Evaluation of Oral Condition and the Effect of Dental Treatment on Physical Parameters of Athletes
Phase: NA
Conditions: Periodontal Diseases, Inflammation Gum, Caries,Dental
Sponsor: Universidade Metropolitana de Santos

Protocol: Evaluation of oral condition and the effect of dental treatment on 
physical parameters of athletes 
 
Researcher: Caio Vinicius G. Roman Torres 
 
Approval of the Research Ethics Committee in Brazil: 93416718.1.0000.0081 
 
Approval date: 09/August/2018 
 
Main goal 
 
Evaluate the oral condition and propose dental treatment according to the needs of athletes 
linked to the Faculty of Physical Education of the Santo Amaro University. 
 
Secondary objectives. 
-Comparing the athlete's performance through physical tests of strength, speed, endurance, 
before and after dental treatment; 
-Relate the oral conditions found with the specific habits of each sport; 
- Assess the effect of biofilm control on the oral and performance conditions of the evaluated 
athletes. 
 
Protocol: 
This research project will comply with Resolution No. 196, of October 16, 1996, of the National 
Health Council, and the Dental Professional Code of Ethics (Resolution CFO No. 042/2003). 
All recruited individuals will be offered verbal and written explanations of the objectives, 
methodology, benefits and possible risks related to participation in the project. Thus, individuals 
who accept to participate in the study, will sign the Free and Informed Consent Term, previously 
evaluated and approved by the Research Ethics Committee involving human beings of UNISA. 
 
 
 
3.1-Experimental design 
 

Students and / or athletes linked to the Faculty of Physical Education of the University Santo 
Amaro must be evaluated. According to an initial survey, about 120 individuals should be 
examined. Clinical parameters such as decayed, lost and / or filled dental index (CPO) and 
periodontal parameters such as probing depth (PS), clinical level of insertion (NCI), plaque index 
(IP) and bleeding index (IS) will be evaluated . Physical tests of strength, speed and resistance 
should be performed and periodontal therapy should be performed according to the needs 
presented by each individual. After 90 days, new clinical examinations and physical tests should 
be performed.  
3.2-Selection of patients 
 
Individuals practicing physical activities linked to UNISA will be included. Initially, we will have a 
convenience sample that will later be stratified into groups for evaluation and analysis. 
Individuals with systemic pathologies, smokers, should be included in the study 
Patients with any of these characteristics should be excluded from the study: pregnancy or 
lactation, use of antibiotics in the last 3 months, phenytoin, calcium antagonists, cyclosporine 
or anti-inflammatory drugs one month before the initial consultation, use of oral or replacement 
contraceptives hormonal, periodontal treatment in the 6 months prior to the start of the study. 
After being properly informed about the nature of the study, individuals must sign a free and 
informed consent form. 
Patients will be submitted to periodontal treatment in undergraduate and graduate clinics at 
the UNISA Department of Dentistry, according to the needs presented. 
 
3.3-Clinical evaluation 
 
Patients will be evaluated by a previously trained and calibrated periodontist. Of the sample, 
10% will be examined twice for each of the clinical criteria evaluated, in order to obtain the inter-
examiner diagnostic reliability measured by Kappa statistics (between 0.8 and 1.0) and intra-
examiner using the standard error of the measurement. (EPM). In the periodontal clinical 
examination, measurements will be obtained for probing depth and clinical level of insertion 
performed at six points per tooth: mesio buccal, labial mesio, buccal mesio, mesio lingual / 
palatine, lingual / palatine medium, this lingual / palatine, using periodontal probe manual 
(PCPUNC 15, Hu-Friedy, Chicago, USA). For Plaque Index and Gingival Index (Ainamo & Bay, 
1975), dichotomous evaluation will be performed on the faces: vestibular, mesial, distal and 
lingual / palatal. 
Patients will be observed in two stages, as shown in figure 1, prior to the start of treatment (T0) 
where clinical examinations will be performed, radiographs will receive dental scaling and root 
planing treatment (T1) and 90 days after therapy (T2) will be evaluated again ( Nakamura-
Minami, et al., 2003; Figueredo et al., 2004; Gomi, et al., 2007). 
 
3.4- Physical Evaluation 

 
The following demographic variables will be assessed: age, sex, race and education. We will 
adopt the following inclusion criteria: Be a practitioner of one of the modalities investigated for 
more than 5 years and perform more physical activity than the minimum recommendations per 
week, for this analysis we will use the international physical activity questionnaire. 
The evaluations performed will be: Aerobic running performance evaluation test, critical speed 
in swimming, body composition evaluation, muscle strength through the 1RM test in the bench 
press and short-term heart rate variability at rest. The evaluations proposed by the present 
study will be carried out in three days, with an interval of 24 hours. 
Risk stratification for cardiovascular events during exercise will be performed according to the 
ACS recommendations. An anamnesis will be performed based on the following cardiovascular 
risk factors: age, family history of cardiovascular disease, smoking, high blood pressure, 
dyslipidemia or hypercholesterolemia, diabetes or hyperglycemia. 
 
 
3.5- Periodontal Therapy 
 
Periodontal treatment will start after physical tests of strength, speed and endurance. The 
individuals evaluated in this study will receive instructions on oral hygiene, including brushing 
technique and use of dental floss / tape, and treatment of dental scaling and root planing 
(RDAR). 
After anamnesis, the individuals included will receive instructions for individualized oral hygiene. 
The treatment of RDAR will be performed in a single session (full-mouth disinfection) according 
to the established protocol (Quirynen et al 1999, 2006), with two sessions carried out in 24 
hours.  
The individuals will be treated by a single periodontist and the scraping and planing procedures 
will be performed on all teeth as follows: local anesthetic infiltrative type of the areas to be 
treated, RDAR using Gracey 5/6 carbon steel curettes, 11/12, 13/14 and MacCall 13/14, 17/18 
curettes, according to their therapeutic indications. Polishing the quadrants treated with 
abrasive paste; oral hygiene instructions including brushing of the Bass type, dental floss and 
sometimes toothbrush inter dental or unitufo (Apatzidou; Riggio, Kinane, 2004, Jervoe-Stormet 
al., 2006). 
After the dental scaling and root planing procedures, 90 days should be waited for reassessment 
and conducting the new clinical and physical exams. The individuals will then be referred to the 
clinics in operation at the Faculty of Dentistry of UNISA according to their needs. 
 
 
3.6 - Statistical analysis 
 

Analysis of variance (ANOVA) will be used to compare the averages of dental clinical values and 
physical tests. Parametric and non-parametric values should be analyzed. The analyzes and 
graphs of the present study will be performed with the aid of the statistical program graphPad 
Prism version 4.0. The data present in the graphs will be expressed as mean ± SEM (standard 
error of the mean).  
With the objective of studying the association between the probing depth, presence of plaque, 
presence of bleeding and existence of maintenance variables, as the physical exercises 
performed before and after dental treatment generalized estimating equation models should 
be used used. The score test will be used to test the target hypotheses, because the observations 
are dependent. The Gaussian with an identity link function will be applied. The half-normal 
probability plot with a simulated envelope15 made it possible to observe that the model was 
well adjusted. R software, version 3.2.5, will be used to analyze the data and a significance level 
of 5% was considered for all the tests.