Comparison of Non-Surgical Periodontal Therapy versus Background Periodontal Care in Reducing Atrial Fibrillation Recurrence in Patients with AF and Periodontitis: A Randomized Trial with Two Arms (Background Therapy Group vs. Conventional Non-Surgical Therapy Group).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
212
Under local anesthesia, full-mouth debridement (supragingival and subgingival scaling and root planing, FM-SRP) was performed by an experienced periodontist, initiated within 48 hours post-atrial fibrillation ablation and completed in two sessions within 48 hours. Polishing was performed using a rubber cup with prophylaxis paste. The procedure utilized Gracey curettes and piezoelectric ultrasonic tips combined with a force-controlled system. Postoperative Care Immediate Care: Local Adjunctive Therapy: 2% minocycline gel was injected into deep periodontal pockets (PD ≥5mm). Antimicrobial Rinse: 0.12% chlorhexidine solution (15 mL, 30-second rinse twice daily) for 14 days. Follow-Up Intervention At the 6-month follow-up, additional oral debridement was performed in the intervention group if indicated by the presence of bleeding points and/or increased probing pocket depth (PPD).
All study participants received oral hygiene instruction using the modified Bass technique. At baseline, supragingival deposits (dental plaque and calculus) were removed with an ultrasonic scaler or rubber cup with prophylaxis paste. To maintain blinding, simulated subgingival instrumentation sounds were played during the procedure for control group participants.
Shanghai Chest Hospital
Shanghai, Xuhui, China
Atrial fibrillation (AF) episodes lasting ≥30 seconds occurring
Atrial fibrillation (AF) episodes lasting ≥30 seconds occurring from 3 months post-ablation (end of blanking period) to the 12-month follow-up.
Time frame: From 3 months post-ablation (end of blanking period) to the 12-month follow-up.
Composite atrial arrhythmia recurrence
AF, atrial flutter (AFL), or atrial tachycardia (AT) episodes lasting ≥30 seconds during the period from 3 months post-ablation to 12-month follow-up.
Time frame: During the period from 3 months post-ablation to 12-month follow-up.
Antiarrhythmic drug usage
Antiarrhythmic drug usage at 12 months.
Time frame: At 12 months.
Change in Periodontal Inflamed Surface Area (PISA)
Change in Periodontal Inflamed Surface Area (PISA) at 12 months
Time frame: At 12 months
Probing depth (PD) reduction ≥2 mm in ≥50% of sites.
Probing depth (PD) reduction ≥2 mm in ≥50% of sites.
Time frame: At 12 months.
Bleeding on probing (BOP) rate reduction ≥30%.
Bleeding on probing (BOP) rate reduction ≥30%.
Time frame: At 12 months.
Clinical attachment level (CAL) stability (change ≤1 mm).
Clinical attachment level (CAL) stability (change ≤1 mm).
Time frame: At 12 months.
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