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The goal of this clinical trial is to assess the effectiveness of local delivery of melatonin and metformin loaded nanoparticle gel as adjunct to scaling and root planning (SRP) in the treatment of periodontal intra bony defect.
fifty two healthy patients(n=52) with at least one periodontal intra-bony defect will be included in the study, all selected patients will be motivated about the benefit of plaque control and periodontal treatment . The participant will be selected from outpatient clinic of the Department of Oral Medicine and Periodontology , Faculty of dentistry, Mansoura University . The participant will be classified into four groups :group I and II are test groups but group III and IV are control groups .Patients in group I will be treated with melatonin loaded nanoparticle gel while in group II will be treated with melatonin and metformin loaded nanoparticles which will be applied weekly for four weeks after SRP had been completed and group III will be treated with placebo gel while group IV will be treated with only scaling and root planning.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| melatonin loaded nanoparticle (test group) | Active Comparator | 13 patients will be treated with melatonin loaded nanoparticle gel as adjunct to scaling and root planning .it will be applied once weekly for four weeks. |
|
| melatonin and metformin loaded nanoparticle (test group) | Active Comparator | 13 patients will be treated with melatonin and metformin loaded nanoparticle gel as adjunct to scaling and root planning .It will be applied once weekly for four weeks. |
|
| placebo gel (control group) | Placebo Comparator | 13 patients will be treated with placebo gel as adjunct to scaling and root planning .It will be applied once weekly for four weeks. |
|
| no gel (control group) | Other | 13 patients will be treated with only scaling and root planning .. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Melatonin gel | Drug | local application of Melatonin gel into the periodontal pocket using a syringe with a blunt cannula until the pocket will be completely filled. It will be applied once weekly for four weeks. After insertion of the local drug delivery system, the region will be secured with a periodontal pack |
| Measure | Description | Time Frame |
|---|---|---|
| Radiographic assessment | all the radiographic parameters will be measured on cone beam computed radiography (CBCT) .The depth of intra bony defect will be measured from cemento enamel junction(CEJ) to base of the defect (BD).The Height of the defect from CEJ to the crest of bone adjacent to the defect and the width of the defect will be from highest point of alveolar crest to dental root adjacent to defect . | all the parameter will be evaluated after 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| plaque index according to Silness P.Loe H 1964 | Each of the four surfaces of the teeth (buccal, lingual, mesial and distal) is given a score from 0-3. The scores from the four areas of the tooth are added and divided by four in order to give the plaque index for the tooth with the following scores and criteria: The Plaque Index System 0 No plaque
|
| Measure | Description | Time Frame |
|---|---|---|
| Gingival bleeding index(GBI - Ainamo & Bay, 1975) | is performed through gentle probing of the orifice of the gingival crevice. If bleeding occurs within 10 seconds a positive finding is recorded and the number of positive sites is recorded and then expressed as a percentage of the number of sites examined. | 6 months |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Amira R AL-Agooz | Mansoura University, Faculty of Dentistry | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Amira R agab AL-agooz | Al Mansurah | Dakhlia | 35516 | Egypt |
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| ID | Term |
|---|---|
| D008687 | Metformin |
| D014080 | Tooth Exfoliation |
| ID | Term |
|---|---|
| D001645 | Biguanides |
| D006146 | Guanidines |
| D000578 | Amidines |
| D009930 | Organic Chemicals |
| D009063 |
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triple blinded study
|
| Metformin and melatonin gel | Drug | local application of Metformin and melatonin gel into the periodontal pocket using a syringe with a blunt cannula until the pocket will be completely filled. It will be applied once weekly for four weeks. After insertion of the local drug delivery system, the region will be secured with a periodontal pack |
|
| placebo gel | Drug | Local application of empty nanoparticles gel into the periodontal pocket using a syringe with a blunt cannula until the pocket will be completely filled. It will be applied once weekly for four weeks. After insertion of the local drug delivery system, the region will be secured with a periodontal pack. |
|
| scaling and root planning | Procedure | full mouth supra- and subgingival scaling and root planning will be performed, and all periodontitis patients will be treated with ultrasonic tips and Gracey curettes for meticulous removal of subgingival and supragingival plaque and calculus. |
|
| 6 months |
| Probing Pocket depth (PPD) |
Is measured from free gingival margin to base of the pocket |
| 6 months |
| Clinical Attachment level (CAL) | Is measured from cementoenamel junction to base of the pocket | 6 months |
| Dental Physiological Phenomena |
| D055688 | Digestive System and Oral Physiological Phenomena |