NCT05232591

Brief Summary

Inflammatory process begins around root apex as a result of bacterial infection of pulp cavity in chronic apical periodontitis. Bone destruction can begin in apical region after immunological reactions at the end of inflammatory process, and radiolucent periapical lesion seems in this way. If bone destruction around apical region is in the rate of 30%, we can notice this difference eventually. Histological manifestations of periapical inflammation can be observed in the result of pulp necrosis and inflammation around apical region. Mocelular methods can determine the type of therapy in various diseases. Each region and tissue reserve specific host factors. Vast majority of pulpal inflammation was trigerred by microorganisms. Certain bacterial virulence factors may damage host tissue directly, other virulence factors can stimulate prolonged non-specific immune response causing tissue damage. In the last phase of infection, immunopathological destruction of pulp tissue is observed due to humoral response. IL-17 is an important inflammatory cytokine released from T cells of the immune system. TNF-alpha and RANKL are also mediators responsible for bone destruction metabolism. TNF is a cytokine mediating immunologic changes during periodontal disease. TNF induction stimulate secondary mediators taking part as chemotactic cytokines. TNF has two different types; TNF-alpha and TNF-beta. TNF-alpha is a polypeptide cytokine produced by macrophages and monocytes. TNF-alpha stimulates bone resorption . There has been limited researches analyzing GCF, blood and tissue of pulp, dentin-derived fluid and periapical fluid for molecular diagnosis so far. GCF is a fluid derived from gingival groove. This fluid contains a lot of host factors such as anticor, bacterial antigen, protein and cytokines. GCF sampling is a non-invasive method, it can be used to provide diagnostic information in all clinical cases. In this study, we will evaluate the levels of IL-17, TNF-alpha and RANKL in the gingival crevicular fluid of teeth with periapical lesion diagnosed with chronic apical periodontitis. Thus, it will be evaluated whether these markers can be used for diagnosis and follow-up of the disease in teeth with periapical lesions.

Trial Health

35
At Risk

Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
40

participants targeted

Target at P25-P50 for all trials

Timeline
Completed

Started Feb 2022

Shorter than P25 for all trials

Status
unknown

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

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

January 17, 2022

Completed
15 days until next milestone

Study Start

First participant enrolled

February 1, 2022

Completed
9 days until next milestone

First Posted

Study publicly available on registry

February 10, 2022

Completed
2 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 30, 2022

Completed
1 month until next milestone

Study Completion

Last participant's last visit for all outcomes

April 30, 2022

Completed
Last Updated

February 10, 2022

Status Verified

February 1, 2022

Enrollment Period

2 months

First QC Date

January 17, 2022

Last Update Submit

February 1, 2022

Conditions

Keywords

Gingival cervicular fluidIL-17TNF-alphaRANKL

Outcome Measures

Primary Outcomes (3)

  • IL-17 Level

    Concentration of IL-17 in GCF

    6 months

  • TNF-alpha

    Concentration of TNF-alpha in GCF

    6 months

  • RANKL

    Concentration of RANKL in GCF

    6 months

Study Arms (2)

1

GCF samples will be taken from the teeth diagnosed with chronic apical periodontitis

Diagnostic Test: The teeth diagnosed with chronic apical periodontitis

2

GCF samples will be taken from the collateral teeth (healthy teeth) of the teeth diagnosed with chronic apical periodontitis.

Diagnostic Test: The teeth diagnosed with chronic apical periodontitis

Interventions

GCF samples will be taken from the teeth diagnosed with chronic apical periodontitis

12

Eligibility Criteria

Age18 Years - 45 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64)
Sampling MethodProbability Sample
Study Population

It is planned to include volunteer patients who came to Van YYU Faculty of Dentistry, Oral and Maxillofacial Radiology Department for routine examination.

You may qualify if:

  • Healthy persons between the ages of 18 and 45 years
  • Mandibular molar teeth that were diagnosed with symptomatic irreversible pulpitis and periapical lesion

You may not qualify if:

  • Patients who are taken analgesic inflammatory drugs with in the last 12 hours
  • Pregnancy or lactation
  • Teeth with periodontal diseases
  • Teeth with sensitive to percussion and palpation
  • Teeth with root resorption
  • Teeth with immature/open apex

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (2)

  • Newton CW, Hoen MM, Goodis HE, Johnson BR, McClanahan SB. Identify and determine the metrics, hierarchy, and predictive value of all the parameters and/or methods used during endodontic diagnosis. J Endod. 2009 Dec;35(12):1635-44. doi: 10.1016/j.joen.2009.09.033.

  • Ricucci D, Siqueira JF Jr, Bate AL, Pitt Ford TR. Histologic investigation of root canal-treated teeth with apical periodontitis: a retrospective study from twenty-four patients. J Endod. 2009 Apr;35(4):493-502. doi: 10.1016/j.joen.2008.12.014.

Biospecimen

Retention: SAMPLES WITHOUT DNA

The gingival cervicular fluid is a biological fluid originating from blood plasma, present in different compositions in the gingival sulcus, and has the characteristics of exudate, which determines the ecology of the gingival sulcus. Cellular components (epithelium, bacteria, leukocytes, erythrocytes, leukocytes, viruses and their by-products), electrolytes, bacterial-metabolic products, cytokines, host and bacterial enzymes and enzyme products-inhibitors (acid phosphatase, alkaline phosphatase, aspartate aminotransferase, lactate dehydrogenase, aryl sulfatase, etc.), and immunoglobulins form the characteristic features of the fluid, revealing the importance of this fluid in terms of periodontal disease.

MeSH Terms

Conditions

Periapical Periodontitis

Condition Hierarchy (Ancestors)

Periapical DiseasesJaw DiseasesStomatognathic DiseasesPeriodontal DiseasesMouth DiseasesPeriodontitis

Central Study Contacts

Hacer Aydınyurt, PhD

CONTACT

Murat Tunca, PhD

CONTACT

Study Design

Study Type
observational
Observational Model
CASE ONLY
Time Perspective
CROSS SECTIONAL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Asist. Prof.

Study Record Dates

First Submitted

January 17, 2022

First Posted

February 10, 2022

Study Start

February 1, 2022

Primary Completion

March 30, 2022

Study Completion

April 30, 2022

Last Updated

February 10, 2022

Record last verified: 2022-02

Data Sharing

IPD Sharing
Will not share