The Effects of Obesity on Glutathione Levels in Patients With Chronic Periodontitis Before and After Periodontal Therapy
Condition: Obesity
MeSH terms: Obesity
Study type: Interventional
Phase: Phase 1

Summary: 
      Obesity may affect periodontal health by inducing gingival oxidative damage through increased
      production in circulating reactive oxygen species (ROS). Previous studies have reported
      decreased glutathione levels in patients with periodontitis when compared to healthy subjects
      in gingival crevicular fluid (GCF), plasma and saliva. In the present study we hypothesized
      that high ROS levels in circulation may decrease glutathione levels in the GCF,plasma and
      saliva in obese patients with chronic periodontitis, whereas periodontal therapy could have
      positive effects on glutathione levels.
    

Detailed description: 
      The purpose of this study was to investigate the effects of obesity on glutathione levels in
      the plasma, GCF and saliva of patients with chronic periodontitis and to evaluate changes
      after nonsurgical periodontal therapy.

      Diagnosed as obese (n=30) and normal-weight (n=30) individuals were categorized; chronic
      periodontitis (CP) and periodontally healthy controls (PH). Gingival crevicular fluid (GCF),
      plasma, saliva samples and clinical measurements were obtained at baseline and a month after
      nonsurgical periodontal therapy.

      Unstimulated salivary samples were collected using standard techniques. About 2 mL whole
      saliva was collected in disposable tubes and centrifuged immediately to remove cell debris
      (10,000 g x 10 minutes). The supernatants (50µL each) were stored at -40C until analyzed. GCF
      samples were collected from a mesio-buccal and disto-palatal site on each tooth. In the CP
      group, the samples were obtained from patients at areas with ≥5 mm CAL, ≥6 mm PD and ≥30%
      bone loss. In gingivitis group, GCF samples were obtained from teeth with BOP and without
      CAL. In the healthy group, GCF samples were collected from teeth exhibiting PD<3 mm without
      CAL and BOP. The area was isolated with cotton rolls, saliva contamination elimination was
      ensured, and it was slightly air dried. GCF was sampled with paper strips. Paper strips were
      placed into the crevice until mild resistance was felt (intracrevicular method) and left in
      the position for 30 seconds. Strips contaminated with blood or saliva were discarded. Each
      sampled strip was placed into a 400µl eppendorf centrifuge tube and stored at -40C until
      analyzed.

      Five milliliters of venous blood was taken from antecubital vein by using a standard
      venipuncture method. Obtained blood sample was collected in vacutainer tubes and
      anti-coagulated with EDTA. The blood samples were then stored at -40C until required for use
      in ELISAs.

      Power analysis indicated that 12 individuals for each group would be sufficient to achieve
      80% power to detect a difference of 0.05 between the alternative and the null hypotheses.

      The Shapiro Wilk test was used to investigate whether or not the data were normally
      distributed. Continuous variables with unequal variances were compared by means of Welch and
      Tamhane's T2 post-hoc test for BMI, PD, CAL and the levels of glutathione. The comparison of
      the age, GI, PI and BOP was analyzed using the Kruskal-Wallis non-parametric test followed by
      post hoc group comparisons with the Bonferroni-adjusted Mann-Whitney U test. Paired Student's
      t-test or Wilcoxon rank-sum test was used to compare the measurements at two points (baseline
      and after SRP). The Spearman's rank correlation test was also used to detect the relationship
      between biochemical and clinical findings.
    

Intervention name(s): nonsurgical periodontal therapy; oral hygiene instructions; nonsurgical periodontal therapy; oral hygiene instructions
Intervention type(s): Procedure; Procedure; Procedure; Procedure
Intervention description(s): Scaling and root planning under local anaesthesia, in a total of four clinical visits Oral hygiene instructions including the modified Bass technique, regular toothpaste, and an appropriate interdental cleaning device with dental floss and interdental brush.; Oral hygiene instructions including the modified Bass technique, regular toothpaste, and an appropriate interdental cleaning device with dental floss and interdental brush; Scaling and root planning under local anaesthesia, in a total of four clinical visits Oral hygiene instructions including the modified Bass technique, regular toothpaste, and an appropriate interdental cleaning device with dental floss and interdental brush.; Oral hygiene instructions including the modified Bass technique, regular toothpaste, and an appropriate interdental cleaning device with dental floss and interdental brush
Other intervention name(s): obese-chronic periodontitis patients; obese-periodontally healthy controls; normal weight-CP patients; normal weight-PH patients
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Diagnostic