Antimicrobial Photodynamic Therapy on Periodontal Treatment and Salivary Status of Type 1 Diabetes Mellitus Patients

Study Overview
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Brief Summary
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The aim of this study is to evaluate adjuvant effect of antimicrobial photodynamic therapy in periodontal treatment and salivary status of type 1 diabetes patients.

Detailed Description
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Diabetes Mellitus is a risk factor for periodontal disease increasing its prevalence, extension and severity. Periodontal disease is considered the sixth complication of diabetes. There is a global epidemic of diabetes, including an increase of type 1 diabetes incidence in younger patients. Adjuvant treatments to scaling and root planing as antimicrobial photodynamic therapy show improved clinical outcomes. Thus, the aim of this randomized clinical trial is to evaluate adjuvant effect of antimicrobial photodynamic therapy in periodontal treatment and salivary status of type 1 diabetes patients.

Official Title
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Adjuvant Effect of Antimicrobial Photodynamic Therapy on Periodontal Treatment and Salivary Status of Type 1 Diabetes Mellitus Patients

Conditions
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Diabetes Mellitus, Type 1, Periodontal Diseases, Periodontal Pocket

Intervention / Treatment
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* Procedure: Scaling root planing
* Procedure: Antimicrobial photodynamic therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnose of Type 1 diabetes mellitus Age between 18 to 65 years old Presence of at least one tooth for hemiarch Moderate and severe periodontal disease Exclusion Criteria: Type 2 diabetes mellitus Total edentulism Smokers Pregnancy Systemic diseases as other endocrine diseases and blood diseases Use of drugs that alter periodontal tissue as phenytoin and cyclosporine

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Scaling Root Planing<br>Treatment by scaling and root planing. Repetition after 7 and 14 days. | Procedure: Scaling root planing<br>* Treatment by scaling and root planing alone.<br>|
| Experimental: Antimicrobial Photodynamic Therapy<br>Scaling and root planing and Antimicrobial photodynamic therapy with red laser (658 nm, 0.1 Watts, 2229 J/cm², 10s per point) and methylene blue dye (10mg/ml). Repetition after 7 and 14 days. | Procedure: Scaling root planing<br>* Treatment by scaling and root planing alone.<br>Procedure: Antimicrobial photodynamic therapy<br>* Treatment with methylene blue dye and red laser<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Periodontal disease (gingivitis and periodontitis) measured by a periodontal probe and classified according to severity | Severe periodontitis was defined by the presence of ≥ 2 interproximal sites in different teeth with clinical attachment level (CAL) ≥ 6mm and ≥1 interproximal site with periodontal probing depth (PPD) ≥5mm. Moderate periodontitis was defined by the presence of ≥ 2 interproximal sites in different teeth with CAL ≥ 4mm or ≥ 2 interproximal sites in different teeth with PPD ≥5mm. Mild periodontitis was defined as ≥ 2 interproximal sites in different teeth with ≥ 3 mm CAL and ≥ 2 interproximal sites in different teeth with ≥ 4 mm PPD or at least 1 site with PPD ≥ 5 mm (20,21). Gingivitis was determined as follows: Subjects were considered healthy if presented PPD ≤3mm/Bleeding on probing (BOP) extent scores < 10% and with gingivitis if presented PPD ≤3mm/ BOP extent scores >10%. | 6 months | 
| Salivary glucose - collection of stimulated saliva in 10 minutes and measured with a colorimetric kit | Salivary glucose is measured by a colorimetric kit and the values are converted and presented as mg/dL. There are no reference value for this measurement. The analysis is done by means of correlation to blood glucose levels in mg/dL. | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Salivary pH and buffering Capacity - collection of stimulated saliva in 10 minutes and measurement of acidity with a pHmeter | Normal Salivary pH = 6 to 7. Buffering capacity: ≥ 5.6 were considered as ''high'', ranging from 4.1 to 5.5 were labelled as ''medium'' and those ≤4 were defined as ''low''. | 6 months | 
| Capillary glycemia measured by a glucometer | Normal glycemia: <100mg/dL | 6 months |