (<4), and(CAL≥5mm) Stage IV: Severe periodontitis with potential for loss of dentition (≥5) and (CAL≥5mm). Grading focuses on assessing risk factors like smoking, diabetes, and outcomes of scaling and root debridement. Grade A: Slow rate of progression (no CAL loss over 5 years), Grade B: Moderate rate of progression (CAL loss<2mm over 5years), and Grade C: Rapid rate of progression (CAL loss ≥2 mm over 5 years). Periodontitis occurs due to a complex of genetic, environmental, and bacterial interaction in which bacterial and host factors play an important role. The imbalance between the previous two factors results in a completely different change from health state to inflammatory disease and once inflammation has begun, activation of many cytokines and molecular mechanisms occur. Cytokines are defined as soluble small proteins (~5-20 kDa) which bind to specific receptors on certain cells, stimulate some internal cellular changes, and cause multiple genetic and chemical regulations. While molecular mechanisms activate the host-derived proteinase that allow the loss of the marginal periodontal ligament fibers, the migration of the junctional epithelium apically, and the proliferation of bacterial biofilm on the root surface. There are two different types of inflammatory cytokines: proinflammatory cytokines that is involved in inflammatory reactions including IL-1β, IL-6, IL-12, TNF-α, and anti-inflammatory cytokines that regulate or control the pro-inflammatory cytokine response including IL-4, Interleukin-1 receptor antagonist (IL-1RA) and IL-10 Scaling and root debridement (NSPT) aimed at mechanical removal of bacterial plaque from the tooth surface is considered the "gold standard." This procedure decreases the number of Gram-negative bacteria in favor of Gram-positive bacteria as well as reduces the overall number of microorganisms in periodontal pockets and decrease amount of proinflammatory cytokines. Traditional clinical periodontal diagnostic parameters used include probing depths, bleeding on probing, clinical attachment levels, plaque index, and radiographs assessing alveolar bone level. They are limited, in that only disease history, not current disease status, can be assessed. Recent methods in oral and periodontal disease diagnostic research are identifying periodontal risk which is quantified by objective measures like biomarkers which are diagnostic tools to measure periodontal disease at the molecular, cellular, tissue, and clinical levels. There are many bone resorption biomarkers such as receptor activator nuclear factor kappa B (RANKL), a tumor necrosis factor (TNF) family cytokine, as well as on macrophage colony-stimulating factor (M-CSF) . M-CSF is required for osteoclastogenesis, stimulating both adhesion and proliferation of osteoclast precursors. The novel cytokine interleukin 34 (IL-34) is the second active component of colony-stimulating factor receptor (CSF-1R). IL-34 was shown to stimulate monocyte activation and colonization of macrophages from bone marrow cells. IL-34 messenger RNA (mRNA) is expressed in a number of tissues, including the heart, brain, lungs, liver, kidneys, spleen, thymus, testes, ovary, small intestine, prostate, and colon, as well as -spleen. IL-34 plays an important role in RANKL-induced osteoclastogenesis. Inhibition of the CSF-1 receptor by IL-34 has been shown to reduce alveolar bone loss in a periodontal rat model, highlighting their role in periodontal pathology. The diagnostic potential of gingival crevicular fluid (GCF) has been evaluated from confirming health and disease status to recent predictive tool. It distinguishes between healthy sites of diseased individuals and healthy sites of periodontally healthy people in the microbial profile and the concentration and formation of molecular biomarkers and therefore predicts patient-or-site-based disease Study in 2018, reported that estimation of IL-34 level detects high-risk individuals with periodontitis and systemic diseases, such as diabetes as high levels of IL-34 in gingival crevicular fluid (GCF) and plasma of patients with chronic periodontitis, further increased when accompanied with type 2 diabetes mellitus (T2DM) IL-34 can be considered a potential inflammatory biomarker of periodontal disease as GCF IL-34 levels was high in patients with periodontitis and decreased after NSPT. On the other hand, salivary levels of IL-34 were significantly lower in the periodontitis group compared to both healthy groups and gingivitis. After receiving non-surgical periodontal treatment at 3 and 6 months post-treatment, IL-34 significantly increased 3 months after treatment compared with baseline. Therefore, Further studies must be carried out to confirm these findings and to better understand the possible role of IL-34 in the pathogenesis of periodontal diseases and to evaluate its levels in GCF in patients with periodontal disease after non-surgical periodontal treatment (NSPT)

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Periodontal Disease Stage 2

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Supra and subgingival scaling will be performed on all patients. Oral Hygiene measures will be instructed following treatment and follow up after 3 months
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
40 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Healthy individuals
Arm Type
No Intervention
Arm Description
No intervention
Arm Title
Stage II periodontitis patients
Arm Type
Active Comparator
Arm Description
Non-surgical periodontal therapy by ultrasonic and universal curettes
Intervention Type
Other
Intervention Name(s)
Non surgical periodontal therapy
Intervention Description
scaling and subgingival debridement
Primary Outcome Measure Information:
Title
1- To measure the IL - 34 levels in ng/L in GCF before &after Non-Surgical Periodontal Therapy of stage II periodontitis patients and compare it to healthy individuals
Description
1- To measure the IL - 34 levels in ng/L in GCF before &after Non-Surgical Periodontal Therapy of stage II periodontitis patients and compare it to healthy individuals
Time Frame
3 months
Secondary Outcome Measure Information:
Title
To evaluate Plaque index before & after Non-Surgical Periodontal Therapy of stage II periodontitis patients
Description
To evaluate Plaque index (0-3 score) before & after Non-Surgical Periodontal Therapy of stage II periodontitis patients
Time Frame
3 months
Title
To evaluate Gingival index before & after Non-Surgical Periodontal Therapy of stage II periodontitis patients
Description
To evaluate Gingival index (0-3 score) before & after Non-Surgical Periodontal Therapy of stage II periodontitis patients
Time Frame
3 months
Title
To evaluate Probing depth before & after Non-Surgical Periodontal Therapy of stage II periodontitis patients
Description
To evaluate Probing depth in mm before & after Non-Surgical Periodontal Therapy of stage II periodontitis patients
Time Frame
3 months
Title
To evaluate Clinical attachment level before & after Non-Surgical Periodontal Therapy of stage II periodontitis patients
Description
To evaluate Clinical attachment level in mm before & after Non-Surgical Periodontal Therapy of stage II periodontitis patients
Time Frame
3 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Patients with stage II Periodontitis. Both genders aged from 20-50 years Minimum 20 natural teeth excluding third molars Good compliance with the plaque control instructions following initial therapy. Availability for follow-up and maintenance program. Exclusion Criteria: .•Smokers Pregnant and lactating females. Systemic diseases that could affect the outcome of the therapy (According to Cornell Medical Index-Health Questionnaire). Patients taking antibiotics, anti-inflammatory, and immunosuppressive therapy during the preceding 3 months before the start of the trial and during the study. Patients who have undergone any periodontal therapy in the last 6 months Vulnerable groups of patients e.g. (handicapped patients).
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Nada S. Ahmed
Phone
00201060041571
Email
nadazidan1271994@gmail.com
First Name & Middle Initial & Last Name or Official Title & Degree
Yasmine A. Fouad, lecturer
Phone
00201005793929
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hala A. Abuel Ela, Professor
Organizational Affiliation
Professor at Faculty of Dentistry, Ain Shams University
Official's Role
Study Director
Facility Information:
Facility Name
Faculty of Dentistry-Ain Shams University
City
Cairo
Country
Egypt
Individual Site Status
Recruiting

12. IPD Sharing Statement

Citations:
PubMed Identifier
36468466
Citation
Dikilitas A, Karaaslan F, Evirgen S, Ertugrul AS. Gingival crevicular fluid CSF-1 and IL-34 levels in patients with stage III grade C periodontitis and uncontrolled type 2 diabetes mellitus. J Periodontal Implant Sci. 2022 Dec;52(6):455-465. doi: 10.5051/jpis.2106260313. Epub 2022 Apr 12.
Results Reference
result
Links:
URL
http://www.ijdr.in/article.asp?issn=0970-9290;year=2018;volume=29;issue=3;spage=280;epage=285;aulast=Guruprasad;type=0
Description
Effect of nonsurgical periodontal therapy on interleukin-34 levels in periodontal health and disease

Learn more about this trial

Interleukin-34 Level in Periodontal Disease

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