Periapical DiseasesNCT05478811
Evaluation of RANKL/OPG Levels in Gingival Crevicular Fluid at 1st and 3rd Months of Activation of NaOCl With Er,Cr YSSG Laser in Root Canal Treatment
A study testing Er,Cr:YSSG laser in people with Periapical Diseases, run by Yuzuncu Yil University at 1 site in Turkey (Türkiye).
Trial summary
Chronic Apical Periodontitis (CAP) is a disease caused by bacterial infection of the dental pulp and characterized by inflammation of the periradicular tissues. This disease is often the result of untreated caries and accompanied by the destruction of periapical bone and soft tissues, can cause tooth loss. Read more about this study
- Who is it for?
- Ages 18 to 50 yearsHealthy volunteers can take part
- Conditions the study is for
- Periapical Diseases
- What is being tested?
- Er,Cr:YSSG laser
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 30 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 1 Jan 2022to 1 Dec 2022
- Phase
- Interventional
- Are there results?
- None posted in the registry
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 18 to 50 years
- All sexes
- Healthy volunteers accepted
- Adult
Who may be able to join
- Healthy persons between the ages of 18 and 50 years
- Mandibular molar teeth that were diagnosed with periapical lesions
Who cannot join
- Pregnancy or lactation
- Patients who do not have periapical lesions,
- Teeth with immature/open apex
- A probing depth of more than 3 mm
- Bleeding during probing will not be included in the study group
- Teeth with root resorption
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Evaluation of RANKL/OPG Levels in Gingival Crevicular Fluid at 1st and 3rd Months of Activation of NaOCl With Er,Cr YSSG Laser in Root Canal Treatment of Mandibular Molar Teeth With Periapical Lesions
Chronic Apical Periodontitis (CAP) is a disease caused by bacterial infection of the dental pulp and characterized by inflammation of the periradicular tissues. This disease is often the result of untreated caries and accompanied by the destruction of periapical bone and soft tissues, can cause tooth loss. Inflammatory periapical lesion is observed in the radiological examination of teeth diagnosed with Chronic Apical Periodontitis. This periapical lesion manifests as a host defense response to microbial challenge caused by infected pulp necrosis. Polymorphonuclear leukocytes, T and B lymphocytes, macrophages and plasma cells and many inflammatory cells are involved in host defense. These inflammatory cells, especially macrophages, mediate the immunological response seen in chronic apical periodontitis. Diagnosis and evaluation of apical periodontitis are made with conventional periapical radiographs. However, radiographic evaluation has some limitations. These limitations can be listed as the radiolucent area on the x-ray being related to the amount of bone loss caused by the lesion, the extent of the bone loss to the cortical bone, the variability of the bone structure in maxilla and mandibula, and the operator experience. The main goal in root canal treatment is to eliminate microorganisms and products in the root canal system with the irrigation agents which we use. NaOCl, which is frequently used for this purpose, is used alone or activated by Er,Cr YSSG laser. It has been reported that NaOCl, which is activated by laser, increases the elimination of microorganism in the root. The gingival crevicular fluid is an inflammatory exudate collected from the gingival sulcus. Peripheral body fluids, such as gingival crevicular fluid, can often be used as descriptors in acute and chronic inflammation. The collection of gingival crevicular fluid is a very simple and risk-free method for the patient. Biomarkers such as inflammatory mediators and neuropeptides can be detected in the gingival crevicular fluid of teeth with periodontal disease. At the molecular level, osteoclast activation is regulated by the triple molecule interaction of RANK, RANKL, and OPG. RANK (Receptor Activator of Nuclear Factor Kappa B) binds to its ligand, RANKL, while synthesizing both mature osteoclasts and its progenitor cells. RANKL provides osteoclast differentiation and activation. OPG (Osteoprotegerin) ligand is a decoy receptor for RANKL, thus inhibiting osteoclast differentiation.When the investigators look at the studies in the literature, there are many studies showing that the level of RANKL/OPG in the gingival crevicular fluid decreases with periodontal treatment. Also, when the investigators look at the studies on endodontic treatment, many mediators such as MMP-8, IL-8, Substance P, Neurokinin A and their changes after root canal treatment were examined. However, no study was found examining RANKL/OPG levels in gingival crevicular fluid after root canal treatment. At the same time, it is known that gingival crevicular fluid is used as a descriptive method in the determination of bone healing after periodontal treatment. However, in the literature, conventional radiological methods and tomography are seen as the most frequently used examination methods in the determination of bone healing after root canal treatment of lesioned teeth. The number of studies in which the gingival groove fluid collection method, which is much less invasive than these methods, is used as a descriptive method is quite limited. In line with this information, it is planned to conduct the research described below by examining the effect of activation with Er,Cr YSSG laser on the RANKL/OPG levels in the gingival crevicular fluid in the 1-3 month bone healing period after root canal treatment in lesioned teeth.
Read the detailed description
The study is planned to be conducted on a total of 30 healthy patients, aged between 18-50 years, who were diagnosed and followed up in the Department of Endodontics, Faculty of Dentistry of Yüzüncü Yıl University. The sample size was calculated in the G*Power 3.1 program based on the data in the study of Arslan et al. In this study, the minimum required number of patients was determined as 30 by taking effect size 1.252193, alpha=0.05 and power=0.90. Mandibular first and second molars diagnosed with Chronic Apical Periodontitis will be included in the study group. Patients who do not have periapical lesions, have open apex, have a probing depth of more than 3 mm, and have bleeding during probing will not be included in the study group. RANKL and OPG levels in the gingival crevicular fluid will be determined using the ELISA test. RANKL and OPG levels in the gingival crevicular fluid of teeth with periapical lesions, which are indicated for root canal treatment, will be recorded with Periopaper (Oraflow, New York, NY).
Before taking a sample of gingival crevicular fluid, the tooth will be washed with water, dried and the plaque and deposits on it will be cleaned with cotton. Then, the tooth will be isolated with a cotton pellet and a suction, and a Periopaper (Oraflow, New York, NY) will be placed 1-2 mm into the gingival sulcus until slight resistance is felt, and a sample of gingival crevicular fluid will be taken after waiting for 30 seconds. Specimens contaminated with blood or saliva will not be included in the study. Then, these samples will be stored at -80°C. The access cavity will be opened to the teeth under local anesthesia with a 2 milliliter Ultracain D-S (Aventis, The Netherlands). The working length will be determined with a #15 K-files (Mani Inc, Tochigi, Japan) with the apex locator (DentsplyMaillefer, UK) and radiographic imaging.
The preperation of the root canals will be completed by ProTaperNext (DentsplyMaillefer, Baillagues, Switzerland) up to the X3 instrument as standard in each patient. 2 ml of 5.25% NaOCl solution will be used at each file change during preperation. During the irrigation process, a 2 milliliter dental injector and a 27 gauge dental needle tip will be used during preperation. The tip of the cannulas will be adjusted to be 1 mm shorter than the working length. Calcium hydroxide (Kalsin; Aktug Tic Bornova,Izmir, Turkey) paste is placed in the root canals after the preperation process and the tooth is temporarily closed with Cavit-G (3M ESPE, Seefeld, Germany). And the patient will be given an appointment 2 weeks later. When the patient comes to the second session appointment, the temporary restoration will be removed and the calcium hydroxide paste from root canals will be removed. Canals will be irrigated with 5 ml NaOCl 5.25% and 17% EDTA solution for the removal of calcium hydroxide. Then canals will reshaped with ProTaperNext X3 (DentsplyMaillefer, Baillagues, Switzerland). And then again 5 ml. NaOCl 5.25% and 17% EDTA solution will be used for irrigation to be ensured that calcium hydroxide is completely removed from the root canals. For final irrigation respectively 5 ml NaOCl %5,25 solution , 5 ml. % 17 EDTA solution and %5,25 NaOCl solution will be used. According to NaOCl activation (Group1: NaOCl, Er,Cr:YSSG will be activated by laser during the final irrigation; Group2 (control): Routine final irrigation procedure will be done, NaOCl will not be activated by any method) teeth will be divided into two main groups (n:15).
After final irrigation and activation procedure, root canals will be dried with sterile paper points, then all root canals will be obturated with sterile gutta-perchas and AH Plus root canal sealer (Dentsply DeTrey Gmbh, Konstanz, Germany) using the single-cone technique. Teeth with completed root canal filling will be restored with composite filling material to ensure coronal sealing. After the treatment, the patients in both groups will be called for control at periodically (1st month - 3rd month) and gingival crevicular fluid samples will be taken again with Periopaper (Oraflow, New York, NY). According to the results which is obtained with the ELISA test, the change in the RANKL and OPG levels in the gingival crevicular fluid of the patients will be evaluated.
- Conditions
- Periapical Diseases
- Being tested
- Er,Cr:YSSG laser, Control
- Keywords
- Gingival cervicular fluidi, RANKL, OPG
- Medical subject headings
- Periapical Diseases
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Er,Cr:YSSG laserDevice
NaOCl, Er,Cr:YSSG will be activated by laser during the final irrigatio
ControlDevice
Routine final irrigation procedure will be done, NaOCl will not be activated by any method)
| Study group | Role | What they receive |
|---|---|---|
| Er,Cr:YSSG laser | Active comparator | NaOCl, Er,Cr:YSSG will be activated by laser during the final irrigation Receives: Device: Er,Cr:YSSG laser; Device: Control |
| Control | Active comparator | Routine final irrigation procedure will be done, NaOCl will not be activated by any method. Receives: Device: Er,Cr:YSSG laser; Device: Control |
What is being measured
The primary outcome is the main question the study is designed to answer.
RANKL/OPG levels
RANKL/OPG levels in the gingival crevicular fluid
Measured: 3 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted28 Jul 2022
- Study start1 Jan 2022
- Primary completion1 Oct 2022 (estimated)
- Study completion1 Dec 2022 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Periapical DiseasesStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Group1: NaOCl, Er,Cr:YSSG will be activated by laser during the final irrigation; Group2 (control): Routine final irrigation procedure will be done, NaOCl will not be activated by any method) teeth will be divided into two main groups (n:15).
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 30 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Yuzuncu Yil University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Esin Özlek, Yuzuncu Yil University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05478811
- Sponsor's protocol ID
- 10/15.12.2021
- Status last verified
- Jul 2022
- First submitted
- 25 Jul 2022
- Last updated
- 2 Aug 2022
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Arslan H, Koseoglu S, Doganay Yildiz E, Arabaci T, Savran L, Yildiz DA, Veyisoglu G. Effect of intracanal diode laser application and low-level laser therapy on CGRP change. Braz Oral Res. 2019 Mar 18;32:e125. doi: 10.1590/1807-3107bor-2018.vol32.0125.
PubMed 30892373Evrendilek F, Ozlek E, Meydan I. Effect of Er, Cr: YSGG laser-activated final irrigation on gingival crevicular fluid RANKL/OPG levels. Sci Rep. 2025 Dec 23;16(1):3430. doi: 10.1038/s41598-025-33466-w.
PubMed 41436629
Study at a glance
From the registry record, last updated by the sponsor on 2 Aug 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Evaluation of RANKL/OPG Levels in Gingival Crevicular Fluid at 1st and 3rd Months of Activation of NaOCl With Er,Cr YSSG Laser in Root Canal Treatment of Mandibular Molar Teeth With Periapical Lesions
- ClinicalTrials.gov ID
- NCT05478811
- Acronym / sponsor ID
- 10/15.12.2021
- Conditions
- Periapical Diseases
- Keywords
- Gingival cervicular fluidi, RANKL, OPG
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 30 participants (estimated)
- Lead sponsor
- Yuzuncu Yil UniversityUniversity, hospital or other
- Study start
- 1 Jan 2022 (actual)
- Primary completion
- 1 Oct 2022 (estimated)
- Study completion
- 1 Dec 2022 (estimated)
- First posted
- 28 Jul 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Chronic Apical Periodontitis (CAP) is a disease caused by bacterial infection of the dental pulp and characterized by inflammation of the periradicular tissues. This disease is often the result of untreated caries and accompanied by the destruction of periapical bone and soft tissues, can cause tooth loss. Inflammatory periapical lesion is observed in the radiological examination of teeth diagnosed with Chronic Apical Periodontitis. This periapical lesion manifests as a host defense response to microbial challenge caused by infected pulp necrosis. Polymorphonuclear leukocytes, T and B lymphocytes, macrophages and plasma cells and many inflammatory cells are involved in host defense. These inflammatory cells, especially macrophages, mediate the immunological response seen in chronic apical periodontitis. Diagnosis and evaluation of apical periodontitis are made with conventional periapical radiographs. However, radiographic evaluation has some limitations. These limitations can be listed as the radiolucent area on the x-ray being related to the amount of bone loss caused by the lesion, the extent of the bone loss to the cortical bone, the variability of the bone structure in maxilla and mandibula, and the operator experience. The main goal in root canal treatment is to eliminate microorganisms and products in the root canal system with the irrigation agents which we use. NaOCl, which is frequently used for this purpose, is used alone or activated by Er,Cr YSSG laser. It has been reported that NaOCl, which is activated by laser, increases the elimination of microorganism in the root. The gingival crevicular fluid is an inflammatory exudate collected from the gingival sulcus. Peripheral body fluids, such as gingival crevicular fluid, can often be used as descriptors in acute and chronic inflammation. The collection of gingival crevicular fluid is a very simple and risk-free method for the patient. Biomarkers such as inflammatory mediators and neuropeptides can be detected in the gingival crevicular fluid of teeth with periodontal disease. At the molecular level, osteoclast activation is regulated by the triple molecule interaction of RANK, RANKL, and OPG. RANK (Receptor Activator of Nuclear Factor Kappa B) binds to its ligand, RANKL, while synthesizing both mature osteoclasts and its progenitor cells. RANKL provides osteoclast differentiation and activation. OPG (Osteoprotegerin) ligand is a decoy receptor for RANKL, thus inhibiting osteoclast differentiation.When the investigators look at the studies in the literature, there are many studies showing that the level of RANKL/OPG in the gingival crevicular fluid decreases with periodontal treatment. Also, when the investigators look at the studies on endodontic treatment, many mediators such as MMP-8, IL-8, Substance P, Neurokinin A and their changes after root canal treatment were examined. However, no study was found examining RANKL/OPG levels in gingival crevicular fluid after root canal treatment. At the same time, it is known that gingival crevicular fluid is used as a descriptive method in the determination of bone healing after periodontal treatment. However, in the literature, conventional radiological methods and tomography are seen as the most frequently used examination methods in the determination of bone healing after root canal treatment of lesioned teeth. The number of studies in which the gingival groove fluid collection method, which is much less invasive than these methods, is used as a descriptive method is quite limited. In line with this information, it is planned to conduct the research described below by examining the effect of activation with Er,Cr YSSG laser on the RANKL/OPG levels in the gingival crevicular fluid in the 1-3 month bone healing period after root canal treatment in lesioned teeth.
Detailed description
The study is planned to be conducted on a total of 30 healthy patients, aged between 18-50 years, who were diagnosed and followed up in the Department of Endodontics, Faculty of Dentistry of Yüzüncü Yıl University. The sample size was calculated in the G*Power 3.1 program based on the data in the study of Arslan et al. In this study, the minimum required number of patients was determined as 30 by taking effect size 1.252193, alpha=0.05 and power=0.90. Mandibular first and second molars diagnosed with Chronic Apical Periodontitis will be included in the study group. Patients who do not have periapical lesions, have open apex, have a probing depth of more than 3 mm, and have bleeding during probing will not be included in the study group. RANKL and OPG levels in the gingival crevicular fluid will be determined using the ELISA test. RANKL and OPG levels in the gingival crevicular fluid of teeth with periapical lesions, which are indicated for root canal treatment, will be recorded with Periopaper (Oraflow, New York, NY).
Before taking a sample of gingival crevicular fluid, the tooth will be washed with water, dried and the plaque and deposits on it will be cleaned with cotton. Then, the tooth will be isolated with a cotton pellet and a suction, and a Periopaper (Oraflow, New York, NY) will be placed 1-2 mm into the gingival sulcus until slight resistance is felt, and a sample of gingival crevicular fluid will be taken after waiting for 30 seconds. Specimens contaminated with blood or saliva will not be included in the study. Then, these samples will be stored at -80°C. The access cavity will be opened to the teeth under local anesthesia with a 2 milliliter Ultracain D-S (Aventis, The Netherlands). The working length will be determined with a #15 K-files (Mani Inc, Tochigi, Japan) with the apex locator (DentsplyMaillefer, UK) and radiographic imaging.
The preperation of the root canals will be completed by ProTaperNext (DentsplyMaillefer, Baillagues, Switzerland) up to the X3 instrument as standard in each patient. 2 ml of 5.25% NaOCl solution will be used at each file change during preperation. During the irrigation process, a 2 milliliter dental injector and a 27 gauge dental needle tip will be used during preperation. The tip of the cannulas will be adjusted to be 1 mm shorter than the working length. Calcium hydroxide (Kalsin; Aktug Tic Bornova,Izmir, Turkey) paste is placed in the root canals after the preperation process and the tooth is temporarily closed with Cavit-G (3M ESPE, Seefeld, Germany). And the patient will be given an appointment 2 weeks later. When the patient comes to the second session appointment, the temporary restoration will be removed and the calcium hydroxide paste from root canals will be removed. Canals will be irrigated with 5 ml NaOCl 5.25% and 17% EDTA solution for the removal of calcium hydroxide. Then canals will reshaped with ProTaperNext X3 (DentsplyMaillefer, Baillagues, Switzerland). And then again 5 ml. NaOCl 5.25% and 17% EDTA solution will be used for irrigation to be ensured that calcium hydroxide is completely removed from the root canals. For final irrigation respectively 5 ml NaOCl %5,25 solution , 5 ml. % 17 EDTA solution and %5,25 NaOCl solution will be used. According to NaOCl activation (Group1: NaOCl, Er,Cr:YSSG will be activated by laser during the final irrigation; Group2 (control): Routine final irrigation procedure will be done, NaOCl will not be activated by any method) teeth will be divided into two main groups (n:15).
After final irrigation and activation procedure, root canals will be dried with sterile paper points, then all root canals will be obturated with sterile gutta-perchas and AH Plus root canal sealer (Dentsply DeTrey Gmbh, Konstanz, Germany) using the single-cone technique. Teeth with completed root canal filling will be restored with composite filling material to ensure coronal sealing. After the treatment, the patients in both groups will be called for control at periodically (1st month - 3rd month) and gingival crevicular fluid samples will be taken again with Periopaper (Oraflow, New York, NY). According to the results which is obtained with the ELISA test, the change in the RANKL and OPG levels in the gingival crevicular fluid of the patients will be evaluated.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
- Model description
- Group1: NaOCl, Er,Cr:YSSG will be activated by laser during the final irrigation; Group2 (control): Routine final irrigation procedure will be done, NaOCl will not be activated by any method) teeth will be divided into two main groups (n:15).
| Arm | Type | Receives |
|---|---|---|
| Er,Cr:YSSG laser | Active comparator | Device: Er,Cr:YSSG laser, Device: ControlNaOCl, Er,Cr:YSSG will be activated by laser during the final irrigation |
| Control | Active comparator | Device: Er,Cr:YSSG laser, Device: ControlRoutine final irrigation procedure will be done, NaOCl will not be activated by any method. |
Who may qualify
- Ages
- 18 to 50 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (2 listed)
- Healthy persons between the ages of 18 and 50 years
- Mandibular molar teeth that were diagnosed with periapical lesions
Key exclusion criteria (6 listed)
- Pregnancy or lactation
- Patients who do not have periapical lesions,
- Teeth with immature/open apex
- A probing depth of more than 3 mm
- Bleeding during probing will not be included in the study group
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Er,Cr:YSSG laserNaOCl, Er,Cr:YSSG will be activated by laser during the final irrigatio | Device | Control, Er,Cr:YSSG laser |
| ControlRoutine final irrigation procedure will be done, NaOCl will not be activated by any method) | Device | Control, Er,Cr:YSSG laser |
Primary outcome
RANKL/OPG levels
Time frame: 3 months
RANKL/OPG levels in the gingival crevicular fluid
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 Aug 2022.
- Background: PubMed 30892373Arslan H, Koseoglu S, Doganay Yildiz E, Arabaci T, Savran L, Yildiz DA, Veyisoglu G. Effect of intracanal diode laser application and low-level laser therapy on CGRP change. Braz Oral Res. 2019 Mar 18;32:e125. doi: 10.1590/1807-3107bor-2018.vol32.0125.
- Derived from this study: PubMed 41436629Evrendilek F, Ozlek E, Meydan I. Effect of Er, Cr: YSGG laser-activated final irrigation on gingival crevicular fluid RANKL/OPG levels. Sci Rep. 2025 Dec 23;16(1):3430. doi: 10.1038/s41598-025-33466-w.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Er,Cr:YSSG laser in people with Periapical Diseases, run by Yuzuncu Yil University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 6 exclusion criteria. 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: status not confirmed, as of the sponsor's last update on 2 Aug 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). 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?
Results are not available in the source record.
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?
RANKL/OPG levels (time frame: 3 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 NCT05478811, 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 2 Aug 2022.