The aim of this study is to assess whether and how a mouthwash containing an ingredient that reduces inflammation in combination with a recently developed treatment is more effective at improving advanced gum disease. Advanced gum disease, also called periodontitis, is an inflammation of the gums which results in decrease in bone levels supporting teeth and can result in tooth loss. Minimally invasive non-surgical treatment (MINST) is a type of deep cleaning of teeth which involves removal of plaque beneath the gum margin and reduces inflammation. In this trial we will assess the additional benefits of combining deep cleaning (MINST) with the use of a mouthwash known to have a beneficial effect on tissue healing by helping the body to 'switch off' inflammation in periodontitis. Participants may be part of a control group, where you they be treated by MINST and provided with a placebo mouthwash The placebo mouthwash does not contain the active ingredient which reduces inflammation. Neither the participants nor the investigators can decide or be aware of which mouthwash the participants be given, as this will be determined randomly and the two mouthwash packages look the same. The duration of the study will be over six months and will consist of a total of seven appointments. The aim of this study is to assess whether we can achieve better outcomes using this mouthwash and the healing of thegums will be assessed clinically. In addition, other parameters such as saliva samples, blood samples and plaque samples will be collected throughout the study, which allows us to examine the healing process in more detail and will help us understand how exactly the combination of MINST and the mouthwash improve healing.
This is a pilot randomised controlled trial comparing patients being treated with MINST non-surgical therapy with an adjunctive test or placebo mouthwash. This will be a single centre trial in the Department of Periodontology at Guy's Dental Hospital. Patients will be recruited and treated at this centre as per the inclusion criteria. The primary outcome is PPD reduction at 6 months in test vs control group, and the secondary outcomes are CAL reduction at 6 months, changes in inflammatory/tissue degradation/repair biomarkers in saliva and GCF between baseline and 6 months post-treatment.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
20
adjunctive anti-inflammatory mouthwash
Contains all the inactive ingredients as the test mouthwash without the LXA4
Oral Clinical Research Unit (OCRU) at King's College London (KCL)
London, United Kingdom
Probing pocket depth
Measure of depth of periodontal pocket taken with periodontal probe (in mm)
Time frame: 6 months
Pocket closure
Reduction of pocket below 5 mm
Time frame: 6 months
Clinical attachment level
Measure of periodontal attachment level taken with periodontal probe (in mm) (sum of pocket depth and gingival recession)
Time frame: 6 months
Patient-related outcome measures
OHIP-14 score recorded by patients in OHIP-14 questionnaire
Time frame: 6 months
Composite outcome
Combination of reduction of pocket depth\<5mm and clinical attachment level gain of at least 3 mm (baseline- 3 months)
Time frame: 6 months
Changes in biomarkers
Changes in levels of mcirobial, inflammatory and host-response biomarkers in gingival crevicular fluid, subgingival plaque, saliva and blood at different points after treatment
Time frame: day 1, day 7, 1 month, 3 months, 6 months
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