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PeriodontitisNCT07077122

Evaluation of the Systemic Burden of Non-surgical Periodontal Therapy: A Randomized Clinical Trial on Five Different Treatment Protocols

A study testing Scaling and Root Planing, antibiotic prophylaxis and 810nm Diode Laser in people with Periodontitis, run by National and Kapodistrian University of Athens at 1 site in Greece.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Periodontitis is a chronic inflammatory disease of the periodontal tissues leading to the destruction of the tooth supporting structures. Despite the fact that periodontal bacteria are etiological agents, host susceptibility related to the inflammatory response to plaque bacteria is the main determinant of the… Read more about this study

Who is it for?
Any age
Conditions the study is for
Periodontitis
What is being tested?
Scaling and Root Planing, antibiotic prophylaxis and 810nm Diode Laser
Could I receive a placebo?
No, everyone receives an active treatment
How many people
75 participants
Where
1 siteGreece
Study dates
25 Aug 2025to 15 Dec 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

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 Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Periodontitis stage III or IV
  • Non-smokers or light smokers (<10 cigarettes/day)
  • No NSAIDs in regular basis or antibiotics 3 months before
  • No previous periodontal treatment 12 months before
  • No presence of other acute or chronic infections
  • No systemic disease or medication known to affect the serum level of inflammatory markers (cyclooxygenase inhibitors, platelet aggregation inhibitors, lipid lowering agents, â-adrenoreceptor antagonists, angiotensin converting enzyme inhibitors, antidiabetic agents, estrogen-based medications, medication for autoimmune disease, magnesium or vitamin E supplements)
  • No pregnancy or lactation
  • Written informed consent.

Who cannot join

None listed.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Greece1 site, 1 recruiting
  • Department of Periodontology, Dental School of Athens

    Athens

    Prof. Madianos P., DDS, PhD, 00302107461181, pmadian@dent.uoa.gr

    Recruiting

Other trials in Greece

About this study

Periodontitis is a chronic inflammatory disease of the periodontal tissues leading to the destruction of the tooth supporting structures. Despite the fact that periodontal bacteria are etiological agents, host susceptibility related to the inflammatory response to plaque bacteria is the main determinant of the development of periodontitis. Non-surgical periodontal therapy (NSPT) represents the base of any therapeutic approach. Its main component is the removal of bacterial deposits, i.e. soft biofilm or mineralized calculus, from the tooth surface via mechanical debridement.

It is well established that patients suffering from periodontitis present with a low-grade systemic inflammatory state when compared to healthy subjects. Increased concentrations of inflammatory biomarkers in systemic circulation, such as, C-reactive protein (CRP) and interleukin (IL)-6, have already been reported. A significant amount of evidence derived from epidemiological as well as experimental studies has implicated periodontitis as a putative risk factor for a number of systemic diseases, such as, cardiovascular diseases, diabetes and respiratory diseases having systemic low-grade inflammation as their underlying pathogenic mechanism. Furthermore, several intervention studies provide evidence that periodontal treatment may improve systemic inflammatory markers and potentially reduce the risk for cardio-metabolic diseases.

Read more

However, periodontal therapy may pose a transient, short-term health hazard immediately after instrumentation of the root surface presumably due to the spill of bacteria and their products in the systemic circulation and the subsequent acute inflammatory response. Positive bacteremia in NSPT ranges from 13% to 80.9% after mechanical debridement depending primarily on the periodontal status of the patient, but also on the study design and the microbiological methodology.

Finally, an important aspect concerning NSPT is method and duration of delivery. NSPT may be carried out with either hand instruments, power driven instruments, such as, ultrasonic and sonic or a "blended approach" using both. Besides these instruments, the adjunctive use of lasers or/and air powder technology has been proposed. Regarding duration, treatment may be staged over several visits with a quadrant approach, or with a full-mouth debridement approach, also referred to as an intensive treatment approach, which delivers complete debridement within 24 hours.

The aim of this clinical trial is to assess the immediate systemic burden of five different treatment protocols for the NSPT on:

  1. bacteremia
  2. serum inflammatory responses. Additionally, saliva CRP levels will be assessed and compared to serum. Moreover, the effectiveness of the treatment protocols on clinical periodontal parameters will be assessed.
Conditions
Periodontitis
Being tested
Scaling and Root Planing, antibiotic prophylaxis, 810nm Diode Laser, Air Polishing
Keywords
periodontitis, inflammatory markers, non-surgical periodontal therapy, bacteremia
Medical subject headings
Periodontitis, Bacteremia

What participants receive

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

  • Scaling and Root PlaningProcedure or surgery

    Mechanical debridement of tooth surfaces using hand and ultrasonic instruments

  • antibiotic prophylaxisDrug

    2g Amoxicillin given 1 hour prior to instrumentation

  • 810nm Diode LaserDevice

    Laser applied at base of gingival pockets prior to mechanical debridement.

  • Air PolishingProcedure or surgery

    air flow-based mechanical debridement with erythritol powder

Study groups in NCT07077122
Study groupRoleWhat they receive
Full-Mouth SRPExperimentaloral hygiene instructions and full mouth scaling and root planing in 24 hours. Clinical re-evaluation in 8 weeks.
Receives: Procedure: Scaling and Root Planing
SRP + AntibioticsExperimentaloral hygiene instructions and full mouth scaling and root planing in 24 hours along with antibiotic prophylaxis. Clinical re-evaluation in 8 weeks.
Receives: Procedure: Scaling and Root Planing; Drug: antibiotic prophylaxis
SRP + LaserExperimentaloral hygiene instructions and 810nm diode laser at the base of the gingival sulcus/pocket following by full mouth scaling and root planing in 24 hours. Clinical re-evaluation in 8 weeks.
Receives: Procedure: Scaling and Root Planing; Device: 810nm Diode Laser
SRP + Air PolishingExperimentaloral hygiene instructions and air polishing following by full mouth scaling and root planing in 24 hours. Clinical re-evaluation in 8 weeks.
Receives: Procedure: Scaling and Root Planing; Procedure: Air Polishing
Quadrant SRP (Control)Active comparatorOral hygiene instructions, scaling and root planing per quadrant with an interval of 7 days per session. Clinical re-evaluation in 8 weeks after last session.
Receives: Procedure: Scaling and Root Planing

What is being measured

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

  1. Change in serum high-sensitivity C-reactive protein (hs-CRP) levels

    For hs-CRP, blood would be collected:

    • Before each periodontal session
    • 24 hours after each periodontal session
    • 7 days after each periodontal session

    Measured: Baseline-7 days after the last periodontal session

Secondary outcomes (15)
  1. Changes in serum Interleukin 6 (IL-6)

    For IL-6, blood would be collected:

    • Before each periodontal session
    • 24 hours after each periodontal session
    • 7 days after each periodontal session

    Measured: Baseline-7 days after the last periodontal session

  2. Presence and load of bacteremia

    culture, PCR, 16S rRNA sequencing

    Measured: Baseline-15 minutes after the last periodontal session

  3. Changes in mean Clinical Attachment Level (CAL)

    CAL would be assessed before treatment initiation and would then be recorded at 8 weeks after the last periodontal session.

    All clinical measurements would be taken using a manual probe. CAL would be recorded at six sites per tooth. Third molars would be excluded from the measurements.

    Measured: Baseline-8 weeks after the last periodontal session

  4. Salivary CRP correlation with serum CRP

    saliva CRP levels will be assessed and compared to serum

    Measured: Baseline-7 days after the last periodontal session

  5. Changes in serum Tumor Necrosis Factor a (TNF-a) levels

    For changes in TNF-a levels, blood would be collected:

    • Before each periodontal session
    • 24 hours after each periodontal session
    • 7 days after each periodontal session

    Measured: Baseline-7 days after the last periodontal session

  6. Changes in Serum amyloid A (SAA) levels

    For changes in SAA levels, blood would be collected:

    • Before each periodontal session
    • 24 hours after each periodontal session
    • 7 days after each periodontal session

    Measured: Baseline-7 days after the last periodontal session

  7. Changes in Serum cystatin c levels

    For changes in serum cystatin c levels, blood would be collected:

    • Before each periodontal session
    • 24 hours after each periodontal session
    • 7 days after each periodontal session

    Measured: Baseline-7 days after the last periodontal session

  8. Changes in Matrix metalloproteinase-8 (MMP-8) levels

    For changes in MMP-8 levels, blood would be collected:

    • Before each periodontal session
    • 24 hours after each periodontal session
    • 7 days after each periodontal session

    Measured: Baseline-7 days after the last periodontal session

  9. Changes in serum D-dimers levels

    For changes in serum D-dimers levels, blood would be collected:

    • Before each periodontal session
    • 24 hours after each periodontal session
    • 7 days after each periodontal session

    Measured: Baseline-7 days after the last periodontal session

  10. Changes in serum Lipopolysaccharide (LPS) levels

    For changes in serum LPS levels, blood would be collected:

    • Before each periodontal session
    • 24 hours after each periodontal session
    • 7 days after each periodontal session

    Measured: Baseline-7 days after the last periodontal session

  11. Changes in mean Pocket Depth (PD)

    PD would be assessed before treatment initiation and would then be recorded at 8 weeks after the last periodontal session.

    All clinical measurements would be taken using a manual probe. PD would be recorded at six sites per tooth. Third molars would be excluded from the measurements.

    Measured: Baseline-8 weeks after the last periodontal session

  12. Changes in mean Gingival Recession (GR)

    GR would be assessed before treatment initiation and would then be recorded at 8 weeks after the last periodontal session.

    All clinical measurements would be taken using a manual probe. GR would be recorded at six sites per tooth. Third molars would be excluded from the measurements.

    Measured: Baseline-8 weeks after the last periodontal session

  13. Changes in Full-Mouth Plaque Score (FMPS)

    FMPS would be assessed before treatment initiation and would then be recorded at 8 weeks after the last periodontal session.

    All clinical measurements would be taken using a manual probe. FMPS would be recorded at six sites per tooth. Third molars would be excluded from the measurements.

    Measured: Baseline-8 weeks after the last periodontal session

  14. Changes in Full-Mouth Bleeding Score (FMBS)

    FMBS would be assessed before treatment initiation and would then be recorded at 8 weeks after the last periodontal session. All clinical measurements would be taken using a manual probe. FMBS would be recorded at six sites per tooth. Third molars would be excluded from the measurements.

    Measured: Baseline-8 weeks after the last periodontal session

  15. Changes in simplified gingival index (s-GI)

    s-GI would be assessed before treatment initiation and would then be recorded at 8 weeks after the last periodontal session. All clinical measurements would be taken using a manual probe. s-GI would be recorded at four sites per tooth. Third molars would be excluded from the measurements.

    Measured: Baseline-8 weeks after the last periodontal session

Timeline

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

  1. First posted22 Jul 2025
  2. Study start25 Aug 2025
  3. Primary completion15 Jul 2027 (estimated)
  4. Study completion15 Dec 2027 (estimated)

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
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
75 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07077122
Sponsor's protocol ID
688/11.02.2025
Other IDs
Ethics committee
Status last verified
Aug 2025
First submitted
30 Jun 2025
Last updated
4 Sep 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: IPD used in the results publication

Publications

  • Sanz M, Marco Del Castillo A, Jepsen S, Gonzalez-Juanatey JR, D'Aiuto F, Bouchard P, Chapple I, Dietrich T, Gotsman I, Graziani F, Herrera D, Loos B, Madianos P, Michel JB, Perel P, Pieske B, Shapira L, Shechter M, Tonetti M, Vlachopoulos C, Wimmer G. Periodontitis and cardiovascular diseases: Consensus report. J Clin Periodontol. 2020 Mar;47(3):268-288. doi: 10.1111/jcpe.13189. Epub 2020 Feb 3.

    PubMed 32011025
  • Sanz M, Herrera D, Kebschull M, Chapple I, Jepsen S, Beglundh T, Sculean A, Tonetti MS; EFP Workshop Participants and Methodological Consultants. Treatment of stage I-III periodontitis-The EFP S3 level clinical practice guideline. J Clin Periodontol. 2020 Jul;47 Suppl 22(Suppl 22):4-60. doi: 10.1111/jcpe.13290.

    PubMed 32383274
  • Kinane DF, Riggio MP, Walker KF, MacKenzie D, Shearer B. Bacteraemia following periodontal procedures. J Clin Periodontol. 2005 Jul;32(7):708-13. doi: 10.1111/j.1600-051X.2005.00741.x.

    PubMed 15966875

Questions about this trial

What is this clinical trial studying?

A study testing Scaling and Root Planing, antibiotic prophylaxis and 810nm Diode Laser in people with Periodontitis, run by National and Kapodistrian University of Athens at 1 site in Greece.

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 8 inclusion and 0 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: looking for participants now, as of the sponsor's last update on 4 Sep 2025. 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 Greece. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Zampa Evangelia (00306987027896, elina_zampa@windowslive.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in serum high-sensitivity C-reactive protein (hs-CRP) levels (time frame: Baseline-7 days after the last periodontal session). 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 NCT07077122, which also lists 3 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 4 Sep 2025.

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