NCT03733379

Brief Summary

The aim of this multicenter randomized clinical trial is to evaluate the clinical, microbiological and immunological effects of probiotics as an adjunct to Scaling and Root Planing alone or in combination with Metronidazole and Amoxicillin in the treatment of periodontitis.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
176

participants targeted

Target at P25-P50 for phase_3

Timeline
Completed

Started Nov 2018

Typical duration for phase_3

Geographic Reach
1 country

2 active sites

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

November 5, 2018

Completed
Same day until next milestone

Study Start

First participant enrolled

November 5, 2018

Completed
2 days until next milestone

First Posted

Study publicly available on registry

November 7, 2018

Completed
2.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 30, 2020

Completed
1 year until next milestone

Study Completion

Last participant's last visit for all outcomes

December 30, 2021

Completed
Last Updated

January 13, 2020

Status Verified

January 1, 2020

Enrollment Period

2.2 years

First QC Date

November 5, 2018

Last Update Submit

January 8, 2020

Conditions

Keywords

PeriodontitisProbioticMetronidazoleAmoxicillinScaling and root planingPeriodontal treatment

Outcome Measures

Primary Outcomes (1)

  • Percentage of subjects reaching ≤ 4 periodontal sites with probing depth (PD) ≥ 5 mm at 12 months

    12 months

Secondary Outcomes (27)

  • Number of sites with PD ≥ 5 mm.

    Baseline, 3, 6 and 12 months

  • Number of sites with PD ≥ 6 mm.

    Baseline, 3, 6 and 12 months

  • Number of sites with PD ≥ 7 mm.

    Baseline, 3, 6 and 12 months

  • Change in the number of sites with PD ≥ 5 mm.

    Baseline, 3, 6 and 12 months

  • Change in the number of sites with PD ≥ 6 mm

    Baseline, 3, 6 and 12 months

  • +22 more secondary outcomes

Study Arms (4)

Control

PLACEBO COMPARATOR

Scaling and root planing + Placebos of Metronidazole and Amoxicillin three times a day (TID) for 14 days + placebo lozenges of probiotics two times a day for 90 days.

Procedure: Scaling and root planingDrug: Metronidazole and Amoxicillin placebosDietary Supplement: Probiotic placebo

Probiotic

EXPERIMENTAL

Scaling and root planing + Placebos of Metronidazole and Amoxicillin three times a day (TID) for 14 days + lozenges of probiotics two times a day for 90 days.

Procedure: Scaling and root planingDrug: Metronidazole and Amoxicillin placebosDietary Supplement: Probiotic

Antibiotic

EXPERIMENTAL

Scaling and root planing + Metronidazole (400 mg/thrice a day,TID) and Amoxicillin (500 mg/ TID) for 14 days + placebo lozenges of probiotics two times a day for 90 days.

Procedure: Scaling and root planingDrug: MetronidazoleDrug: Amoxicillin

Antibiotic + probiotic

EXPERIMENTAL

Scaling and root planing + Metronidazole (400 mg/thrice a day,TID) and Amoxicillin (500 mg/ TID) for 14 days + lozenges of probiotics two times a day for 90 days.

Procedure: Scaling and root planingDrug: MetronidazoleDrug: AmoxicillinDietary Supplement: Probiotic placebo

Interventions

SRP will be performed in four to six appointments lasting approximately 1 h each, using manual curettes (Hu-Friedy, Chicago, IL, USA) and ultrasonic device (Cavitron Select SPC, Dentsply professional, York, PA, USA) under local anesthesia. The deep sites will be scaled throughout the first week and treatment of the entire oral cavity will be completed in 14 days.

Also known as: SRP
AntibioticAntibiotic + probioticControlProbiotic

Amoxicillin and metronidazole placebos thrice a day for 14 days (beginning with the first SRP session).

ControlProbiotic

Metronidazole 400 mg thrice a day for 14 days (beginning with the first SRP session).

AntibioticAntibiotic + probiotic

Amoxicillin 500 mg thrice a day for 14 days (beginning with the first SRP session).

AntibioticAntibiotic + probiotic
ProbioticDIETARY_SUPPLEMENT

The probiotic contains 2 different strains of Lactobacillus reuteri: L.reuteri DSM 17938 and L. reuteri ATCC PTA 5289 each at a concentration of 1 x 108 CFU per tablet. It will be used 2 times per day by 90 days.

Probiotic
Probiotic placeboDIETARY_SUPPLEMENT

The placebo is identical to the active but without L. reuteri. The two Study Products are identical in taste, texture and shape. It will be used 2 times per day by 90 days.

Antibiotic + probioticControl

Eligibility Criteria

Age30 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • ≥30 years of age;
  • at least 15 teeth (excluding third molars and teeth with advanced decay indicated for extraction);
  • a minimum of 6 teeth with at least one site each with probing depth (PD) and clinical attachment level (CAL) ≥5 mm;
  • at least 30% of the sites with probing depth (PD) and clinical attachment level (CAL) ≥4 mm and bleeding on probing (BOP);

You may not qualify if:

  • pregnancy;
  • breastfeeding;
  • current smoking and former smoking within the past 5 years;
  • systemic diseases that could affect the progression of periodontitis (e.g. diabetes, immunological disorders, osteoporosis);
  • scaling and root planing an in the previous 12 months;
  • antibiotic therapy in the previous 6 months;
  • long-term intake of anti-inflammatory medications;
  • need for antibiotic pre-medication for routine dental therapy;
  • use of orthodontic appliances;
  • extensive dental prosthetic rehabilitation;
  • allergy to metronidazole and/or amoxicillin.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Federal University of Paraná

Curitiba, Paraná, 80210170, Brazil

RECRUITING

University of Guarulhos

Guarulhos, São Paulo, 07023-070, Brazil

NOT YET RECRUITING

Related Publications (5)

  • Feres M, Figueiredo LC, Soares GM, Faveri M. Systemic antibiotics in the treatment of periodontitis. Periodontol 2000. 2015 Feb;67(1):131-86. doi: 10.1111/prd.12075.

    PMID: 25494600BACKGROUND
  • Feres M, Soares GM, Mendes JA, Silva MP, Faveri M, Teles R, Socransky SS, Figueiredo LC. Metronidazole alone or with amoxicillin as adjuncts to non-surgical treatment of chronic periodontitis: a 1-year double-blinded, placebo-controlled, randomized clinical trial. J Clin Periodontol. 2012 Dec;39(12):1149-58. doi: 10.1111/jcpe.12004. Epub 2012 Sep 27.

  • Borges I, Faveri M, Figueiredo LC, Duarte PM, Retamal-Valdes B, Montenegro SCL, Feres M. Different antibiotic protocols in the treatment of severe chronic periodontitis: A 1-year randomized trial. J Clin Periodontol. 2017 Aug;44(8):822-832. doi: 10.1111/jcpe.12721. Epub 2017 Jul 26.

  • Laleman I, Yilmaz E, Ozcelik O, Haytac C, Pauwels M, Herrero ER, Slomka V, Quirynen M, Alkaya B, Teughels W. The effect of a streptococci containing probiotic in periodontal therapy: a randomized controlled trial. J Clin Periodontol. 2015 Nov;42(11):1032-41. doi: 10.1111/jcpe.12464. Epub 2015 Nov 29.

  • Retamal-Valdes B, Teughels W, Oliveira LM, da Silva RN, Fritoli A, Gomes P, Soares GMS, Temporao N, Furquim CP, Duarte PM, Doyle H, Faveri M, Figueiredo LC, Feres M. Clinical, microbiological, and immunological effects of systemic probiotics in periodontal treatment: study protocol for a randomized controlled trial. Trials. 2021 Apr 15;22(1):283. doi: 10.1186/s13063-021-05246-0.

MeSH Terms

Conditions

Periodontitis

Interventions

Tooth ExfoliationRoot PlaningMetronidazoleAmoxicillinProbiotics

Condition Hierarchy (Ancestors)

Periodontal DiseasesMouth DiseasesStomatognathic Diseases

Intervention Hierarchy (Ancestors)

Dental Physiological PhenomenaDigestive System and Oral Physiological PhenomenaDental ScalingDental ProphylaxisPeriodonticsDentistrySubgingival CurettagePreventive DentistryNitroimidazolesNitro CompoundsOrganic ChemicalsImidazolesAzolesHeterocyclic Compounds, 1-RingHeterocyclic CompoundsAmpicillinPenicillin GPenicillinsbeta-LactamsLactamsAmidesSulfur CompoundsHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-RingDietary SupplementsFoodDiet, Food, and NutritionPhysiological PhenomenaFood and Beverages

Study Officials

  • Magda Feres, Professor

    University of Guarulhos

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Belén Retamal-Valdes, Professor

CONTACT

Magda Feres, Professor

CONTACT

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR INVESTIGATOR
PI Title
Professor

Study Record Dates

First Submitted

November 5, 2018

First Posted

November 7, 2018

Study Start

November 5, 2018

Primary Completion

December 30, 2020

Study Completion

December 30, 2021

Last Updated

January 13, 2020

Record last verified: 2020-01

Locations