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The aim of this study is to evaluate how smoking affects the healing process of the gums after treatment. The researchers will measure the levels of two specific proteins (PLAP-1 and Sclerostin) in the gum fluid of patients with stage II periodontitis. These measurements will be compared between smokers and non-smokers before and after receiving non-surgical periodontal therapy (cleaning and scaling) to see if smoking changes the body's response to treatment.
Patients diagnosed with Stage II Periodontitis will be recruited and divided into two groups: Group I (current smokers) and Group II (non-smokers). At the beginning of the study (baseline), clinical periodontal parameters will be recorded, including probing depth, clinical attachment level, and plaque index. Gingival Crevicular Fluid (GCF) samples will be collected from the most affected sites using paper strips.
Following the initial assessment, all participants will undergo non-surgical periodontal therapy consisting of full-mouth scaling and root planing (SRP) using ultrasonic and hand instruments. Oral hygiene instructions will be provided to all patients.
Patients will be re-evaluated after 6 months following the treatment. Clinical parameters will be re-recorded, and GCF samples will be collected again. The samples will then be analyzed using Enzyme-Linked Immunosorbent Assay (ELISA) to determine the concentration levels of Periodontal Ligament Associated Protein-1 (PLAP-1) and Sclerostin. The study aims to correlate these protein levels with the clinical healing outcomes in both smokers and non-smokers.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| smoker with periodontitis | Active Comparator | patients with stage II periodontitis who are current smoker and will receive non-surgical periodontal therapy |
|
| Non-smokers with periodontitis | Active Comparator | patients with stage II periodontitis who have never smoked and will receive Non-surgical therapy |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Non Surgical Periodontal Treatment includes post operative mouth wash with Listerine® (ethanol 21.6%, methyl salicylate 0.06%, menthol 0.042%, thymol 0.064% and eucalyptol 0.092%) | Procedure | scaling , curettage and root planning |
| Measure | Description | Time Frame |
|---|---|---|
| change in periodontal ligament associated protien-1 levels | Concentration of PLAP-1 measured in Gingival Crevicular Fluid (GCF) using ELISA technique. This protein reflects the status of the periodontal ligament. | Baseline (before treatment) and 6 months after treatment |
| Change in Sclerostin levels | Concentration of Sclerostin measured in Gingival Crevicular Fluid (GCF) to evaluate bone remodeling activity. | Baseline and 6 months after treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Probing Pocket Depth | Measurement of the depth of the gum pockets using a periodontal probe to assess clinical healing. | Baseline , 3 and 6 months after treatment |
| Change in Clinical Attachment Level |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Manar Morsi Morsi, MSc | Faculty of Dental Medicine for Girls, Al-Azhar University | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of Dental Medicine for Girls, Al-Azhar University | Cairo | Nasr City | 4450113 | Egypt |
The individual participant data will not be available to preserve patient confidentiality and because the informed consent signed by participants did not include a provision for public data sharing
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Measurement of the distance from the cemento-enamel junction to the bottom of the pocket to assess tissue attachment gain.
| Baseline , 3 and 6 months after treatment |
| Change in Plaque Index (PI). | Evaluation of the amount of plaque on tooth surfaces using the Silness and Löe Plaque Index. Scores range from 0 (no plaque) to 3 (abundance of soft matter). Lower scores indicate better oral hygiene. | Baseline , 3 and 6 months after treatment. |
| Change in Gingival Index (GI). | Assessment of the severity of gingival inflammation using the Löe and Silness Gingival Index. Scores range from 0 (normal gingiva) to 3 (severe inflammation, tendency to spontaneous bleeding). | Baseline, 3 and 6 months after treatment. |
| Change in Bleeding on Probing (BOP) percentage. | Presence or absence of bleeding recorded within 30 seconds after probing. It is calculated as the percentage of sites that bleed upon probing relative to the total number of sites probed. | Baseline, 3 and 6 months after treatment. |
| ID | Term |
|---|---|
| D000073865 | Cigarette Smoking |
| D010518 | Periodontitis |
| ID | Term |
|---|---|
| D000073869 | Tobacco Smoking |
| D012907 | Smoking |
| D001519 | Behavior |
| D064424 | Tobacco Use |
| D010510 | Periodontal Diseases |
| D009059 | Mouth Diseases |
| D009057 | Stomatognathic Diseases |
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| ID | Term |
|---|---|
| C057473 | Listerine |
| D000431 | Ethanol |
| C033069 | methyl salicylate |
| D008610 | Menthol |
| D013943 | Thymol |
| ID | Term |
|---|---|
| D000438 | Alcohols |
| D009930 | Organic Chemicals |
| D003511 | Cyclohexanols |
| D000441 | Hexanols |
| D005233 | Fatty Alcohols |
| D000081005 | Cyclohexane Monoterpenes |
| D003510 | Cyclohexanes |
| D003516 | Cycloparaffins |
| D006840 | Hydrocarbons, Alicyclic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D039821 | Monoterpenes |
| D013729 | Terpenes |
| D008055 | Lipids |
| D010636 | Phenols |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
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