Effect of MOPs During Orthodontic Movement in Periodontitis Patients

Universidad Complutense de Madrid28 enrolled

Overview

Micro-osteoperforations (MOPs) cause cortical bone injuries and consequently increase the expression of inflammatory mediators, allowing for increased bone and periodontal ligament remodeling associated with orthodontic movement. It remains unclear the effect of orthodontic intrusion combined with MOPs application on teeth with reduced periodontium. The general objective will be to determine the efficacy of MOPs during orthodontic tooth movement (OTM) in terms of periodontal and orthodontic outcomes in stage IV periodontitis patients, case type 2 with pathological tooth migration (PTM), characterized the presence of at least one flared tooth of the upper-anterior sextant with an intrabony defect (intrabony component \<5mm)

This is a comparative 2-arm parallel single-blinded randomized controlled clinical trial, with allocation ratio of 1:1, aimed to test an intervention (the use of MOPs) on CAL changes 12 months after placing orthodontic appliances. The control intervention will be the same treatment without the bone traumatic intervention. Sample: Patients with stage IV periodontitis case type 2 characterized with PTM characterized the presence of at least one flared tooth of the upper-anterior sextant with an intrabony defect (intrabony component \<5mm) attending the Post-graduate Program of Periodontology and the Post-graduate Program of Orthodontics of the Faculty of Dentistry at the Complutense University of Madrid (UCM).

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Stage IV Periodontitis

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: Patients will be included if agreeing to undertake combined periodontal and orthodontic therapy following the clinical practice guideline of stage IV periodontitis patients, and fulfilling the following criteria: * adult patients older than 18-year-old; * systemically healthy (see exclusion criteria); * diagnosed as stage IV (Papapanou et al., 2018) case-type 2 (Herrera et al. 2022) periodontitis; * the presence of at least one flared tooth of the upper-anterior sextant with an intrabony defect (intrabonny component \<5mm) (experimental teeth); * in need of orthodontic therapy. Exclusion Criteria: * systemic diseases (diabetes mellitus, obesity, cardiovascular diseases); * any medication that could affect the level of inflammation, (such as chronic antibiotics, phenytoin, cyclosporin, anti-inflammatory drugs, systemic corticosteroids, or calcium channel blockers); * pregnant or lactating woman; * inability to respond questions or to attend follow-up visits; * extreme skeletal malocclusions requiring orthognathic surgery; * patients smoking more than 10 cigarettes/day; and * the presence of PD greater or equal to 5mm with BOP after step 3 of periodontal therapy

Outcomes

Primary Outcomes

CAL

clinical attachment level (CAL) in mm

Time frame: 12 months

Secondary Outcomes

Type of movement

Description of the type of movement (categorical outcome)

Time frame: 12 months

Duration of orthodontic treatment

Total duration in months

Time frame: >12 months

External apical root resorption (EARR)

Presence of EARR (in mm3)

Time frame: 12 months

Probing pocket depth (PPD)

PPD in mm

Time frame: 12 months

Gingival margin level (GM)

GM in mm

Time frame: 12 months

Gingival recessions

Recessions in mm

Time frame: 12 months

Bleeding on probing (BOP)

BOP (presence or absence)

Time frame: 12 months

Suppuration on probing (SOP)

SOP (presence or absence)

Time frame: 12 months

Plaque index (PI)

PI (categorical outcome)

Time frame: 12 months

Radiographic periodontal outcomes

Radiographic bone level (RBL), radiographic defect angle

Time frame: 12 months

Inflammatory biomarkers in gingival crevicular fluid (GCF)

Inflammatory biomarkers RANKL and OPG, in picograms.

Time frame: 12 months

Oral health related quality of life questionnaire (OHRQoL)

Time frame: 12 months

Pain questionnaire

Pain questionnaire (VAS scale 0-100)

Time frame: 12 months

Aesthetic component of the Index of Orthodontic Treatment Need (IOTN)

IOTN after orthodontic therapy

Time frame: 12 months

Effect of MOPs During Orthodontic Movement in Periodontitis Patients

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts