Gut Microbial Changes After Periodontal Treatment

Study Overview
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Brief Summary
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Periodontitis is a chronic inflammatory disease of the tooth supporting structures induced by a dysbiosis in the oral and subgingival microenvironment of susceptible patients. The long-term swallowing of high doses of periodontal pathogenic microorganisms could induce a dysbiosis of the intestinal microbiota, favouring the establishment of an 'inflamed' microbiome in terms of composition and/or function. The present project is aimed at a better understanding of the etiopathogenetic correlation between periodontitis and intestinal dysbiosis, and aims to explore the hypothesis that non-surgical periodontal treatment may reduce bacterial alpha diversity in stool samples. Fifty patients affected by stage III-IV periodontitis will be recruited, and treated by means of full-mouth scaling and root planing. Salivary and stool samples, together with a complete periodontal charting and a food diary will be collected and compared at baseline and 3 months after treatment. Age, gender and BMI-matched healthy individuals will be recruited as controls.

Official Title
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Evaluation of Salivary and Intestinal Microbiological Response in Patients With Stage III-IV Periodontitis After Non-surgical Periodontal Therapy

Conditions
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Periodontitis, Dysbiosis, Intestinal Disease

Intervention / Treatment
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* Procedure: Non-surgical periodontal treatment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: periodontitis Stage III or IV BMI between 20 and 29 kg/m2 free diet presence of at least 20 teeth Exclusion Criteria: systemic diseases (including diabetes, thyroid, liver, or kidney diseases) dietary allergies use of antibiotics or probiotics during the previous 30 days pregnancy or breast feeding

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Non-surgical periodontal treatment NSPT<br>Subgingival instrumentation with ultrasonic devices and curettes of all periodontal pockets in 2 or 4 appointments | Procedure: Non-surgical periodontal treatment<br>* Subgingival instrumentation with ultrasonic devices and curettes of all periodontal pockets<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in microbiome alpha diversity measured from stool samples at 3 months | Taxonomic and functional variation of gut bacteria after treatment | [Time Frame: Baseline and 90 days] | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in microbiome alpha diversity measured from saliva samples at 3 months | Taxonomic and functional variation of salivary bacteria after treatment | [Time Frame: Baseline and 90 days] | 
| Changes in mean clinical attachment level (CAL) at 3 months | Variation in CAL after therapy assessed using a millimetre marked manual periodontal probe at 6 sites per tooth element | [Time Frame: Baseline and 90 days] | 
| Changes in periodontal pocket depth (PPD) at 3 months | Variation in PPD after therapy assessed using a millimetre marked manual periodontal probe at 6 sites per tooth element | [Time Frame: Baseline and 90 days] | 
| Changes in full mouth bleeding score (FMBS) at 3 months | Variation in the percentage of bleeding sites after therapy assessed by gentle probing at 6 sites per tooth element | [Time Frame: Baseline and 90 days] |