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Atlas of Experimental Gingivitis in Humans (ATL)

Primary Purpose

Gingivitis

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Stent-Induced Biofilm Overgrowth
Sponsored by
University of North Carolina, Chapel Hill
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Gingivitis

Eligibility Criteria

18 Years - 30 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Adult males or females between the age of 18 and 30 years.
  • Non-diabetic and no history of smoking within the last 5 years.
  • Have read, understood and signed an informed consent form.
  • Must be able and willing to follow study procedures and instructions.
  • Must have at least 3 natural adjacent teeth in both maxillary (top) posterior sextants that will be selected for baseline gingival biopsy and SIBO gingival biopsy.
  • Must be in good general health, as evidenced by medical hx (exclusion conditions defined under subject exclusion criteria below).
  • Females of childbearing capacity must be willing to have pregnancy test to confirm they are not pregnant.

Exclusion Criteria

  • History of intravenous bisphosphonates.
  • Current or history (less than 5 years) of tobacco use in any form prior to enrollment (self-report)
  • Chronic disease with oral manifestations including diabetes mellitus.
  • Infectious disease such as hepatitis, HIV, or tuberculosis.
  • Anemia or other blood dyscrasias.
  • Currently taking anticoagulant therapy or drugs, such as heparin or warfarin.
  • Those requiring antibiotic prophylaxis prior to dental treatment
  • Exhibiting gross oral pathology or a history of periodontal disease.
  • Individuals with a history or are currently using birth control containing hormones.
  • Individuals without a history (less than 1 year) of regular professional oral health care, including prophylaxis. (self-report)
  • Pregnant, breastfeeding or planning for pregnancy within 3 months.
  • Individuals who used antibiotics/chronically used NSAIDs
  • Anything that would place the individual at increased risk or preclude the individual's full compliance with or completion of the study.

Sites / Locations

  • Adams School of Dentistry

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Healthy Volunteers

Arm Description

Enrolled subjects will be included in an experimental gingivitis model (SIBO) for 21 days and use an acrylic stent fabricated before and dispensed at the baseline appointment

Outcomes

Primary Outcome Measures

Percent Composition of Human Gingival Tissue at Day 1
Percentage of the human gingival biopsies that are epithelial, immune, or mesenchymal cells in health.
Percent Composition of Human Gingival Tissue at Day 21
Percentage of the human gingival biopsies that are epithelial, immune, or mesenchymal cells during inflammation.
Percent Composition of Human Gingival Epithelial Cells at Day 1
Percentage of the human gingival epithelial cell subtypes that are present (i.e. keratinocytes, Langerhans cells, etc.) in health.
Percent Composition of Human Gingival Epithelial Cells at Day 21
Percentage of the human gingival epithelial cell subtypes that are present (i.e. keratinocytes, Langerhans cells, etc.) during inflammation.
Percent Composition of Human Gingival Immune Cells at Day 1
Percentage of the human immune cell subtypes that are present (i.e. CD4, CD8, etc.) in health.
Percent Composition of Human Gingival Immune Cells at Day 21
Percentage of the human immune cell subtypes that are present (i.e. CD4, CD8, etc.) during inflammation.
Percent Composition of Human Gingival Mesenchymal Cells at Day 1
Percentage of the human mesenchymal cell subtypes that are present (i.e. stromal endothelial, etc.) in health.
Percent Composition of Human Gingival Mesenchymal Cells at Day 21
Percentage of the human mesenchymal cell subtypes that are present (i.e. stromal endothelial, etc.) in health.
Genes Expressed In Epithelial Cells at Day 1
Gene expression will be ranked by highest to lowest and a list of the top 100 genes in epithelial cells in health will be produced.
Genes Expressed In Epithelial Cells at Day 21
Gene expression will be ranked by highest to lowest and a list of the top 100 genes in epithelial cells during inflammation will be produced.
Genes Expressed In Immune Cells at Day 1
Gene expression will be ranked by highest to lowest and a list of the top 100 genes in immune cells in health will be produced.
Genes Expressed In Immune Cells at Day 21
Gene expression will be ranked by highest to lowest and a list of the top 100 genes in immune cells during inflammation will be produced.
Genes Expressed In Mesenchymal Cells at Day 1
Gene expression will be ranked by highest to lowest and a list of the top 100 genes in mesenchymal cells in health will be produced.
Genes Expressed In Mesenchymal Cells at Day 21
Gene expression will be ranked by highest to lowest and a list of the top 100 genes in mesenchymal cells during inflammation will be produced.
Genes Expressed In Epithelial Cell Subtypes at Day 1
Gene expression will be ranked by highest to lowest and a list of the top 100 genes in epithelial cell subtypes in health will be produced.
Genes Expressed In Epithelial Cell Subtypes at Day 21
Gene expression will be ranked by highest to lowest and a list of the top 100 genes in epithelial cell subtypes during inflammation will be produced.
Genes Expressed In Immune Cell Subtypes at Day 1
Gene expression will be ranked by highest to lowest and a list of the top 100 genes in immune cell subtypes in health will be produced.
Genes Expressed In Immune Cell Subtypes at Day 21
Gene expression will be ranked by highest to lowest and a list of the top 100 genes in immune cell subtypes during inflammation will be produced.
Genes Expressed In Mesenchymal Cell Subtypes at Day 1
Gene expression will be ranked by highest to lowest and a list of the top 100 genes in mesenchymal cell subtypes in health will be produced.
Genes Expressed In Mesenchymal Cell Subtypes at Day 21
Gene expression will be ranked by highest to lowest and a list of the top 100 genes in mesenchymal cell subtypes during inflammation will be produced.

Secondary Outcome Measures

Full Information

First Posted
September 24, 2019
Last Updated
August 10, 2020
Sponsor
University of North Carolina, Chapel Hill
Collaborators
Sunstar, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT04105569
Brief Title
Atlas of Experimental Gingivitis in Humans
Acronym
ATL
Official Title
An Atlas of Experimental Gingivitis in Humans at Single Cell Resolution
Study Type
Interventional

2. Study Status

Record Verification Date
August 2020
Overall Recruitment Status
Completed
Study Start Date
October 15, 2019 (Actual)
Primary Completion Date
December 3, 2019 (Actual)
Study Completion Date
December 3, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of North Carolina, Chapel Hill
Collaborators
Sunstar, Inc.

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
Pilot case series with a split-mouth design to track subjects with known exposure (dental biofilm accumulation) over 21 days. Descriptive design, using single cell RNA sequencing as a "digital biopsy" to catalog and contrast inflamed versus non-inflamed tissues from within the same mouth and across patients. Specimens (human) will biobanked from the 'digital biopsy' site for future analysis, including: Gingival crevicular fluid, oral epithelial stem/progenitor cells, and plaque samples, for 'omics analyses including metabolomics, microbiomic, and genomic data.
Detailed Description
Purpose is to conduct the first study of human gingiva in health and after biofilm-induced inflammation in the gingiva using scRNAseq. The pilot will involve induction of experimental gingivitis in all participants. Participants include recruitment of 6 participants. Following consenting, screening, and enrollment, a customized acrylic stent will be used only on the selected sextant/teeth specified in the protocol, and only during tooth brushing to prevent oral hygiene in selected sextant/teeth. After the completion of the 3-week gingivitis induction phase, participants will enter a 2 week resolution phase. In the resolution phase, participants will reinstate full mouth oral hygiene, with the exception of flossing. Oral prophylaxis will be performed to regain health. During the 3 week gingivitis induction phase, participants will be required to return to the clinic every 7 days for safety checks. Study Procedures (methods): Medical history, demographics (height/weight), urine based pregnancy test, vital signs (to include blood pressures, and pulse), standard dental clinical measures (to include plaque index, gingival index, bleeding on probing, and clinical attachment level), alginate impressions taken for fabrication of an acrylic stent (mouth guard), 2 gingival biopsies, 4 subgingival (below the gum line) plaque samples, 4 Gingival Crevicular Fluid (naturally occurring fluid between the gum and teeth) samples, and adult prophylaxis

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gingivitis

7. Study Design

Primary Purpose
Basic Science
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
6 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Healthy Volunteers
Arm Type
Experimental
Arm Description
Enrolled subjects will be included in an experimental gingivitis model (SIBO) for 21 days and use an acrylic stent fabricated before and dispensed at the baseline appointment
Intervention Type
Procedure
Intervention Name(s)
Stent-Induced Biofilm Overgrowth
Other Intervention Name(s)
Dental Stent
Intervention Description
Customized acrylic dental (sextant) stent will be used during brushing for 21 days to influence reversible gingival tissue inflammation.
Primary Outcome Measure Information:
Title
Percent Composition of Human Gingival Tissue at Day 1
Description
Percentage of the human gingival biopsies that are epithelial, immune, or mesenchymal cells in health.
Time Frame
Day 1
Title
Percent Composition of Human Gingival Tissue at Day 21
Description
Percentage of the human gingival biopsies that are epithelial, immune, or mesenchymal cells during inflammation.
Time Frame
Day 21
Title
Percent Composition of Human Gingival Epithelial Cells at Day 1
Description
Percentage of the human gingival epithelial cell subtypes that are present (i.e. keratinocytes, Langerhans cells, etc.) in health.
Time Frame
Day 1
Title
Percent Composition of Human Gingival Epithelial Cells at Day 21
Description
Percentage of the human gingival epithelial cell subtypes that are present (i.e. keratinocytes, Langerhans cells, etc.) during inflammation.
Time Frame
Day 21
Title
Percent Composition of Human Gingival Immune Cells at Day 1
Description
Percentage of the human immune cell subtypes that are present (i.e. CD4, CD8, etc.) in health.
Time Frame
Day 1
Title
Percent Composition of Human Gingival Immune Cells at Day 21
Description
Percentage of the human immune cell subtypes that are present (i.e. CD4, CD8, etc.) during inflammation.
Time Frame
Day 21
Title
Percent Composition of Human Gingival Mesenchymal Cells at Day 1
Description
Percentage of the human mesenchymal cell subtypes that are present (i.e. stromal endothelial, etc.) in health.
Time Frame
Day 1
Title
Percent Composition of Human Gingival Mesenchymal Cells at Day 21
Description
Percentage of the human mesenchymal cell subtypes that are present (i.e. stromal endothelial, etc.) in health.
Time Frame
Day 21
Title
Genes Expressed In Epithelial Cells at Day 1
Description
Gene expression will be ranked by highest to lowest and a list of the top 100 genes in epithelial cells in health will be produced.
Time Frame
Day 1
Title
Genes Expressed In Epithelial Cells at Day 21
Description
Gene expression will be ranked by highest to lowest and a list of the top 100 genes in epithelial cells during inflammation will be produced.
Time Frame
Day 21
Title
Genes Expressed In Immune Cells at Day 1
Description
Gene expression will be ranked by highest to lowest and a list of the top 100 genes in immune cells in health will be produced.
Time Frame
Day 1
Title
Genes Expressed In Immune Cells at Day 21
Description
Gene expression will be ranked by highest to lowest and a list of the top 100 genes in immune cells during inflammation will be produced.
Time Frame
Day 21
Title
Genes Expressed In Mesenchymal Cells at Day 1
Description
Gene expression will be ranked by highest to lowest and a list of the top 100 genes in mesenchymal cells in health will be produced.
Time Frame
Day 1
Title
Genes Expressed In Mesenchymal Cells at Day 21
Description
Gene expression will be ranked by highest to lowest and a list of the top 100 genes in mesenchymal cells during inflammation will be produced.
Time Frame
Day 21
Title
Genes Expressed In Epithelial Cell Subtypes at Day 1
Description
Gene expression will be ranked by highest to lowest and a list of the top 100 genes in epithelial cell subtypes in health will be produced.
Time Frame
Day 1
Title
Genes Expressed In Epithelial Cell Subtypes at Day 21
Description
Gene expression will be ranked by highest to lowest and a list of the top 100 genes in epithelial cell subtypes during inflammation will be produced.
Time Frame
Day 21
Title
Genes Expressed In Immune Cell Subtypes at Day 1
Description
Gene expression will be ranked by highest to lowest and a list of the top 100 genes in immune cell subtypes in health will be produced.
Time Frame
Day 1
Title
Genes Expressed In Immune Cell Subtypes at Day 21
Description
Gene expression will be ranked by highest to lowest and a list of the top 100 genes in immune cell subtypes during inflammation will be produced.
Time Frame
Day 21
Title
Genes Expressed In Mesenchymal Cell Subtypes at Day 1
Description
Gene expression will be ranked by highest to lowest and a list of the top 100 genes in mesenchymal cell subtypes in health will be produced.
Time Frame
Day 1
Title
Genes Expressed In Mesenchymal Cell Subtypes at Day 21
Description
Gene expression will be ranked by highest to lowest and a list of the top 100 genes in mesenchymal cell subtypes during inflammation will be produced.
Time Frame
Day 21

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
30 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Adult males or females between the age of 18 and 30 years. Non-diabetic and no history of smoking within the last 5 years. Have read, understood and signed an informed consent form. Must be able and willing to follow study procedures and instructions. Must have at least 3 natural adjacent teeth in both maxillary (top) posterior sextants that will be selected for baseline gingival biopsy and SIBO gingival biopsy. Must be in good general health, as evidenced by medical hx (exclusion conditions defined under subject exclusion criteria below). Females of childbearing capacity must be willing to have pregnancy test to confirm they are not pregnant. Exclusion Criteria History of intravenous bisphosphonates. Current or history (less than 5 years) of tobacco use in any form prior to enrollment (self-report) Chronic disease with oral manifestations including diabetes mellitus. Infectious disease such as hepatitis, HIV, or tuberculosis. Anemia or other blood dyscrasias. Currently taking anticoagulant therapy or drugs, such as heparin or warfarin. Those requiring antibiotic prophylaxis prior to dental treatment Exhibiting gross oral pathology or a history of periodontal disease. Individuals with a history or are currently using birth control containing hormones. Individuals without a history (less than 1 year) of regular professional oral health care, including prophylaxis. (self-report) Pregnant, breastfeeding or planning for pregnancy within 3 months. Individuals who used antibiotics/chronically used NSAIDs Anything that would place the individual at increased risk or preclude the individual's full compliance with or completion of the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kevin M Byrd, DDS, PhD
Organizational Affiliation
Adams School of Dentistry, UNC Chapel Hill
Official's Role
Principal Investigator
Facility Information:
Facility Name
Adams School of Dentistry
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27599
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Single-cell RNA sequencing data will be shared through the Gene Expression Omnibus (GEO), a public functional genomics data repository supporting MIAME-compliant data submissions, which accepts sequence-based data. Gene list data will be searchable, cell by cell, through an online database. The files will be deposited both as raw reads (.fastq) and differential gene expression (.txt and .xlsx). Once data have been cleaned, assessed for differential gene expression, and validated by FISH/IHC, data will be made public. This will allow us to make this data freely available for others to investigate and reanalyze for their own purposes to accelerate further discoveries.
IPD Sharing Time Frame
Gene expression data will be available for download once the manuscript has been accepted for publication.
IPD Sharing Access Criteria
Gene expression lists by cell types will be provided to download freely in association with available journal access.

Learn more about this trial

Atlas of Experimental Gingivitis in Humans

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