Clinical Trial Details
— Status: Completed
Administrative data
NCT number |
NCT02907528 |
Other study ID # |
OSU-FAPESP 101 |
Secondary ID |
|
Status |
Completed |
Phase |
N/A
|
First received |
|
Last updated |
|
Start date |
January 2014 |
Est. completion date |
January 2016 |
Study information
Verified date |
March 2021 |
Source |
Ohio State University |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Interventional
|
Clinical Trial Summary
Objective: To clinically evaluate mandibular furcation treated with Beta tricalcium
phosphate/hydroxyapatite (βTCP/HA) isolated or combined with enamel matrix derivative (EMD +
βTCP/HA) and EMD alone.
Material and Methods: 39 patients, presenting at least one mandibular class II furcation
defect, probing pocket depth (PPD) ≥ 4 mm and bleeding on probing, were included. The defects
were assigned to the βTCP/HA group 1 (n = 13); open-flap debridement (OFD) + βTCP/HA filling;
βTCP/HA + EMD group 2 (n = 13); OFD + βTCP/HA + EMD filling; and EMD group 3 (n = 13) OFD +
EMD filling. Plaque (PI) and gingival index (GI), PPD, relative gingival margin position
(RGMP), vertical and horizontal attachment level (RVCAL and RHCAL), and furcation diagnosis
were evaluated at baseline, 6 and 12 months.
Description:
Although enamel matrix derivative (EMD) has been used to promote periodontal regeneration,
little is known of its effect on the microbiome. Therefore, this investigation aimed to
identify the changes in periodontal microbiome following treatment with EMD using a
deep-sequencing approach. Thirty-nine patients having mandibular class II buccal furcation
defects were randomized to beta-tricalcium-phosphate/hydroxyapatite graft (BONE group),
EMD+BONE or EMD alone. Plaque was collected from furcation defects at baseline, 3 and 6
months post-treatment. Bacterial DNA was analyzed using terminal restriction fragment length
polymorphism (t-RFLP) and 16S pyrotag sequencing. 169,000 classifiable sequences were
compared to HOMD using the QIIME and PhyloToAST pipelines. Statistical comparisons were made
using parametric tests. At baseline, a total of 422 species were identified from the 39
defects, belonging to Fusobacterium, Pseudomonas, Streptococcus, Filifactor and Parvimonas.
All three regenerative procedures predictably altered the disease-associated microbiome, with
a restitution of health-compatible species. However, EMD and BONE+EMD groups demonstrated
more long-term reductions in higher number of species than in BONE group (p<0.05), especially
disease-associated species e.g. Selenomonas noxia, F.alocis, and Fusobacterium. EMD may
promote periodontal regeneration by predictably altering a dysbiotic subgingival microbiome,
decreasing pathogen richness and increasing commensal abundance.