Heart failure (HF) is a rapidly growing public health issue affecting more than 40 million individuals globally; while gum disease with bone loss affects 50% of people in general. The objective of this study is to evaluate the effect of dental treatment on blood levels of a HF parameter at 3 and at 6 months. In addition to verify the relation between blood and salivary exam results and severity of HF. Imune response against one important oral bacterial will be also monitored at 3 and 6 months. Approximately 80 adult individuals will be included and divided into 3 groups. The first two groups will receive dental scaling and root planing (periodontitis individuals with heart failure \[n = 25\]; periodontitis individuals without heart failure \[n = 25\]). The third group named negative control will receive dental treatment only after 6 months of dental follow-up (periodontitis individuals with heart failure \[n = 25\]). HF treatment by oral medication will be continuous. Blood, salivary, microbiological and immune examinations will be performed in addition to the periodontal treatment of scaling and root planning. Clinical data will be obtained both for initial diagnosis and disease staging and for longitudinal follow-up.
Heart failure (HF) is a rapidly growing public health issue with an estimated prevalence of \> 40 million individuals globally; while periodontitis affects 50% of people in general, and its most severe form affects approximately 11% of the population. The primary objective of this study is to evaluate the effect of periodontal therapy on blood levels of NT-proBNP (N-terminal pro-B-type natriuretic peptide) at 3 and at 6 months. Secondary aims are the relation between biomarker blood levels and a) functional classes and b) its salivary levels. Antibodies against P. gingivalis besides species' levels will be also determined initially and at 3 and 6 months. As 66 participants must complete the study, 75 to 85 individuals over 35 years of age will be included and randomly assigned to dental scaling and root planing (periodontitis individuals with heart failure \[n = 25\]; periodontitis individuals without heart failure \[n = 25\]) or negative control (periodontitis individuals with heart failure \[n = 25\]). Blood, salivary, microbiological and immune examinations will be performed in addition to the periodontal treatment of scaling and root planning. Clinical data will be obtained both for initial diagnosis and disease staging and for longitudinal follow-up. NT-proBNP and antibodies against P. gingivalis will be evaluated by enzyme immunoassay using commercially available kits while P. gingivalis levels will be determined by quantitative polymerase chain reaction (qPCR).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
80
manual quadrant scaling and root planing followed by dental prophylaxis within 4 weekly sections and oral hygiene instructions
University of Taubate Dental School
Taubaté, São Paulo, Brazil
NT-proBNP in blood samples
Changes in NT-proBNP (N-terminal pro-B-type natriuretic peptide) levels in blood samples. Higher levels indicate worse heart failure status.
Time frame: baseline versus 6 months
Salivary NT-proBNP
Comparative NT-proBNP levels between blood and saliva samples at each time-point
Time frame: baseline, 3 and 6 months
clinical pocket depth response
Changes in periodontal pocket depth (mm). Higher values indicate deeper periodontal pockets.
Time frame: baseline, 3 and 6 months
clinical attachment level response
Changes in periodontal clinical attachment level (mm). Higher values indicate worse periodontal breakdown.
Time frame: baseline, 3 and 6 months
clinical bleeding response
Changes in bleeding on probing (0 indicates absence and 1 presence of bleeding onto gentle periodontal probing).
Time frame: baseline, 3 and 6 months
P. gingivalis bacterium salivary levels
P. gingivitis bacterium levels in saliva samples
Time frame: baseline and 3 months
P. gingivalis antibody salivary levels
Antibodies against P. gingivitis in saliva samples
Time frame: baseline and 3 months
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