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Periodontal DiseasesNCT03364751

Effect of Switching From Cigarette Smoking to the Use of IQOS on Periodontitis Treatment Outcome

A study testing IQOS and Cigarette in people with Periodontal Diseases and Chronic Periodontitis, run by Philip Morris Products S.A. at 26 sites in Japan.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study was to demonstrate in patients with generalized chronic periodontitis that switching from cigarette smoking to using IQOS improves the response to periodontal therapy and the overall oral health status compared to continuing cigarette smoking. Read more about this study

Who is it for?
Ages 30 years and older
What is being tested?
IQOS and Cigarette
Could I receive a placebo?
No, everyone receives an active treatment
How many people
179 participants
Where
26 sitesJapan
Study dates
7 Nov 2017to 12 Jun 2019
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 30 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Main Inclusion Criteria:

  1. Patient is aged ≥ 30 years old.
  2. Patient has smoked on average at least 10 commercially available cigarettes per day for at least 5 years
  3. Patient has generalized chronic periodontitis (i.e., more than 30% of diseased teeth with a PD ≥ 4 mm).

Main Exclusion Criteria:

  1. Patient has self-reported history of diagnosed systemic diseases (e.g., stroke or acute cardiovascular event within the last 5 years, diabetes, active cancer).
  2. Patient received root planing therapy within the 6 months prior to Visit 1.
  3. Patient received surgical periodontal therapy within 3 years prior to Visit
  4. Patient was treated within the 3 months prior to Visit 1 with systemic antibiotics or was treated with topical antibiotics applied in the mouth.
  5. Continuous systemic use of steroidal or non-steroidal anti-inflammatory drugs for more than 20 days during the past 30-day period (except for low dose aspirin, i.e., ≤300 mg).
  6. Female patients who are pregnant, breast-feeding, or planning a pregnancy within the course of the study.

Trial locations and contacts

26 sites in 1 country.

26 sites in 1 country

Japan26 sites
  • Sakai Dental Clinic

    Bunkyō, Tokyo, 113-0033

  • Takano Dental Clinic

    Chikusei, Ibaraki, 308- 0031

  • Kudan Dental Clinic

    Chiyoda City, Tokyo, 102-0074

  • Yano Dental Clinic

    Chōfu, Tokyo, 182-0024

  • Nikaido Dental Clinic

    Chūō, Tokyo, 103-0027

  • Kimura Dental Clinic

    Fukuoka, 810-0001

  • Yamashita Dental Office

    Fukuoka, 810-0001

  • Yasumasu Dental Office

    Fukuoka, 810-0001

  • Tsukiyama Dental Clinic

    Fukuoka, 811-1302

  • Yoshida Shigeru Dental Office

    Fukuoka, 812-0011

  • Mase Dental Clinic

    Futtsu, Chiba, 293-0001

  • Kato Dental Clinic

    Himi, Toyama, 935-0015

  • Yamashita Dental Clinic

    Kagoshima, 890-0053

  • Heart Dental Clinic

    Kagoshima, 892-0844

  • Yoshino Dental Clinic

    Kawaguchi, Saitama, 332-0016

  • AOI Universal Hospital

    Kawasaki, Kanagawa, 210-0822

  • Higashi Dental Office

    Kumamoto, 860-0855

  • Matsunobu Dental Office

    Miyako, Fukuoka, 800-0323

  • Tsudanuma Olive Dental Clinic

    Narashino, Chiba, 275-0016

  • Taniguchi Dental Clinic

    Sapporo, Hokkaido, 003-0023

  • Mune Dental Clinic

    Setagaya City, Tokyo, 157-0072

  • Kikuchi Dental Clinic

    Shinjuku, Tokyo, 160-0023

  • Saida Dental Clinic

    Tokorozawa, Saitama, 359-1146

  • Miyata Dental Clinic

    Toshima City, Tokyo, 171-0043

  • Tsukuba Healthcare Dental Clinic

    Tsukuba, Ibaraki, 305-0834

  • Yoshinaga Dental Office

    Uki, Kumamoto, 869-0521

Other trials in Japan

About this study

Official title: A 6-month Randomized, Controlled, Open-label, 2-arm Parallel Group, Multicenter Study to Evaluate the Effect of Switching From Cigarette Smoking to the Use of IQOS in Smokers With Generalized Chronic Periodontitis on the Response to Mechanical Periodontal Treatment and Oral Health Status.

The purpose of this study was to demonstrate in patients with generalized chronic periodontitis that switching from cigarette smoking to using IQOS improves the response to periodontal therapy and the overall oral health status compared to continuing cigarette smoking.

Note: "IQOS" is the Tobacco Heating System (THS) with Marlboro Heatsticks, marketed in Japan under the brand name IQOS

Read the detailed description

This was a randomized, controlled, open-label, 2-arm, parallel group ambulatory study with the randomization stratified by daily cigarette consumption over the month (30 days) prior to Visit 1 (10-19 cigarettes/day vs. > 19 cigarettes/day) and disease severity recorded at Visit 1 (< 5 mm Pocket Depth [PD] vs. ≥ 5 mm PD) based on the most severely diseased tooth, in smokers with generalized chronic periodontitis who are randomized to either switch from cigarette smoking to IQOS use or continuing cigarette smoking.

Being tested
IQOS, Cigarette
Keywords
Oral Health, Smoking, Cigarette, Reduced risk product, Tobacco heating system, THS, Modified risk tobacco product, Clinical attachment level
Medical subject headings
Periodontal Diseases, Chronic Periodontitis, Periodontal Pocket, Tooth Mobility, Gingival Diseases, Cigarette Smoking, Smoking

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • IQOSOther

    Patients will switch from cigarette smoking to ad libitum IQOS use.

  • CigaretteOther

    Patients will continue to smoke cigarettes ad libitum.

Study groups in NCT03364751
Study groupRoleWhat they receive
IQOS armActive comparator~86 patients, switching from cigarette smoking to IQOS use.
Receives: Other: IQOS
Cigarette armActive comparator~86 patients, continuing cigarette smoking.
Receives: Other: Cigarette

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Periodontal Pocket Depth (PD) Change From Baseline at 6 Months

    Pocket depth (PD) is the distance from the gingival margin to which a probe penetrates into the pocket. Mean Periodontal PD change from baseline will be measured in all sites with initial PD ≥ 4 mm, following mechanical periodontal therapy, in patients who switch to IQOS use compared to those who continue cigarette smoking.

    Measured: At 6 months

Secondary outcomes (17)
  1. Periodontal Pocket Depth (PD) Change Over Time. (Mean PD in All Subjects With Initial PD ≥ 4 mm)

    Pocket depth (PD) is the distance from the gingival margin to which a probe penetrates into the pocket. Mean Periodontal PD change from baseline will be measured in all sites with initial PD ≥ 4 mm, following mechanical periodontal therapy, in patients who switch to IQOS use compared to those who continue cigarette smoking.

    Measured: At 3 months

  2. Clinical Attachment Level (CAL) Change Over Time (Mean CAL in All Subjects With Initial PD ≥ 4 mm)

    Clinical attachment level (CAL) is the measured distance from cementoenamel junction (CEJ) to the bottom of pocket using a periodontal probe. Mean CAL change from baseline will be measured in sites with initial PD ≥ 4 mm, following mechanical periodontal therapy, in patients who switch to IQOS use compared to those who continue cigarette smoking.

    Measured: At 3 months and 6 months

  3. Periodontal Pocket Depth (PD) Change Over Time. (Mean PD in All Subjects With Initial PD ≥ 4 mm) - Descriptive Statistics

    Pocket depth (PD) is the distance from the gingival margin to which a probe penetrates into the pocket. Mean Periodontal PD change from baseline will be measured in all sites with initial PD ≥ 4 mm, following mechanical periodontal therapy, in patients who switch to IQOS use compared to those who continue cigarette smoking.

    Measured: From baseline to 3 months and 6 months

  4. Clinical Attachment Level (CAL) Change Over Time (Mean CAL in All Subjects With Initial PD ≥ 4 mm) - Descriptive Statistics

    Clinical attachment level (CAL) is the measured distance from cementoenamel junction (CEJ) to the bottom of pocket using a periodontal probe. Mean CAL change from baseline will be measured in sites with initial PD ≥ 4 mm, following mechanical periodontal therapy, in patients who switch to IQOS use compared to those who continue cigarette smoking.

    Measured: From baseline to 3 months and 6 months

  5. Full-mouth Periodontal PD Change Over Time.

    Pocket depth (PD) is the distance from the gingival margin to which a probe penetrates into the pocket. Change in mean full-mouth PD will be measured, following mechanical periodontal therapy, in patients who switch to IQOS use compared to those who continue cigarette smoking.

    Measured: From baseline to 3 months and 6 months

  6. Full-mouth Clinical Attachment Level (CAL) Over Time.

    Clinical attachment level (CAL) is the measured distance from cementoenamel junction (CEJ) to the bottom of pocket using a periodontal probe. Change in mean full-mouth CAL will be measured, following mechanical periodontal therapy, in patients who switch to IQOS use compared to those who continue cigarette smoking.

    Measured: From baseline to 3 months and 6 months

  7. Peridontal PD Reduction.

    Pocket depth (PD) is the distance from the gingival margin to which a probe penetrates into the pocket. Mean PD change will be measured in sites with initial PD < 4 mm, and with initial PD of 4 mm to <5 mm, 5 mm to < 6 mm, 6 mm to < 7 mm and ≥ 7 mm.

    Measured: From baseline to 3 months and 6 months

  8. Clinical Attachment Level Improvement

    Clinical attachment level (CAL) is the measured distance from cementoenamel junction (CEJ) to the bottom of pocket using a periodontal probe. Mean CAL change will be measured in sites with initial PD < 4 mm, and with initial PD of 4 mm to <5 mm, 5 mm to < 6 mm, 6 mm to < 7 mm and ≥ 7 mm.

    Measured: From baseline to 3 months and 6 months

  9. Number of Periodontally Diseased Sites.

    Pocket depth (PD) is the distance from the gingival margin to which a probe penetrates into the pocket. Any change will be recorded in the number of periodontally diseased sites with Pocket Depth (PD) < 4 mm, with PD 4 mm to < 5mm, with PD 5 mm to < 6 mm , with PD 6 mm to < 7 mm and with PD ≥ 7 mm. PD is the distance from the gingival margin to which a probe penetrates into the pocket.

    Measured: From baseline to 3 months and 6 months

  10. Gingival Inflammation

    Gingival inflammation will be measured by calculating the gingival index (GI) score for each target tooth.

    The gingival index (GI) scores each site on a 0 to 3 scale, with 0 being normal and 3 being severe inflammation characterized by edema, redness, swelling, and spontaneous bleeding.

    Measured: From baseline to 3 months and 6 months

  11. Tooth Mobility

    Tooth mobility will be graded according to Miller's mobility index (MMI), which is the most widely accepted method for routine clinical examinations of tooth mobility. The tooth is held between the metallic handles of two instruments and moved in the buccolingual or buccopalatal direction, and the moved distance is visually estimated by the person conducting the examination.

    Grade 0: Physiologic movement within 0.2 mm; Grade 1: Slight mobility, tooth can be moved 0.2 - 1 mm labiolingually; Grade 2: Moderate mobility, tooth can be moved 1 - 2 mm labiolingually or mesiodistally; Grade 3: Severe mobility, tooth can be moved more than 2 mm labiolingually or mesiodistally, or ability to depress the tooth in a vertical direction.

    Measured: From baseline to 3 months and 6 months

  12. Presence of Plaque on Tooth Surfaces in Full Mouth

    Plaque will be measured using the plaque control record (PCR) percentage.

    Measured: From baseline to 3 months and 6 months

  13. Inflammatory Status in Periodontal Pockets

    Gum inflammation was measured using percentage of teeth bleeding on probing (BOP).

    BOP in full mouth was measured to assess inflammatory status in the pocket and was assessed as YES or NO of bleeding at 6 sites per tooth. Gently probing (approximately 20 g pressure), the bleeding site within 30 seconds was assessed as YES.

    Measured: From baseline to 3 months and 6 months

  14. Concentrations of Urinary Nicotine Equivalents (NEQ)

    This biomarker of exposure to a tobacco smoke constituent will be measured in patients who switch to IQOS use and patients who continue cigarette smoking. Concentrations measured in urine and expressed as concentration adjusted for creatinine (mg/g creat).

    Measured: From baseline to 3 months and 6 months

  15. Concentrations of Total 4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanol (Total NNAL)

    This biomarker of exposure to a tobacco smoke constituent will be measured in patients who switch to IQOS use and patients who continue cigarette smoking. Concentrations measured in urine and expressed as concentration adjusted for creatinine (pg/mg creat).

    Measured: From baseline to 3 months and 6 months

  16. Concentrations of 2-cyanoethylmercapturic Acid (CEMA)

    This biomarker of exposure to a tobacco smoke constituent will be measured in patients who switch to IQOS use and patients who continue cigarette smoking. Concentrations measured in urine and expressed as concentration adjusted for creatinine (ng/mg creat).

    Measured: From baseline to 3 months and 6 months

  17. Use of Tobacco or Nicotine-containing Products in Patients Switching to IQOS Use and Patients Who Continue Cigarette Smoking.

    Self-reported use of tobacco or nicotine containing products will be measured over the study in patients switching to IQOS use and patients who continue cigarette smoking.

    Measured: From baseline to 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 Dec 2017
  2. Study start7 Nov 2017
  3. Primary completion21 Dec 2018
  4. Study completion12 Jun 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Other
Allocation
Randomised
Intervention model
Single group
Masking
Single blind
Who is masked
Investigator
Enrolment
179 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03364751
Sponsor's protocol ID
P1-OHS-01-JP
Status last verified
Jan 2023
First submitted
23 Nov 2017
Last updated
30 Jan 2023
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Pouly S, Ng WT, Benzimra M, Soulan A, Blanc N, Zanetti F, Picavet P, Baker G, Haziza C. Effect of Switching to the Tobacco Heating System Versus Continued Cigarette Smoking on Chronic Generalized Periodontitis Treatment Outcome: Protocol for a Randomized Controlled Multicenter Study. JMIR Res Protoc. 2021 Jan 18;10(1):e15350. doi: 10.2196/15350.

    PubMed 33459599
  • Effect of switching from cigarette smoking to the use of the tobacco heating system on periodontitis treatment outcome: Periodontal parameter results from a multicenter Japanese study Authors: Pouly, Sandrine; Ng, Wee Teck; Blanc, Nicolas; Hession, Paul; Zanetti, Filippo; Battey, James N. D.; de La Bourdonnaye, Guillaume; Heremans, Annie; Haziza, Christelle Journal Title: Frontiers in dental medicine Publication Date: 7/22/2022 Volume: 3 DOI: 10.3389/fdmed.2022.915079

Questions about this trial

What is this clinical trial studying?

A study testing IQOS and Cigarette in people with Periodontal Diseases and Chronic Periodontitis, run by Philip Morris Products S.A. at 26 sites in Japan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 30 Jan 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 26 sites in Japan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 18 Feb 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Periodontal Pocket Depth (PD) Change From Baseline at 6 Months (time frame: At 6 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03364751, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Jan 2023.

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