Periodontal Pocket Clinical Trial
Official title:
The Effect of Lycopene Antioxidant Gel Compared to Minocycline Hydrochloride Microspheres as Adjunctive to Non Surgical Periodontal Treatment by Measuring Matrix Metalloproteinase-9, Transforming Growth Factor-Beta 1, Interleukin-8, and Tissue Inhibitor of Metalloproteinases -1
Periodontal diseases are among the most common medical conditions that may influence humans; 50% of the adult population can be affected by this illness. The condition is usually initiated by lack or reduction in oral hygiene which is then aggravated by the presence of microorganisms within biofilm which will induce a sequel of events that will lead to periodontitis. Scaling, root planning, and polishing (SRP) are the golden standard procedures in the treatment. Systemic antibiotics as adjunctive therapy has been established to be an excellent modality in controlling the bacterial virulence, hence, supporting the conventional SRP therapy. in order to avoid and limit the harmful effect of systemic antibiotics different locally applied preparations have been introduced including antioxidants. The aim of this prospective clinical study is to compare between the effect of Minocycline hydrochloride (HCL) microsphere and Lycopene gel when they are applied intrapocket subgingival with conventional SRP therapy
Periodontal diseases are among the most common medical conditions that may influence humans;
50% of the adult population can be affected by this illness. The condition is usually
initiated by lack or reduction in oral hygiene which is then aggravated by the presence of
microorganisms within biofilm which will induce a sequel of events that will lead to
periodontitis. The multifactorial nature of the disease necessitates a multifactorial
approach to restore the balance within the oral echo system. Scaling, root planning, and
polishing (SRP) are the golden standard procedures in the treatment; the therapeutic nature
of these clinical intervention is based on disrupting the biofilm and stimulate the host
defense mechanism to have the upper hand in targeting the microorganisms and their toxins.
Systemic antibiotics as adjunctive therapy has been established to be an excellent modality
in controlling the bacterial virulence, hence, supporting the conventional SRP therapy; in
order to avoid and limit the harmful effect of systemic antibiotics different locally applied
preparations have been introduced. Clinical parameters bleeding on probing (BOP), pocket
depth (PD), and clinical attachment level (CAL) have been improved when Minocycline
hydrochloride (HCL) microspheres was locally applied as an adjunctive drug to conventional
SRP. Oxidative stress is another factor related to periodontitis. The free radicals are a
by-product of the inflammatory reaction induced by the disease progression; free radicals
eliminated by antioxidants which is naturally found in the diet especially fruits and
vegetables; however, when the imbalance occur and the free radicals over weighed the
antioxidants there will be further initiation of the destruction mechanism. The role of
antioxidant as therapeutic agent in reducing the oxidative stress has been well studied and
their supporting effect to the conventional SRP treatment is well documented. Lycopene
extract can be applied as a gel intrapocket subgingival and it can have a promising result
with the SRP.
The aim of this prospective clinical study is to compare between the effect of Minocycline
HCL microsphere and Lycopene gel when they are applied intrapocket subgingival with
conventional SRP therapy. The study will utilize split mouth technique; three sites within
the oral cavity that have a pocket depth greater than 5 mm will be included. Each site will
be designated to receive a specific treatment, Control group (site) will have SRP and water
irrigation treatment, active group (site) will have local application of Minocycline HCL gel
following SRP therapy, and the experimental site which will receive lycopene and SRP
treatment. The influence of these therapeutic agents will be determined by the expression of
selected inflammation-related markers in the gingival crevicular fluid collected from the
experimental sites. The markers that will be examined are MMP-9, interleukin (IL)-8, TGF-Beta
1, and TIMP1. The change in the clinical parameters will be measured before the commencement
of treatment and it will be examined later to observe the effect of each locally applied drug
when compared to the control group (SRP plus water irrigation).
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