Short-term Effect of 2% Atorvastatin Dentifrice in Periodontal Status.
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|ClinicalTrials.gov Identifier: NCT01929135|
Recruitment Status : Completed
First Posted : August 27, 2013
Results First Posted : July 28, 2014
Last Update Posted : July 28, 2014
Periodontal disease (PD) is an inflammatory, infectious and destructive condition of the tissues surrounding the teeth. However, even if bacteria are required to initiate periodontal disease, the immune response is responsible for most of the destruction of the periodontal tissues. Statins may be used to control the immune response to periodontal pathogens, a factor that has not yet been managed clinically and even less massively.
Recently it has been reported the pharmacological effectiveness of topically used statins. For periodontal disease, at least four well conducted clinical trials have been published using a topically statin formula for pocket irrigation in adult populations with chronic periodontal disease, observing surprising clinical results in all of them (with clinical and statistical significance) and no adverse reactions.
The purpose of the present study is asses the effectiveness of a medicated 2% atorvastatin dentifrice, as complement to non-surgical conventional periodontal treatment. Clinical examination will be made at the beginning and after one month of treatment.
|Condition or disease||Intervention/treatment||Phase|
|Chronic Periodontitis||Drug: Medicated 2% atorvastatin dentifrice Drug: Non-medicated dentifrice||Phase 2|
An medicated 2% atorvastatin dentifrice (2 mg x every 0.1 ml of dentifrice) will be prepared for dental brushing. It will be used as a base a fluoride dentifrice, to which will be added atorvastatin in the prescribed amount. Medicated prototypes and placebos will be dosed in 5 ml syringes indicating each 0.5 ml measures to facilitate dispensing the product and ensure proper use. Thus, each syringe will be for 10 doses of toothpaste (10 brushings). 6 syringes will be provided to each patient, so that they have enough for a month of treatment, during which they will have to brush 2 times a day.
A clinical trial with two parallel groups (1:1) will be conducted, where there will be 2 groups of 19 patients each. The estimated sample size was based on the difference in attachment level achieved in the study Goodson et al (Goodson, Haffajee, Socransky, Kent, Teles, Hasturk, Bogren, Van Dyke, Wennstrom, Lindhe. Control of periodontal infections: A randomized controlled trial I. The primary outcome attachment gain and pocket depth reduction at Treated sites. J Clin Periodontol 2012, 39: 526-536), with a power of 90%, a significance level of 0.05 two-tailed.
Treatments and protocols:
Patients will be treated at the Department of Periodontology of Health Care Center, Universidad de Los Andes in San Bernardo, Santiago, Chile.
The two groups will undergo non-surgical periodontal therapy consisting of scaling and root planning of all tooth groups.
Therapy will be supplemented with oral hygiene instruction, indicating patients to brush with the dentifrice that will be provided, 2 times a day for two minutes each time. Then they will be told to spit the dentifrice excesses during 30 seconds, but not to rinse their teeth, or consume liquids or solid foods for at least 30 minutes. A group of 19 patients will receive the medicated 2%atorvastatin dentifrice while the other group of 19 patients will receive dentifrice without the drug to act as a placebo.
The record of the application of statins will be done by a professor at the Faculty of Dentistry, before periodontal clinical evaluation, in order not to influence the researcher.
The allocation to each group will be random and there will be a sequence concealment.
Continuous variables will be described by measures of central tendency and dispersion. Dichotomous variables will be tabulated and described by absolute frequencies and percentages according to each group. The delta of the outcome variables will be calculated as the difference between measurements before and after intervention. Multiple linear regression models will be used to compare the deltas of outcome variables after adjusting for gender, diabetes and tobacco use. A p value of <0.05 is considered statistically significant. The analysis will be performed with Stata software (version 12; Stata Corporation, Lakeway Drive, College Station, Texas, USA).
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||38 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||Double (Participant, Investigator)|
|Official Title:||Short-term Effect of 2% Atorvastatin Dentifrice as an Adjunct to Periodontal Therapy: A Randomized Double-blind Clinical Trial.|
|Study Start Date :||May 2013|
|Actual Primary Completion Date :||January 2014|
|Actual Study Completion Date :||June 2014|
Experimental: Medicated 2% atorvastatin dentifrice
A group of 19 patients received non surgical periodontal therapy accompanied by instruction for oral hygiene, using a medicated 2% atorvastatin dentifrice 2 times a day for two minutes each time, for 30 days.
Drug: Medicated 2% atorvastatin dentifrice
Non surgical periodontal therapy accompanied by medicated 2% atorvastatin dentifrice (20 mg per ml) 2 times a day for two minutes each time, for 30
Other Name: medicated dentifrice with atorvastatin
Placebo Comparator: Non-medicated dentifrice
A group of 19 patients received non surgical periodontal therapy accompanied by instruction for oral hygiene, using a non-medicated dentifrice as placebo 2 times a day for two minutes each time, for 30 days.
Drug: Non-medicated dentifrice
Non surgical periodontal therapy accompanied by non medicated dentifrice 2 times a day for two minutes each time, for 30 days.
Other Name: Placebo dentifrice
- Change in Periodontal Inflammation Surface Area (PISA) [ Time Frame: baseline and 1 month later of intervention ]
PISA will be computed through an Excel spreadsheet, using data of clinical attachment level, gingival recession and bleeding on probing.
Change in PISA: baseline measure minus 1 month later measure.
- Change in Mean Pocket Depth (PD) [ Time Frame: baseline and 1 month later ]
The PD will be defined as the distance from the free gingival margin to the bottom of the pocket. For each tooth will be conducted periodontal probing at 6 sites (mesiobuccal, mediobuccal, distobuccal, mesiolingual / palatal, mediolingual / palatal, distolingual/ palatal).
Change in mean PD: baseline measure minus 1 month later measure.
- Change in Clinical Attachment Level (CAL) [ Time Frame: baseline and 1 month after intervention ]
The Clinical Attachment Level (CAL) is defined as the distance from the cement-enamel junction to the fornix of the pocket. For each tooth will be performed periodontal probing at 6 sites (mesiobuccal, mediobuccal, distobuccal mesiolingual / palatal mediolingual / distolingual palatal / lingual).
Change in CAL: baseline measure minus 1 month later measure.
- Change in Bleeding on Probing Index (BOP) [ Time Frame: baseline and 1 month after intervention ]
The bleeding on probing index (BOP) will be determined by assigning + to the presence of bleeding on vestibular / palatine probing of the tooth examined and with a sign - the abscence. Later the + signs will be summed and divided by the number of sites examined.
Change in BOP: baseline measure minus 1 month later measure.
- Change in Gingival Index [ Time Frame: baseline and 1 month after intervention ]
Determined as score assigned to each site evaluated respect to clinical criteria as followed:
0. No inflammation
- Mild inflammation, slight change in color, slight edema, no bleeding on probing.
- Moderate inflammation, moderate glazing, redness, bleeding on probing.
- Severe inflammation, marked redness and hypertrophy, ulceration, tendency to spontaneous bleeding.
Then was calculated a score for each sextant summed the score and divided by the number of examined sites. Later was summed each sextant score and divided by sextant evaluated.
The change was calculated as baseline measure minus 1 month later measure.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01929135
|Centro de Salud Universidad de los Andes, San Bernardo|
|Santiago, Región Metropolitana, Chile|
|CIBRO Universidad de los Andes|
|Santiago, Región Metropolitana, Chile|
|Principal Investigator:||David R Rosenberg, DDS, MDS||Universidad de los Andes|